What is an umbilical cord granuloma. How is it treated. What are the home care instructions for umbilical cord granulomas. When should you seek medical advice for umbilical cord complications. How do you properly measure a child’s temperature.

Understanding Umbilical Cord Granulomas

An umbilical cord granuloma is a common complication that can occur in newborns after the umbilical cord stump falls off. This small mass of pinkish-red tissue forms at the base of the belly button and may be moist, draining fluid, or slightly inflamed. Understanding this condition is crucial for new parents to ensure proper care and treatment.

What causes umbilical cord granulomas?

Umbilical cord granulomas typically form when the umbilical cord stump doesn’t heal properly after falling off. This can be due to excess moisture, improper cleaning, or individual healing factors. While not usually serious, granulomas require attention to prevent potential complications.

Treatment Options for Umbilical Cord Granulomas

Healthcare providers have several methods to treat umbilical cord granulomas effectively. The choice of treatment depends on the size and persistence of the granuloma.

Silver nitrate application

The most common treatment for umbilical cord granulomas is the application of silver nitrate. This chemical solution helps dry out the granuloma, promoting healing without causing pain to the newborn. The procedure is typically quick and can be done in a doctor’s office.

Alternative treatments

In rare cases where silver nitrate is ineffective, other procedures may be considered:

• Liquid nitrogen application to freeze the tissue
• Tying off the granuloma with surgical thread
• Surgical removal in persistent cases

Your healthcare provider will discuss these options if they become necessary.

Home Care Instructions for Umbilical Cord Granulomas

Proper home care is essential for managing umbilical cord granulomas and preventing complications. Follow these guidelines to ensure optimal healing:

Hygiene practices

1. Wash your hands thoroughly before and after cleaning the area.
2. Clean the granuloma and surrounding area with a moist cloth or cotton swab.
3. Remove all drainage and clean an inch around the base.
4. Pat the area dry with a clean cloth and allow it to air-dry.

Diaper management

To prevent contamination from urine and stool, roll your child’s diapers down below the belly button until the granuloma heals. If necessary, cut a notch in the front of the diaper to accommodate the navel area.

Bathing precautions

Avoid submerging your baby in bathwater until the granuloma has healed. Instead, opt for sponge baths or use a damp washcloth for cleaning.

Monitoring for Signs of Infection

Vigilant observation is crucial to detect any signs of infection or complications related to umbilical cord granulomas. Be alert for the following symptoms:

• Increased redness or swelling around the granuloma
• Cloudy or foul-smelling discharge
• Bleeding from the granuloma
• Pain or discomfort when touching the area
• Fever in the newborn
• Rash, pimples, or blisters around the navel

If you notice any of these signs, contact your healthcare provider promptly.

When to Seek Medical Advice

While most umbilical cord granulomas resolve with proper care, certain situations require immediate medical attention. Contact your child’s healthcare provider if:

• Your child develops a fever
• The granuloma doesn’t heal within the timeframe provided by your healthcare provider
• There are signs of infection around the granuloma
• Bleeding occurs from the granuloma
• Your child appears to be in pain when the area is touched
• A rash or skin abnormalities develop around the navel
• Your child seems unwell or displays any concerning symptoms

Proper Temperature Measurement in Children

Accurately measuring your child’s temperature is crucial for monitoring their health, especially when dealing with potential complications like umbilical cord granulomas. Understanding the different methods and their appropriate use is essential for parents and caregivers.

Types of digital thermometers

Digital thermometers are the preferred choice for measuring a child’s temperature. They come in several varieties, each suited for different age groups and situations:

• Rectal thermometers: Most accurate for children under 3 years old
• Forehead (temporal) thermometers: Suitable for children 3 months and older
• Ear (tympanic) thermometers: Accurate for children 6 months and older
• Armpit (axillary) thermometers: Least reliable but can be used as an initial check for any age
• Oral thermometers: Suitable for children 4 years and older

Guidelines for temperature measurement

When measuring your child’s temperature, consider the following guidelines:

1. For infants under 3 months, a rectal temperature provides the most accurate reading.
2. Forehead thermometers can be used for initial checks in infants under 3 months with signs of illness, but confirm with a rectal temperature if concerned.
3. Ear temperatures are reliable for children over 6 months old.
4. Armpit temperatures can be used as a quick check for any age but may require confirmation with a more accurate method.
5. Oral temperatures should only be taken in children 4 years and older who can cooperate.

Always use caution when using rectal thermometers and follow the manufacturer’s instructions for all devices.

Preventing Complications in Umbilical Cord Healing

While umbilical cord granulomas are generally not serious, taking steps to prevent complications during the healing process is important. By following proper care techniques and being vigilant, you can promote healthy healing and reduce the risk of issues.

Keeping the area dry

Moisture can contribute to the formation of granulomas and slow the healing process. To keep the umbilical area dry:

• Gently pat the area dry after cleaning
• Allow air circulation by exposing the area when possible
• Avoid tight clothing that may trap moisture

Proper cleaning techniques

Consistent and gentle cleaning is key to preventing infection and promoting healing:

1. Use warm water and mild soap to clean the area
2. Avoid harsh chemicals or alcohol-based products
3. Clean in a circular motion, moving outward from the center
4. Rinse thoroughly and pat dry

Remember, gentle care is crucial to avoid irritating the sensitive skin around the umbilical area.

Long-term Care and Follow-up

After the initial treatment of an umbilical cord granuloma, ongoing care and follow-up are important to ensure complete healing and prevent recurrence. Understanding what to expect in the weeks following treatment can help parents navigate this process more confidently.

Healing timeline

The healing process for umbilical cord granulomas can vary, but typically:

• Most granulomas begin to shrink within a week of treatment
• Complete healing usually occurs within 2-3 weeks
• In some cases, a second treatment may be necessary if the granuloma persists

Follow-up appointments

Your healthcare provider may schedule follow-up appointments to monitor the healing progress. These visits allow for:

1. Assessment of the granuloma’s response to treatment
2. Early detection of any complications
3. Adjustment of care instructions if needed
4. Addressing any concerns or questions you may have

Attend all scheduled follow-up appointments and don’t hesitate to contact your provider if you have concerns between visits.

Understanding Normal Umbilical Cord Healing

To better recognize when complications like granulomas occur, it’s helpful to understand the normal umbilical cord healing process. This knowledge can help parents distinguish between typical healing and potential issues that require medical attention.

Stages of umbilical cord healing

The umbilical cord stump typically goes through several stages as it heals:

1. Initial clamping and cutting at birth
2. Gradual drying and shriveling of the stump
3. Changing color from yellowish-green to brown or black
4. Falling off, usually within 1-3 weeks after birth
5. Complete healing of the navel area

Signs of normal healing

During the healing process, it’s normal to observe:

• A small amount of clear or slightly bloody discharge
• Slight redness around the base of the cord stump
• A scab-like appearance as the stump dries
• A small divot or depression where the cord was attached

Understanding these normal signs can help parents differentiate between typical healing and potential complications like granulomas.

Emotional Support for Parents

Dealing with umbilical cord complications can be stressful for new parents. It’s important to acknowledge the emotional aspect of caring for a newborn, especially when faced with unexpected health concerns.

Managing anxiety

It’s natural to feel anxious about your baby’s health. To manage these feelings:

• Educate yourself about umbilical cord care and healing
• Communicate openly with your healthcare provider
• Connect with other parents who have experienced similar situations
• Practice self-care and stress-reduction techniques

Seeking support

Don’t hesitate to seek support when needed:

1. Reach out to family and friends for practical help
2. Consider joining a new parent support group
3. Consult with a postpartum support specialist if you’re feeling overwhelmed
4. Discuss any persistent concerns with your healthcare provider

Remember, caring for a newborn is a learning process, and it’s okay to ask for help and support along the way.

Umbilical Cord Granuloma (Newborn)

The umbilical cord connects the unborn baby to the mother in the uterus. After birth, the cord is no longer needed. It is clamped and then cut. This leaves a small stump.

In most cases, the umbilical cord stump dries up and falls off the newborn in the first few weeks of life. But sometimes after the stump falls off a granuloma forms. This is a small mass or stalk of pinkish-red tissue. The granuloma may be moist and drain fluid. The area around it may be slightly inflamed or infected.

Granulomas may be treated with silver nitrate. This chemical dries the granuloma. It is not painful to the newborn. In rare cases, the granuloma may need to be removed with a procedure. For instance, liquid nitrogen may be put on the granuloma to freeze the tissue. Or the granuloma may be tied off with thread used for stitches (sutures). Your provider will give you more information if these procedures are needed.

Home care

Medicines

A granuloma itself does not need any prescribed medicines.  The healthcare provider may prescribe medicine if the granuloma looks infected. If so, follow the provider’s instructions for giving this medicine to your child.

General care

• Wash your hands well before and after you clean the area around the granuloma. This will help prevent infection.

• Care for the area around the granuloma as directed. Use a clean, moist cloth or cotton swab. Be sure to remove all drainage and clean an inch around the base. Pat the area with a clean cloth and let it air-dry. 

• Roll your child’s diapers down below the belly button (navel) until the granuloma has healed. This helps prevent contamination from urine and stool. If needed, cut a notch in the front of the diapers to make a space for the belly button.

• Don’t put your baby in bathwater until the granuloma has healed. Instead, bathe your baby with a sponge or damp washcloth.

• Watch for signs of infection. See “When to call your child’s healthcare provider” below.

Follow-up care

Follow up with your child’s healthcare provider as advised. Let the provider know if you have other questions or concerns.

When to get medical advice

Call your child’s healthcare provider right away if any of these occur:

• Your child has a fever (see “Fever and children” below).

• Your child’s granuloma does not heal in the timeframe given by the provider.

• Your child has signs of infection around the granuloma, such as increased redness, swelling, or cloudy or bad-smelling drainage.  

• There is bleeding from the granuloma.

• Your child cries or seems to be in pain when you touch the area around the cord and belly button.

• Your child develops a rash, pimples, or blisters around the navel.

• Your child seems ill or has any other symptoms that concern you.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• 
  Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• 
  Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• 
  Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• 
  Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• 
  Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37. 2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

• Rectal, forehead, or ear: 102°F (38.9°C) or higher

• Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

• Repeated temperature of 104°F (40°C) or higher in a child of any age

• Fever of 100.4° F (38° C) or higher in baby younger than 3 months

• Fever that lasts more than 24 hours in a child under age 2

• Fever that lasts for 3 days in a child age 2 or older

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Umbilical Granulomas: Causes, Treatments, and Prevention

Written by WebMD Editorial Contributors

In this Article

• Causes of Umbilical Granulomas
• Impact of Umbilical Granulomas on Health
• Treating Umbilical Granulomas
• Preventing Umbilical Granuloma Infections
• When to Go to the Doctor

‌An umbilical granuloma is a small red bump of tissue that can form in a newborn’s belly button during the first several weeks after they’re born. Many babies will develop a granuloma and have no problems. However, some umbilical granulomas can become infected. In rare cases, adults can also form painful umbilical granulomas. Here’s what you need to know about how they can affect your health.

Umbilical granulomas are a type of scar tissue that forms in the belly button. Most umbilical granulomas form when the belly button is healing after the umbilical cord falls off. They look like small red lumps in your child’s navel. Unlike the rest of their skin, the granuloma will be a little shiny and covered in a clear discharge.

After the umbilical cord is cut, a small stump remains on your baby’s stomach. Typically, the stump will fall off on its own and heal without a problem. However, in rare cases, an umbilical granuloma will form where the stump fell off. Only about 1 in 500 babies will develop an umbilical granuloma.

Rarely, an adult may develop an umbilical granuloma. These lumps are caused by trauma to the bully button. One of the most common causes of an adult umbilical granuloma is navel piercing. While granulomas in babies are not painful, they may be painful for adults.

Granulomas are relatively minor complications. However, they do require treatment because they won’t resolve on their own. Most granulomas will continue to slowly grow until they’re treated. These lumps can easily become infected.‌

An infected granuloma is a critical health problem. Since granulomas are connected to the umbilical opening, infection can spread quickly. If you believe your child has an infected granuloma, reach out for medical care right away to keep the infection from getting worse.

In most cases, treating granulomas is simple. Your child’s pediatrician will probably be able to treat and remove the lump in their office. Granuloma treatments include:

Silver nitrate: Umbilical granulomas in babies don’t have nerve endings, so they can be treated with a small amount of silver nitrate. The doctor will place the silver nitrate on the granuloma, and it will burn off the tissue. Your baby will not feel any pain during the process. Adults may need a topical anesthetic to numb the area before the same treatment.

Liquid nitrogen: If silver nitrate isn’t an option, then liquid nitrogen can also be used. The liquid is very cold and freezes the lump immediately. After it’s frozen, the granuloma tissue dissolves away.‌

Suture thread ties: In some cases, your doctor may tie off the granuloma with suture thread. This cuts off blood flow to the lump. Over time, it will dry up and shrivel until it disappears.

Salt: Another way to dry out the granuloma is by using salt. Since granulomas are covered in clear mucus, the salt dries them out and causes them to shrivel away. Your doctor will give you instructions on how to apply salt to the granuloma safely.‌

Surgery: In rare cases, an umbilical granuloma may need to be surgically removed. This is most common for infected granulomas, because surgical removal is the quickest treatment. If your baby’s granuloma is infected, surgery will help stop the spread of infection and help them recover more quickly.

Since granulomas are a type of scar tissue, they’re difficult to prevent. However, if your baby develops a granuloma, you can often prevent infections.

The best way to prevent infections is to protect your baby’s belly button and keep the area clean. Gently wiping the area down with warm soap and water can prevent drainage and bacteria from building up. Your child’s doctor may have other recommendations, as well. Always follow their instructions for taking care of your baby’s navel.

All granulomas should be treated by a doctor. However, if a granuloma gets infected, it needs to be treated immediately. Your baby may need antibiotics to prevent the infection from getting worse. Signs your baby needs to go to the doctor right away include:

• ‌A fever of more than 100. 4 degrees Fahrenheit
• ‌A rash around the belly button
• ‌The granuloma is bleeding
• ‌The belly button is draining a bad-smelling liquid
• ‌The area around the granuloma is swollen or red
• ‌Your baby seems to be in pain when you touch their belly button

Top Picks

How and with what to treat the navel of a newborn: treatment of the umbilical wound

The expression “navel of the earth” did not appear by chance, because in the first weeks after the birth of a baby, it is the navel that becomes the center of attention of a young mother. There is a simple explanation for this: this place on the body is very susceptible to injury and infection. Therefore, it is very important to carefully monitor the healing process and treat the wound in a timely manner.

HOW THE UMBILIC WOUND IS FORMED

When a baby is born, the umbilical cord is immediately fixed with a special clamp and tightly bandaged near the future navel. Only after that it is cut off. An incision is made between the ligation site and the clamp. The remaining small area dries up and disappears on its own, and an umbilical wound appears in this place and later the navel itself. If all hygiene rules and doctor’s recommendations are followed, complete healing occurs approximately 2 weeks after birth. If the newborn is seen by a health visitor from a local clinic, she can help with the first home treatment and show how to continue to do this for parents.

MAIN RECOMMENDATIONS

Treatment of the umbilical wound in a newborn is primarily aimed at protecting against inflammation and infection. To do this, follow a few simple rules.

1. Air baths and free access of air to the umbilical cord is one of the main conditions for wound healing. The main danger is the constant wearing of a diaper. This is a hygiene product that makes life much easier for parents, but closes the navel and often rubs it. To avoid problems, you should either buy diapers with special slots, or make holes yourself.

2. Humidity is an ideal environment for bacteria and infection to develop. Therefore, the navel should always remain dry (of course, with the exception of bathing). Parents need to constantly monitor the cleanliness and dryness of diapers and undershirts, if necessary, immediately change them to new ones. By the way, after washing, the baby’s things should be carefully ironed.

3. Many mothers are afraid to bathe a baby with an unhealed navel. But water procedures are not just allowed, but are an integral part of hygiene (unless the doctor has given other instructions on this matter).

4. More recently, doctors advised treating the umbilical wound with brilliant green and hydrogen peroxide. However, recent studies have shown that there is a need for this procedure only if a crust has formed after the umbilical residue falls off. In this case, it is worth treating the wound once a day. First, drop a little hydrogen peroxide into the navel, remove the softened crusts with a cotton swab or disc, and gently blot the umbilical cavity with a cotton swab dipped in brilliant green.

5. Bathing is important, but don’t do it too often. Hygiene procedures are needed by the baby on average once a day. The less often you disturb the wound, the faster it will heal.

6. Since the care of the umbilical wound requires constant air access, it cannot be covered with a plaster or bandage. For speedy healing, the skin needs to breathe.

7. Be sure to call your doctor if you notice that the skin around your navel is red and swollen. It is also necessary to contact a specialist if unpleasant purulent discharge appears inside the navel. Another reason for concern is the long healing of the umbilical wound (normally, this process usually takes 10-14 days, a maximum of 3 weeks).

Following this simple procedure for treating an umbilical wound can help protect your baby from infection and speed up the healing process.

Newborn navel care

What procedures are required to be carried out with the navel of a newborn will be described in this article by the pediatrician of the DocDeti clinic Alexandra Zhukovskaya.

Do I need to treat the navel with green? Glue a patch with a coin to the umbilical hernia? Should I sprinkle salt on a healed belly button with a granuloma?

After birth, the umbilical cord is cut with a sterile instrument and a plastic clip is applied to it. The rest of the umbilical cord will dry up, turn black and fall off without further intervention in about 2 weeks.

What kind of belly button care is required?

“Dry cord management” is accepted worldwide:

1. Before touching an unhealed navel, be sure to wash your hands with soap and water.

2. It is not recommended to touch the navel even with clean hands.

3. The navel should be open in the air, for this, turn up the diaper or use diapers that have a cutout.

4. Avoid getting wet. If urine/feces gets on the navel, rinse gently with water and pat dry with a clean towel.

5. Postpone bathing until the umbilical cord falls off. Before that, wipe the baby with a damp sponge or wash only the face and wash the ass.

6. No need to interfere with the normal microflora to do its job: DO NOT smear the navel with brilliant green, peroxide, alcohol antiseptics.

This approach is safe and effective – this has been proven by large scientific studies.

If all of the above hygiene measures are observed, then antiseptics will only increase the healing time by disrupting natural processes.

Because of the green, in addition, you can not notice the redness and skip the inflammation.

In the case when the birth did not take place in the maternity hospital and the umbilical cord was cut with a non-sterile instrument, a doctor’s consultation will be required. Usually in such situations it is recommended to treat the navel with chlorhexidine.

The rest of the umbilical cord fell off, what’s next?

• After that, at the bottom of the navel, a mucous viscous discharge will be visible (without redness, unpleasant odor, swelling). It usually takes 1-2 days to dry.

• If ​​there are bloody crusts, then you do not need to pick them out, they will fall off on their own.

In what situations should you be concerned?

1. The umbilical cord has not fallen off after 2-3 weeks.

2. The navel bleeds, as if the wound is fresh (does not just leave a mark, as with an accidental touch).

3. The navel is red and swollen.

4. A purulent discharge with a pungent odor is seen in the navel.

If you suspect that the navel has become inflamed, it is recommended to immediately consult a doctor. Omphalitis – inflammation of the navel – is a very serious thing, but with timely treatment they can cope with it.

Let’s move on to the umbilical hernia, which is a hole in the muscular frame of the abdomen at the site of the former umbilical cord. Every fifth newborn has an umbilical hernia.

A patch with a coin, a bandage, a bandage – do not accelerate the overgrowth of the hernial opening.

Often passes on its own by 1-1.5 years (in extreme cases, by 4 years).

It happens that in place of the fallen off umbilical cord there is a “mushroom” / “pimple” with a smooth surface – this is called an umbilical granuloma.

It occurs when the connective tissues “overdone”, healing the wound.

It is treated using a simple and affordable method: pour a pinch of salt on the granuloma, cover with a dry cotton pad for half an hour 3 times a day, repeat the steps for 3 days.