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 applied to 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 require 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 allow it to 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 seek medical advice” 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 seek 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 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

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Everything You Need to Know About Umbilical Granulomas

When you leave the hospital with your newborn baby, you’re usually armed with tips for helping the stump of your baby’s umbilical cord heal. What starts as a pale, wet-looking lump inside your baby’s belly button eventually begins to dry up and harden, turning into a dark and shriveled knot before falling off completely.

Once your baby’s stump finally falls off, it reveals a super cute little belly button—and, often, a small raw spot where the last bit of cord was attached (kind of like when a scab falls off). This is totally normal and should heal up pretty quickly.

In some cases, though, not only does this spot seem to never heal, it actually grows into a small lump of tissue inside your baby’s belly button. If this happens, your baby probably has an umbilical granuloma. While it’s completely harmless and painless for your baby, it usually has to be treated by a doctor to avoid infection.

Umbilical Cord Care 101

For the most part, you don’t have to do much to aid in the umbilical cord healing process other than keep the area around the stump clean and dry. Your pediatrician will examine your baby’s umbilical cord at each newborn well visits, checking for infection.   

In the meantime, you will probably be advised not to give your baby a full bath or submerge their belly button in water. Stick to sponge baths until your baby’s cord has fallen off completely:

• In a small tub or in your sink, gently cleanse your baby’s skin with warm, soapy water and a washcloth.
• Carefully wipe the area around your baby’s belly button with the washcloth, avoiding getting the umbilical cord stump overly wet.
• Pat your baby dry, including their belly button. If the top of your baby’s diaper rubs up against the belly button, fold the top part of the diaper down to leave the area exposed and free of friction.

The umbilical cord should fall off on its own between one and three weeks after birth; if the cord is still attached after three weeks, you should let your pediatrician know. Sometimes, it falls off sooner—as long as it wasn’t removed on purpose, that’s totally fine. 

When Does a Granuloma Form?

According to the American Pediatric Surgical Association (APSA), about 1 in every 500 newborns will end up with an umbilical granuloma. 

A granuloma is a clump of tissue somewhere in or on the body that forms as a result of inflammation or infection. They can be associated with certain medical conditions, but when they form in the belly button after a newborn’s umbilical cord has fallen off, it’s due to the development of scar tissue during the healing process. (Some adults develop granulomas in the belly button after navel piercings.)

After your baby’s cord falls off, it’s normal for there to be a small red spot or even a red lump of tissue left behind…at first. But if, after two weeks, your baby’s belly button isn’t fully healed or you notice new growth of tissue, you should contact your doctor for next steps.

What Does It Look Like?

The granuloma itself will look like a small, moist, pink or red ball. It may be covered with a thin yellow or white film, drain light-colored fluid, or look pink or inflamed around its perimeter. 

Can It Hurt My Baby?

An umbilical granuloma is not painful or dangerous, and it’s not a cancerous growth. The only reason doctors treat umbilical granulomas is to prevent further growth that could become restrictive or lead to future problems, and to prevent any kind of umbilical infection.

How Is It Treated?

In most cases, your child’s pediatrician will treat your baby’s granuloma with a chemical called silver nitrate. When a tiny amount is applied to the granuloma, it burns or cauterizes the tissue, forcing it to stop growing and, eventually, shrink; this doesn’t hurt your baby, because there are no nerve endings in the granuloma tissue.

If this doesn’t work, there are other treatment options:

1. Your pediatrician can remove the granuloma by applying a small amount of liquid nitrogen to the growth to freeze it off.
2. Your pediatrician can tie suture thread around the base of the granuloma to deprive the tissue of blood flow. This will force it to dry up. 

Neither one of these procedures are painful for your baby. In some rare cases, surgery may be required to remove the granuloma, but the vast majority of these growths are treated with simple procedures at your pediatrician’s office.

Can I Do Anything to Prevent It?

No. No one knows why some newborns develop granulomas and others don’t. There are no genetic or environmental causes, and we don’t have any evidence proving that granulomas are more likely to form when proper umbilical cord care isn’t performed after birth. It may be more common in babies when the cord takes longer than average to fall off, but again, we don’t know for sure.

Other Umbilical Cord Problems

You should always be on the lookout for signs of infection in your newborn’s belly button. According to the American Academy of Pediatrics (AAP), an umbilical infection may:

• produce a foul-smelling discharge
• ooze yellow fluid or pus
• cause fever and/or irritability
• make the surrounding area look bright red, inflamed, or streaked with red
• cause your newborn distress when you touch it

Another common umbilical cord problem is an umbilical hernia. Per the APSA, about 20% of babies have an umbilical hernia, a condition where the muscles around the belly button aren’t fully connected. This leaves a little bit of room for internal tissue to bulge out through the belly button and is often most noticeable when a baby is crying. Like a granuloma, hernias are not painful for your baby.

Although umbilical hernias sound scary, the AAP says most heal on their own without intervention by the time a child is 18 months old. If not, an outpatient surgery may be required when the child is older to close the gap. (This usually isn’t done until a child is closer to 5 years old.)

When to Call Your Doctor

While most umbilical cord issues aren’t harmful or painful for your baby, you should let your doctor know if your baby’s umbilical cord isn’t healing the way it’s supposed to. This might include not falling off in the first month of life, leaving behind a growth of tissue for more than two weeks, or appearing infected at any time.  

A Word From Verywell

While it may be nerve-wracking to think about your child having an umbilical granuloma, you can find ease knowing that it isn’t painful or harmful to your baby, and most can be easily removed by a doctor. In no time, your child’s belly button will be ready for warm baths and plenty of tickles.

Umbilical Cord Symptoms

Is this your child’s symptom?

• Umbilical cord or navel questions about newborns
• The navel is also called the belly button or umbilicus

Symptoms

• Umbilicus (navel) has a cloudy discharge or even some dried pus on the surface
• Bleeding occurs from cord’s point of separation
• Separation of cord is delayed past 3 weeks

Omphalitis: Serious Complication

• Definition. Bacterial infection of the umbilical stump with spread to the skin around it. It’s a medical emergency.
• How Often. 1 out of 200 newborns.
• Symptoms. Redness spreads around the navel. The area may be tender, swollen and have a foul odor.

Umbilical Granuloma: Minor Complication

• Definition. Small round growth in center of navel after the cord falls off. It’s red. Covered with clear mucus. Not dry like normal skin.
• How Often. 1 out of 500 newborns.
• Outcome. Usually grows in size if not treated. Can become an entry point for umbilical infections.
• Treatment. Easily treated in the doctor’s office by putting on a chemical called silver nitrate.

Dry Cord Care or Alcohol Cord Care

• The AAP and ACOG both advise dry cord care (natural drying). (Guidelines for Perinatal Care, 2012). It has become common practice in US hospitals.
• The book advises against using alcohol for routine umbilical cord care.
• Alcohol cord care is advised in less developed countries with high infection rates.

When to Call for Umbilical Cord Symptoms

Call Doctor or Seek Care Now

• Age less than 1 month old and looks or acts abnormal in any way
• Bleeding won’t stop after 10 minutes of direct pressure applied twice
• Spot of blood more than 2 inches (5 cm) across
• Red streak runs from the navel
• Red skin spreads from around the navel
• Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Small bleeding lasts more than 3 days
• Pimples, blisters or sores near navel
• Lots of drainage (such as urine, mucus, pus) from the navel
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• After using care advice for 3 days, navel is not dry and clean
• Small piece of red tissue inside the navel
• Cord stays attached more than 6 weeks
• You have other questions or concerns

Self Care at Home

• Normal cord care
• Normal navel care after cord falls off
• Minor infection of cord or navel
• Normal bleeding from cord or navel
• Normal delayed separation of the cord after 3 weeks

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice

Treatment for Normal Umbilical Cord

1. What You Should Know About Normal Umbilical Cords:
   • Normal cords don’t need any special treatment.
   • Just keep them dry (called dry cord care or natural drying).
   • Reason: Cords need to dry up, before they will fall off.
   • As they dry up, cords normally change color. They go from a shiny yellowish hue, to brown or gray.
   • The cord will normally fall off between 1 and 3 weeks.
   • Here is some care advice that should help.
2. Normal Dry Cord Care:
   • Check the skin around the base of the cord once a day.
   • Usually the area is dry and clean. No treatment is needed.
   • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
   • You will need to push down on the skin around the cord to get at this area. You may also need to bend the cord a little to get underneath it.
   • Caution: Don’t put alcohol or other germ killer on the cord. Reason: Dry cords fall off sooner. (Exception: instructed by your doctor to use alcohol).
3. Bathing:
   • Keep the cord dry. Avoid tub baths.
   • Use sponge baths until the cord falls off.
4. Fold Diaper Down:
   • Keep the area dry to help healing.
   • To provide air contact, keep the diaper folded down below the cord.
   • Another option for disposable diapers is to cut off a wedge with a scissors. Then seal the edge with tape.
5. Poop on Cord:
   • Getting some poop on the cord or navel is not serious.
   • If it occurs, clean the area with soap and water.
   • This should prevent any infections.
6. Call Your Doctor If:
   • Develops a red streak or redness around belly button
   • Fever occurs
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Navel After Cord Falls Off

1. What You Should Know About Navels After the Cord Falls Off:
   • The cord can’t fall off too early.
   • The average cord falls off between 10 and 14 days. Normal range is 7 to 21 days. Even if it falls off before 7 days, you can follow this advice.
   • After the cord has fallen off, the navel will gradually heal.
   • It’s normal for the center to look red at the point of separation.
   • It’s not normal if the redness spreads on to the belly.
   • It’s normal for the navel to ooze some secretions.
   • Sometimes the navel forms a scab. Let it heal up and fall off on its own.
   • The navel has a small risk of becoming infected.
   • Here is some care advice that should help.
2. Normal Navel Care:
   • Keep the navel (belly button) clean and dry.
   • If there are any secretions, clean them away. Use a wet cotton swab. Then dry carefully.
   • Do this gently to prevent any bleeding.
   • Caution: Don’t use any rubbing alcohol. Reason: can interfere with healing.
3. Bathing:
   • After the cord falls off, continue sponge baths for a few more days.
   • Help the belly button area dry up.
   • Then, tub baths will be fine.
4. Fold Diaper Down:
   • Keep the navel dry to help healing.
   • To provide air contact, keep the diaper folded down below the navel.

5. What to Expect: The belly button should be healed and dry by 7 days.

6. Call Your Doctor If:
   • Develops a red streak or redness around belly button
   • Fever occurs
   • Cloudy discharge occurs
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Minor Infection of Cord or Navel

1. What You Should Know About a Minor Infection of Cord or Navel:
   • The belly button will ooze secretions for several days.
   • Normal secretions are clear or blood tinged mucus.
   • A cloudy discharge is usually a mild infection.
   • This can be from normal skin bacteria.
   • A small amount of pus may be present.
   • Here is some care advice that should help.
2. Clean the Navel:
   • Clean the navel (belly button) 2 times a day.
   • Use a wet cotton swab or cloth.
   • Clean away any dried secretions or pus.
   • Do this gently to prevent any bleeding.
   • Caution: Don’t use any rubbing alcohol. Reason: Can interfere with healing.
3. Antibiotic Ointment for Pus:
   • If any pus is present, use an antibiotic ointment (such as Polysporin).
   • No prescription is needed.
   • Put a tiny amount on the belly button.
   • Do this 2 times per day after the area has been cleaned.
   • Do this for 2 days. After that, use the antibiotic ointment only if you see more pus.
4. Bathing:
   • Do not use tub baths until the cord falls off. The navel should be well healed.
5. Fold Diaper Down:
   • Keep the belly button dry to help healing.
   • To provide air contact, keep the diaper folded down. Keep it below the cord and belly button.
6. What to Expect:
   • With treatment, the cloudy discharge and pus should be gone in 2 to 3 days.
   • The navel should become dry and healed by 7 days.
7. Call Your Doctor If:
   • Develops a red streak or redness around the belly button
   • Fever occurs
   • Cloudy discharge not gone after 3 days of using this care advice
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Bleeding Around Cord

1. What You Should Know About Mild Bleeding Around the Cord:
   • A few drops of blood are normal when the cord falls off or catches on something.
   • The diaper rubbing against the belly button may make it start up again.
   • Here is some care advice that should help.
2. Bleeding:
   • To stop bleeding, put direct pressure on the navel for 10 minutes. Use a clean cloth.
   • Clean the area beforehand, rather than afterwards.
   • Reason: This helps prevent bleeding from starting back up.
3. Diaper:
   • Prevent the diaper from rubbing on the belly button.
   • Do this by folding the diaper down away from the belly button.
   • You can also cut a wedge out of the diaper.
4. What to Expect:
   • The bleeding may come back a few times.
   • It should only be a small smear of blood.
   • The bleeding site should heal up by 2 days.
5. Call Your Doctor If:
   • Bleeding gets worse
   • Few drops of blood lasts more than 3 days
   • Your baby starts to look or act abnormal
   • You think your child needs to be seen

Treatment for Normal Delayed Separation of the Cord Beyond 3 Weeks

1. What You Should Know Cords Falling Off:
   • Most cords fall off between 10 and 14 days. Normal range is 7 to 21 days.
   • All cords slowly fall off on their own.
   • Continue to be patient.
   • Here is some care advice that should help.
2. Stop Alcohol:
   • If you have been using rubbing alcohol to the cord, stop doing so.
   • Rubbing alcohol can kill the good bacteria that help the cord fall off.
3. Diaper:
   • Help the cord dry up faster by keeping the diaper folded below it.
   • Another approach is to cut out a wedge of the diaper (if disposable).
   • Air contact helps the cord stay dry.
4. Call Your Doctor If:
   • Cord starts to look infected
   • Fever occurs
   • Cord is still on for more than 6 weeks
   • Your baby starts to look sick or act abnormal
   • You think your child needs to be seen

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 05/30/2021

Last Revised: 03/11/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

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Pediatric Emergency Care and Medicine: Open Access, Medical & Clinical Reviews, Vitiligo & Dermatomyositis, Open Dermatology Journal, Cesko-Slovenska Dermatologie, Journal of Pakistan Association of Dermatologists, Journal of the American College of Clinical Wound Specialists.

Seborrheic Dermatitis

Seborrheic dermatitis is a common inflammatory disease of the skin characterized by scaly lesions usually on the scalp, hairline, and face.Seborrheic dermatitis appears as red, inflamed skin covered by greasy or dry scales that may be white, yellowish, or gray.

Related Journals of Seborrheic Dermatitis
Vitiligo & Dermatomyositis, Clinical Pediatrics & Dermatology, Archives of Medicine, Dermatologic Clinics,     Mycoses, JDDG – Journal of the German Society of Dermatology, Clinical, Cosmetic and Investigational Dermatology.

Umbilical Granuloma

It is easy to fall into a potentially callous mindset in the Emergency Department – “If it isn’t an emergency, then it can wait to see the Primary.”  While that may be a valid statement, it won’t win you any bed-side manner awards.  It also mandates the ability to determine what presentations are not due to underlying emergent issues, which can be tricky in kids (hence the common theme of remaining vigilant).

Additionally, if the family brings their kid at 3am, they likely think it is at least important enough to warrant your potential concern.  Fortunately, many times the “important” issue revolves around a typical oddity of being a young child (like periodic breathing).  Being comfortable with some minor issues, particularly neonatal issues (currently, there are 26 categorized neonatal Morsels), can make you more comfortable with dealing with the potential emergent conditions that exist within seemingly innocuous presentations.  Umbilical Granuloma is a good example.

• In utero, the umbilical cord is one of the most important structures. After birth, it becomes useless.
  • All of the structures associated with it should be obliterated or recede.
  • When they don’t, problems can occur.
• Umbilical Cord Stump may remain attached from 3 to 45 days.
  • Mean duration was ~2 weeks.
  • Delayed cord separation is associated with some immune problems.
• The care for the umbilical stump vary from institution to institution.
  • Some recommend no care.
  • Some recommend soaps or alcohol application.
  • All fear umbilical stump infection (omphalitis)!

• Most common cause of Umbilical Masses.
• Form within the 1st week after cord separation.
• They:
  • are moist and pink
  • range in size from 1 mm to 10 mm.
  • can be associated with some sanguinous or even greenish discharge.
• Most often treated, successfully, with Silver Nitrate application.
  • Silver nitrate is not without its complications.
  • Some advocate for application of salt crystals instead.

• Silver Nitrate  can act as an antiseptic, an astringent, or a caustic agent (depends on the concentration)
• While it can help resolve an Umbilical Granuloma, it can also burn the tissue around it!
  • Contact with normal tissue should be avoided.
  • The Umbilical Granuloma should be dried before application to limit the potential spread of the silver nitrate by the discharge from the Umbilical Granuloma.
• When dealing with a persistent Umbilical Granuloma:
  • don’t just keep adding silver nitrate.
  • If the Umbilical Granuloma persists after 2 applications, consider other potential issues.

• Omphalitis
  • The issue we all worry about.
  • Can complicate the other issues as well.
  • This is an emergency!
• Omphalomesenteric Remnants
  • The Omphalomesnteric Duct (OMD), also known as the vitelline duct, is present in early gestation.
  • The OMD connects the yolk sac with the developing GI tract.
  • It should involute at week 8 or 9 of gestation.
  • Remnants occur in ~2% of the population.
    • May persist as tissue attached to ileum = Meckel’s Diverticulum
      • May present with painless rectal bleeding.
      • Most common of these anomalies.
    • May persist as a cyst beneath the umbilicus = OMD Cyst
    • May persist as a patent Fistula between the GI tract an umbilicus.
      • Present as persistent drainage, often with fecal material!
    • May persist as a Polyp at the umbilicus = Umbilical Polyp
      • Present as a Very Red mass within the umbilicus.
      • Can contain gastric or intestinal tissue.
      • Do not resolve with silver nitrate.
      • Often confused with Umbilical Granuloma!
• Urachal Remnants
  • Fistula – present with clear drainage or drainage of urine from the umbilicus.
  • Cyst – present with painful mass between the suprapubic region and the umbilicus.
  • Both can become infected.

• Look for signs of infection (obviously). If infected, do sepsis work up and consult surgery!
• If it appears as if you are dealing with a simple Umbilical Granuloma, gently and carefully apply silver nitrate and arrange follow-up.
• Refer to Surgery:
  • If the Umbilical Granuloma / mass did not respond to silver nitrate.
  • If it is unusually RED.
  • If there is significant drainage.
  • If there is a mass associated.

Kondrich J1, Woo T, Ginsburg HB, Levine DA. Evisceration of small bowel after cauterization of an umbilical mass. Pediatrics. 2012 Dec;130(6):e1708-10. PMID: 23166332. [PubMed] [Read by QxMD]

The omphalomesenteric duct (OMD), a temporary structure essential to fetal development, normally involutes completely by week 8 or 9 of gestation. On occasion, the OMD persists, the clinical presentations of which vary widely. We describe a case of a 6-week-old male with a patent OMD remnant that was initially treated as an umbilical granuloma, which then potentially allowed for prolapse of the small bowel through the umbilical ring. The patient […]

Nagar H. Umbilical granuloma: a new approach to an old problem. Pediatr Surg Int. 2001 Sep;17(7):513-4. PMID: 11666047. [PubMed] [Read by QxMD]

Umbilical granuloma (UG) is the most common umbilical abnormality in neonates, causing inflammation and drainage. Most fail to epithelialize and persist for more than 2 months. The common treatment is application of a 75% silver nitrate stick, usually repeated two to three times over a number of clinic visits. Burns have been reported following spillage onto the surrounding tissues. During a 10-year period, 302 neonates were treated for UG using […]

Chamberlain JM1, Gorman RL, Young GM. Silver nitrate burns following treatment for umbilical granuloma. Pediatr Emerg Care. 1992 Feb;8(1):29-30. PMID: 1603685. [PubMed] [Read by QxMD]

Three infants treated for umbilical granuloma with silver nitrate suffered chemical burns to the periumbilical area which prompted visits to the emergency department. Treatment was conservative, and the outcome was good in all cases. We recommend caution when applying silver nitrate to the umbilicus, careful drying of the umbilical exudate to prevent spillage, and discussion with parents that burns may occur but apparently are not serious. The po […]

Novack Ah2, Mueller B, Ochs H. Umbilical cord separation in the normal newborn. Am J Dis Child. 1988 Feb;142(2):220-3. PMID: 3341328. [PubMed] [Read by QxMD]

During a 13-month period, 363 infants were followed up through the first six weeks to determine the effect of perinatal factors (birth weight, gestational age, type of delivery, and pregnancy and neonatal complications) on umbilical cord separation. Also, breast-feedings and umbilical cord care were studied. Except for cesarean section deliveries, study infants were similar to all infants (N = 1474) admitted to the same nursery during the study p […]

Sean M. Fox

I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renowned educators and clinicians. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. I strive every day to inspire my residents as much as they inspire me.

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What’s The Best Way To Care For My Baby’s Umbilical Cord?

Hooray! You’ve made it through pregnancy, labor and delivery, and now you have a new little wonderful bundle of joy in your life. If you’re a first-time parent, you’re finding out (fast) about all the tasks that come along with that wonderful bundle: feeding, diapering, burping, swaddling…and that’s just the beginning!

Lauren Adler, MD, FAAP

It can all seem pretty overwhelming at first but don’t worry—at Westchester Health Pediatrics, we’ve got you covered. We’ve helped hundreds of parents take care of their newborns and we’re ready to help you, too.

One question we often get asked about is how to properly take care of the umbilical cord. There are several do’s and don’ts you should follow, which we’ll go over here in this blog so you can feel confident you’re doing the right things.

Why is there an umbilical cord stump?

During pregnancy, the umbilical cord supplies nutrients and oxygen to your developing baby. After birth, it’s no longer needed because your baby can now breathe and feed on his/her own. The cord is clamped and then cut, leaving behind a short stump that in time, dries up and falls off.

How to care for your baby’s umbilical cord

Pediatricians used to recommend cleaning the base of the cord with rubbing alcohol. However, we’ve now found that this can irritate a baby’s skin and delay the healing, so we no longer suggest it. Instead, we recommend following these six guidelines:

1. Keep the stump dry. You want the base of the umbilical cord to dry out. For this to happen, it needs to be exposed to air as often as possible, which will also speed up the healing process. If you can, if the weather is warm enough, dress your baby in just a t-shirt and diaper (preferably one that has a notch cut out of it, or if not, fold the front of the diaper down) to allow more time for the cord to dry.
2. Keep it clean. If the umbilical cord stump looks dirty or sticky, gently dab it with a wet washcloth (no soap or alcohol), then pat it dry with a dry cloth.
3. Only give your baby sponge baths. Do not immerse your baby in a full-body water bath until after the umbilical cord has fallen off. If the stump gets really wet, lightly pat and then fan the area to dry it completely. Do not rub it dry—this could cause irritation.
4. Avoid covering the stump with a diaper. Many newborn-size disposable diapers now have a little notch cut out at the waistband. Another option is to fold down the front of a regular newborn diaper so that it’s not covering and rubbing against the stump. Also, change wet and dirty diapers as soon as possible so they don’t leak upward toward the navel.
5. Dress your baby loosely. We recommend loose-fitting clothing that doesn’t press against the stump, like a loose onesie or just a t-shirt.
6. Let the stump fall off on its own. Resist the temptation to pull off the stump yourself, even if it seems to be connected by only a small thread. If it does get unattached too soon, this could cause continuous bleeding. (If this happens, call your pediatrician immediately.)

Signs of infection to look out for

While the umbilical cord is healing, it’s normal to see a little blood near the stump. Much like a scab, the stump might bleed a little when it falls off.

However, you should contact your pediatrician right away if the umbilical area oozes pus, the surrounding skin becomes red and swollen, or the area develops a pink moist bump. These could be signs of an umbilical cord infection which can result in omphalitis (which could be life-threatening and needs to be treated immediately).

Also, take your baby to your pediatrician if the stump still hasn’t separated after three weeks. This might be a sign of an underlying problem, such an infection or immune system disorder.

Signs of infection:

• Red, swollen appearance
• A fluid-filled lump on or near your baby’s umbilical cord stump
• Oozing pus or any foul-smelling discharge
• Bleeding from the scab (though a little dried blood is normal)
• Fever
• Lethargy, low appetite, irritability
• Abdominal swelling

If your baby develops an umbilical granuloma

An umbilical granuloma is a small nodule of firm pinkish-red tissue (similar to scar tissue) with yellow-green drainage. This is different from an infection because it’s not accompanied by swelling, redness, warmth, tenderness or a fever. We most often treat it by cauterization (silver nitrate applied to the area to burn the tissue). There are no nerve endings in this naval area, so it is not painful for your baby.

After the stump drops off

When your baby’s umbilical cord stump eventually does fall off, you might notice a small raw spot or small amount of blood-tinged fluid oozing out. This is nothing to worry about. Most cords dry completely and then fall off. See your pediatrician if the stump hasn’t fallen off after four weeks.

Count on us for information and advice to help you raise your baby

You’ve got questions, we’ve got answers. Whether you’re a new parent or an old hand, we want you to know that you can turn to us for help, whatever stage of development your child is in. We’re parents too, with years of experience helping parents care for their babies, including how to take care of the umbilical cord. To read about our tips, advice and guidance specifically for new parents, click here.

Helpful articles you might want to read:

Want to know more about umbilical cord care? Come see us.

If you’d like more information about the proper way to take care of your baby’s umbilical cord, or if you have questions about any aspect of caring for your newborn, please make an appointment with one of our Westchester Health Pediatrics pediatricians. Our #1 goal is to help you raise a happy, healthy child and for you to feel confident as a parent. Whenever, wherever you need us, we’re here for you.

By Lauren Adler, MD, FAAP, Lead Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

Umbilical Conditions – American Pediatric Surgical Affair

Condition: Umbilical Conditions (belly button or navel: hernia, infection, granuloma, drainage)

Overview (“What is it?”)

• The umbilicus (belly button or navel) is a structure in the middle part of the bely. During the development of the baby in the mother’s womb, the umbilical cord connects the baby to the mother. Through blood vessels in the umbilical cord, the mother supplies the baby with nutrients and oxygen and the baby releases waste products.
• After birth, the umbilical cord is cut. The baby takes over the functions of providing nutrition and oxygen for himself or herself, as well as getting rid of waste. In most cases, the muscles around the belly button close within days after birth.
• Definitions
  1. Umbilical hernia:  When the muscles around of the belly button don’t fuse, there is a defect allowing inside contents (such as intestine) to pop out. This usually does not cause the baby pain.
  2. Umbilical granuloma: Moist tissue causing crusting of the belly button. This can get bigger without treatment. A granuloma does not cause the baby pain.
  3. Umbilical infection (omphalitis):  Infection of the belly button. This can cause pain and discomfort. It represents a serious condition needing prompt medical therapy.
  4. Umbilical drainage: Fluid coming from the belly button.
• Epidemiology:   About 20% of babies have umbilical hernias. About 85% of belly button hernias close on their own by the time the child is about three years of age.
  • Umbilical granulomas happen in 1 out of 500 babies.
  • Umbilical infections happen in 1 out of 200 babies.

Signs and Symptoms (What symptoms will my child have?”)

• Umbilical hernia:  Bulge occurs in the belly button, may get bigger when the baby bears down with increasing pressure in the belly, such as when the baby is crying or bearing down. In extremely rare cases, the contents of the bulge can get stuck in the defect. In this case, the belly button becomes tender and painful. This situation requires the child to be seen immediately—either the doctor’s office or emergency room.
• Umbilical granuloma:  Small, round, wet tissue that can happen after the belly button stump falls off.
• Umbilical infection:  Redness and swelling around the belly button. The child may have a fever and fussiness. If the infection is uncontrolled, the area of redness may spread to a larger area or have streaks.
• Umbilical drainage:  Fluid that comes out of the belly button. If the fluid is yellow and thin, may signal a communication to the bladder (urachal remnant). If the fluid is thick and smells bad, may be an infection. If green, doctors will consider abnormal connection to the intestine.

Diagnosis (“What tests are done to find out what my child has?”)

The conditions that can occur with the belly button are usually pretty obvious on examination. In some cases, if there is a question regarding abnormal connection to the bladder or intestine, an ultrasound may be used. The ultrasound uses sound waves to create an image and does not use radiation.

Treatment (“What will be done to make my child better?”)

• Umbilical hernias:  About 85% of belly button hernias close on their own. Since umbilical hernias do not cause pain and rarely get stuck, it is very safe to wait until the child is about three years old to repair a hernia if it has not closed yet.
  • Surgery:  The goal of the operation is to close the hole in the muscle underneath the belly button. A cut is made around (usually below) the belly button. Stitches are used to close the hole. The skin is usually closed using dissolvable stitches.
    • Benefits:  Closing the hernia decreases the chance of organs in the belly getting stuck. The hernia is not able to get bigger as the child grows.
    • Risks:  Bleeding, infection, fluid under the incision. Recurrence of the hernia is rare.
    • Preoperative preparation:  You may be asked to give the child a bath the night before or the morning of the operation. The child should have nothing solid to eat for at least eight hours before surgery.
    • Postoperative care:  Most patients are discharged the same day after surgery. The child should be able to tolerate liquids before leaving.
• Umbilical granulomas
  • Medical treatment:  Most umbilical granulomas are treated with silver nitrate. Silver nitrate chemically burns the moist tissue, shrinking it and allowing the area to heal. Silver nitrate can burn normal skin as well, so one must be careful to apply the material on the granuloma only. Sometimes, petroleum jelly (Vaseline®) is applied to the normal skin around the granuloma to protect it. Repeated applications of silver nitrate may be needed
• Umbilical infections:  Umbilical infections can be very serious, especially in small babies. It is very important to seek medical attention if this is a concern.
  • Medical treatment:  Antibiotics are medicines that fight bacteria. These can be given by mouth or through the vein depending on how severe the infection is.
  • Surgical treatment:  If antibiotics cannot control the infection, the child may need to have the pus drained. This can be done by putting a needle in the pus and pulling out the infected fluid, placing a drain, or cutting the skin right over the infection and allowing the pus to drain (incision and drainage). The last option may need to be done in the operating room.
    1. Postoperative care:  If surgical drainage was done, the wound is usually packed with gauze. The packing keeps the wound open, allowing the infected material to drain outside the body. The wound heals from the bottom to the skin. The skin usually takes several days to close.
• Umbilical drainage:  The doctors will try to determine the cause of the drainage. Depending on the source, the treatments are different.
  • Surgical treatment:  If the doctors determine that there is an abnormal connection to the bladder or the intestines, surgery will be needed to find the connection and close it. This is usually done by making a cut by the belly button.
    • Benefits:  The source of the drainage is found and controlled.
    • Risks:  Bleeding, infection, fluid under the incision
    • Preoperative preparation:  You may be asked to give the child a bath the night before or the morning of the operation. The child should have nothing solid to eat for at least eight hours before surgery.
    • Postoperative care:  Most patients are discharged the same day after surgery or a few days later depending on the extent of surgery. The child should be able to tolerate a regular diet before leaving.

Home Care (“What do I need to do once my child goes home?”)

• For Umbilical Hernia Repairs
  • Diet:  Most patients are able to eat a general diet.
  • Activity:  No activity limitations.
  • Wound care:  The patient can shower in three days but may want to wait 5-7 days after surgery before soaking the wound.
  • Medicines:  Medication for pain such as acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®) or something stronger like a narcotic may be needed to help with pain for a few days after surgery. Stool softeners and laxatives are needed to help regular stooling after surgery, especially if narcotics are still needed for pain.
  • What to call the doctor for:  Problems that may indicate infection such as fevers, wound redness and drainage should be addressed.
  • Follow-up care:  The patient should be seen by a surgeon or pediatrician/family practice doctor at least once to check the surgical wound.
• For Abscess Drainage
  • Diet:  General diet.
  • Activity:  No activity limitations
  • Wound care:  If the child was discharged the same day after the drainage, the packing gauze should be removed the following day. The child may and should shower with soap and water daily. Apply a dry gauze to the area and change as needed.
  • Medicines:  Medication for pain such as acetaminophen (Tylenol®) or ibuprofen (Motrin® or Advil®) or something stronger like a narcotic may be needed to help with pain for a few days after surgery. Stool softeners and laxatives are needed to help regular stooling after surgery, especially if narcotics are still needed for pain.
  • What to call the doctor for:  If the child has such as fevers, wound redness and drainage should be addressed.
  • Follow-up care:  The patient should be seen by a surgeon or pediatrician/family practice doctor at least once to check the surgical wound.

Long term-Outcomes

Children with umbilical hernias, umbilical granulomas, umbilical infections and umbilical drainage do well. Sometimes, umbilical infections can be severe and may involve removal of skin and muscle. Severe infections can be life-threatening.

Care of the umbilical cord, prevention and treatment of omphalitis

The umbilical cord, which connects the baby and the placenta in utero, consists of blood vessels and connective tissue covered with a membrane, which is washed by amniotic fluid. After birth, the umbilical cord is cut and the baby is physically separated from the mother. Within 1-2 weeks of life, the umbilical cord dries up (mummifies), the surface at the place of attachment of the umbilical cord epithelizes and the dry residue of the umbilical cord falls off.Until the umbilical cord has fallen off and the umbilical wound has not epithelized, there is a high probability of penetration of the infectious pathogen through the umbilical vessels into the child’s blood. However, the umbilical cord cannot be sterile, since in the process of normal childbirth and immediately after birth, the baby’s skin, including the umbilical cord, is colonized mainly by opportunistic microorganisms, such as coagulase-negative staphylococci and diphtheroids, as well as conditionally pathogenic bacteria such as E. coli and streptococci.

Umbilical cord transection and cord care are procedures that have been known for a very long time, their technology varies depending on the established practice and cultural characteristics. In many developing countries, the umbilical cord is cut with non-sterile instruments (razors or scissors), after which a variety of substances, such as coal, fat, cow dung or dried bananas, are still used to process the umbilical cord to accelerate mummification and falloff. Such cord care is a source of bacterial infection, including neonatal tetanus, which still occurs in developing countries and contributes significantly to neonatal mortality.The high mortality rate of newborns in developing countries from umbilical sepsis and a decrease in neonatal mortality in countries where the rules of asepsis and antiseptics have long been used for any manipulations on the umbilical cord, including in our country, prove that the prevention of omphalitis is based on cord transection and care behind the umbilical residue with a sterile instrument and clean hands. Nevertheless, there is still no consensus regarding the prevention of infectious pathology associated with the penetration of microorganisms through the vessels of the umbilical cord.Most often, alcohol, silver nitrate solution, iodine preparations, chlorhexidine, aniline dyes (gentian violet, acriflavine, brilliant green solution, etc.) are used for this purpose. Some countries recommend the topical use of antimicrobial agents, including bacitracin, neomycin, nitrofurans, or tetracycline, in the form of moisture-absorbing powders in order to accelerate the mummification of the umbilical cord, in the form of an aqueous and alcoholic solution or ointment. There is also the practice of caring for the umbilical cord without the use of antibacterial or disinfectants; the umbilical cord is kept dry and clean.It was previously recommended to bathe the baby immediately after birth with the addition of disinfectant solutions such as hexachlorophene, as this procedure can reduce skin colonization, however, hexachlorophene is absorbed through the skin and may have neurotoxic effects, so its use in neonatal practice is not currently recommended.

I. Technique of cutting the umbilical cord and processing the umbilical cord in the delivery room

The newborn is taken in a sterile diaper.A sterile individual kit is used for the initial treatment of the newborn.

It is recommended to clamp and cross the umbilical cord 1 min after birth.

It is considered safe to clamp the umbilical cord between 1 and 3 minutes after birth.

Early cord clamping (immediately after delivery) can lead to low hemoglobin levels and late anemia. At the same time, too late clamping of the umbilical cord often leads to the development of hypervolemia and polycythemia, which can be the cause of respiratory disorders, hyperbilirubinemia.

1. Compression and cutting of the umbilical cord (IA):

– The midwife of the maternity ward wearing sterile gloves performs the transection of the umbilical cord.

– Apply one Kocher clamp to the umbilical cord at a distance of 10 cm from the umbilical ring.

– Place the second Kocher clamp on the umbilical cord as close as possible to the external genitals of the woman in labor.

– Apply the third Kocher clamp 2 cm outward from the first.

– Wipe the section of the umbilical cord between the first and third clamps of Kocher with a gauze ball moistened with 95% ethanol solution, cross with sterile scissors.

2. Processing of the umbilical cord:

Currently, the most reliable and safe is a disposable plastic clamp, which is applied to the umbilical cord.

A midwife of the maternity ward in the delivery room performs a plastic clamp on the umbilical cord after the first attachment of the baby to the breast.

Before applying the plastic staple (or ligature), the personnel perform hand hygiene. The place where the clamp is applied is treated with 70% ethyl alcohol.

3. Technique of applying the plastic clamp:

– Change gloves.

– Carry out hygienic treatment of hands.

– Put on sterile gloves.

– Squeeze blood from the umbilical ring to the periphery with a sterile gauze pad.

– Treat the area of ​​the umbilical cord with a 70% solution of ethyl alcohol with a sterile gauze napkin.

– Place a plastic clamp on the umbilical cord at a distance of 2-3 cm, but not less than 1 cm from the umbilical ring.If the clamp is applied too close to the skin, the skin of the umbilical ring may become chafed.

– After applying the clamp, cut off the umbilical cord tissue above the clamp, wipe off the blood with a sterile gauze pad.

– If the clamp needs to be removed, use special sterile forceps.

Not recommended: Applying a gauze bandage and reprocessing the umbilical cord immediately after the clamp is applied.

4. Care of the umbilical cord (IA) The umbilical cord undergoes natural mummification and independent separation within 2 weeks.The final epithelialization of the umbilical wound occurs within 3-4 weeks after birth.

During daily examination of the umbilical cord, it is necessary to pay attention to the stage of the natural separation of the umbilical cord:

– the umbilical cord dries up, decreases in volume;

– becomes denser;

– becomes dark brown;

– separated from the child’s body;

– the bottom of the umbilical wound is covered with epithelium.

Recommended:

– No sterile conditions are required to care for the umbilical cord.

– It is enough to keep the umbilical cord residue dry and clean, to protect it from contamination with urine, feces, as well as from injury – exclude tight swaddling or the use of disposable diapers with tight fixation.

– In case of contamination (urine, feces), the umbilical cord residue and the skin around the umbilical ring should be washed with water and the liquid soap used in the compartment and dried with a clean gauze cloth.

The timing of discharge from the obstetric hospital is determined by the state of health of the mother and child.From an epidemiological point of view, including in order to reduce the frequency of purulent-inflammatory diseases of the umbilical wound, early discharge on the 3-4th day after childbirth is justified, including before the umbilical cord falls off. In other words, the discharge of a newborn home does not depend on the time when the umbilical cord remains.

Before discharge by the doctor, the neonatologist advises the mother / parents on the care of the newborn, including the care of the skin and umbilical cord, with a corresponding note in the medical documentation of the newborn.

Not recommended:

– to use bandages and additional tying of the umbilical cord to accelerate the fall of the umbilical cord;

– to treat the umbilical cord residue with any antiseptics (solutions of aniline dyes, alcohol, potassium permanganate solution, etc.), since the local use of antiseptics not only does not reduce the frequency of infections, but also helps to delay the spontaneous fall of the umbilical cord residue.

– Forcible removal (cutting off) of the umbilical cord is not recommended, since such a procedure can cause severe complications (bleeding, injury to the intestinal wall with an undiagnosed umbilical cord hernia, infection).The effectiveness of this procedure has not been proven, and the potential danger is obvious. Forced removal of the umbilical cord remains should be recognized as an unreasonable invasive intervention, potentially dangerous for the life of the newborn.

II. Diagnostics and treatment of omphalitis (IB) Omphalitis is an inflammatory process of the bottom of the umbilical wound, skin and subcutaneous tissue around the navel, umbilical vessels.

Classification according to ICD X: R-38

Children who have been diagnosed with omphalitis, regardless of the form, should be transferred from the obstetric hospital to the department of pathology of newborns and premature babies, and in severe cases of necrotic form of omphalitis – in the department surgery of newborns.

Etiology: the most common pathogens are bacteria –

gram-positive ( S. aureus ) and gram-negative ( E. coli, P. mirabilis, P. vulgaris, M. morganii), P. aeruginosa , etc.

Clinical forms:

– simple omphalitis;

– phlegmonous omphalitis (diffuse-purulent);

– necrotizing omphalitis.

Simple omphalitis:

The most favorable prognostic form is the most common simple form (weeping navel) (Fig. 1):

– local hyperemia;

– edema of the umbilical (umbilical) ring;

– infiltration of subcutaneous fatty tissue around the umbilical ring;

– long-term non-healing umbilical wound, from which there is serous or serous-purulent discharge;

– periodically the umbilical wound is covered with a crust of an unpleasant odor from the umbilical cord or discharge from the umbilical wound;

– excessive growth of granulating tissue is possible, which leads to the formation of fungus;

– the general condition of the child does not suffer.

Phlegmonous omphalitis (diffuse-purulent) (Fig. 2): in addition to the symptoms described above, the following are noted:

– the spread of the inflammatory process to the surrounding tissues;

– hyperemia and infiltration of the skin in the navel;

– an umbilical wound in the form of an ulcer, covered with fibrinous overlays, surrounded by a dense skin ridge;

– discharge of pus from the umbilical wound when pressing on the umbilical region;

– phlegmon of the anterior abdominal wall;

– deterioration of the general condition, increase in intoxication, increase in body temperature.

Necrotic omphalitis is observed in weakened children with the addition of an anaerobic infection (Fig. 3):

– necrosis of the skin and subcutaneous tissue (The necrotic process can cover all layers of the anterior abdominal wall and cause peritonitis);

– the mummification of the umbilical cord remains suspended, it becomes wet, takes on a dirty brown tint and an unpleasant putrid odor;

– a severe complication of phlegmonous and necrotic forms of omphalitis is an ascending infection – thrombosis of the umbilical, portal veins, portal hypertension, liver abscesses and sepsis.

Tactics of treatment of simple, phlegmonous and necrotic forms of omphalitis

1. In order to control the detection, operational (daily) registration of pyoinflammatory diseases, including anti-epidemic measures in the prescribed manner, the attending physician promptly brings information to the head of the department and the hospital epidemiologist (assistant epidemiologist) about the case (s) in the newborn (s) of phlegmonous and / or necrotic forms of omphalitis.

2. Ultrasound examination of internal organs (with suspicion of phlegmonous or necrotic form of omphalitis).

3. The following laboratory tests are prescribed:

– clinical blood test;

– blood culture with determination of the sensitivity of microflora to antibiotics;

– sowing a detachable umbilical wound to identify bacterial pathogens;

– determination of markers of the systemic inflammatory response (procalciotonin, C-reactive protein).

4. Additionally with phlegmonous form of omphalitis:

– consultation of a pediatric surgeon to confirm the diagnosis;

– hospitalization in the children’s surgical department is required;

– surgical intervention required;

– antibiotic therapy is prescribed, taking into account the sensitivity to drugs, immunosubstitution therapy with immunoglobulin preparations for intravenous infusion according to the instructions for the drug.

5.Additionally, for necrotic omphalitis:

– consultation with a pediatric surgeon to confirm the diagnosis;

– hospitalization in the children’s surgical department is required;

– surgical intervention required;

– antibiotic therapy is prescribed taking into account sensitivity to drugs, detoxification therapy, immunosubstitution therapy with immunoglobulin preparations for intravenous infusion according to the instructions for the drug.

6.Antibacterial therapy for phlegmonous and necrotizing omphalitis until the results of inoculation and sensitivity of microflora are obtained, parenteral (intravenous or intramuscular) administration of drugs from the group of penicillins in combination with aminoglycosides is recommended, doses, method and frequency of administration are determined by the instructions for the drug.

In case of ineffectiveness of treatment within 3 days , the antibiotic therapy is changed to cephalosporins of the second generation (cefuroxime), doses, method and frequency of administration are determined by the instructions for the drug.

When identifying methicillin-resistant Staphylococcus aureus (MRSA), drugs from the group of glycopeptides (vancomycin) are prescribed, doses, method and frequency of administration are determined by the instructions for the drug.

7. Local treatment.

– If only redness of the umbilical ring is noted, without edema and spread of erythema to the skin around the umbilical ring, treatment is not required.

– In complicated forms of omphalitis (phlegmonous and necrotic), the scope of conservative therapy and indications for surgery is determined by the surgeon.

III. Prevention (IA) 1. Compliance with the rules of asepsis and antiseptics when working with newborns.

2. Compliance with the technique of crossing the umbilical cord, processing the umbilical cord in the delivery room, provided for by this protocol.

3. “Dry method” of the umbilical residue.

4. Providing a hospital epidemiologist (assistant epidemiologist), deputy chief physician of the hospital together with the heads of structural units for active detection of nosocomial infections by prospective observation, which consists in the following: diseases;

– receiving daily information from all functional units of the maternity hospital (department) about cases of infectious diseases among newborns and women in childbirth, violations of the sanitary and epidemiological regime, the results of bacteriological studies;

– investigation of the causes of their occurrence and information of the management for taking urgent measures.

5. Registration and registration of newborn diseases caused by opportunistic microorganisms is carried out in accordance with the ICD-10 codes.

6. Implementation of the principles of infection control with regular audits of infectious and inflammatory diseases in obstetric institutions and neonatological hospitals.

7. Consulting the mother (parents) on the care of the newborn’s skin, umbilical cord in conditions of joint stay and after discharge from the maternity hospital, with a note in the history of the child’s development.

Literature

1. Elhassani S.B. The umbilical cord: care, anomalies, and diseases // South. Med. J. – 1984. – Vol. 77, No. 6. – P. 730-736.

2. Centers for Disease Control and Prevention (CDC). Neonatal tetanus – Montana, 1998 // MMWR Morb. Mortal. Wkly Rep. – 1998. Nov. 6. – Vol. 47, No. 43. -P. 928-930.

3. The World Health Report 1998. Life in the 21st century. A vision for all. Geneva. World Health Organization; 1998, CHRPSR 1999 // Int.J. Epidemiol. – 1997. – Vol. 26, No. 4. – P. 897-903.

4. Bennett J., Macia J., Traverso H. et al. Protective effects of topical antimicrobials against neonatal tetanus. Source Task Force for Child Survival and Development. – Atlanta, Georgia, USA: Meegan, 2001.

5. Dore S., Buchan D., Coulas S. Alcohol versus natural drying for newborn cord care // JOGNN. – 1998. – Vol. 27. – P. 621-627.

6. Zupan J., Garner P. Topical umbilical cord care at birth (Cochrane Review) // The Cochrane Library.- 2001. – Is. 2. Oxford, Copyright © 2007 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd World Health Organization, Reproductive Health (Technical Support) Maternal and Newborn Health / Safe Motherhood, Geneva. Care of the Umbilical Cord, A review of the evidence 1999.

7. Hutton E.K., Hassan E.S. Late vs early clamping of the umbilical cord in full-term neonates. Systematic review and metaanalysis of controlled trials // JAMA. – 2007. – Vol. 297. – P.1241 1252.

8. Shabalov N.P. Neonatology: Textbook. allowance: In 2 volumes, 5th ed., rev. and add. – M .: MEDpress-inform, 2009. – T. 1. – P. 184.

9. Basic assistance – international experience / Ed. N.N. Volodin, G.T. Dry; scientific. ed. E.N. Baybarina, I.I. Ryumin. – M .: GEOTAR-Media, 2008 .– 208 p. (Specialist Library Series) 10. Cullen T. Embryology, Anatomy, and Diseases of the Umbilicus Together with Diseases of the Urachus. – Philadelphia: W.B. Saunders, 1916.

11. Forshall 1957 Septic umbilical arteritis // Arch. Dis. Child. – 1957. – Vol. 32. – P. 25-30.

12. Kvassnaya L.G., Ostrovsky A.D. Sepsis of newborns. – L .: Medicine, 1975.

13. National leadership / Ed. N.N. Volodin. – M .: GEOTAR-Media, 2007.

14. Shaffer T.E., Baldwin J.N., Rheins M.S. Staphylococcal infections in newborn infants: I. Study of an epidemic among infants and nursing mothers // Pediatrics.- 1956. – Vol. 18. – P. 750-761.

15. Baldwin J.N., Rheins M.S., Sylvester R.F. Staphylococcal infections in newborn infants: III. Colonization of newborn infants by staphylococcus pyogenes // Am. J. Dis. Child. – 1957. – Vol. 94. – P. 107-116.

16. Corner B.D., Crowther S.T., Eades S.M. Control of staphylococcal infection in a maternity hospital: Clinical survey of the prophylactic use of hexachlorophane // Br. Med. J. – 1960. – Vol. 1. – P.1927-1929.

17. Gillespie W.A., Simpson K., Tozer R. Staphylococcal infection in a maternity hospital: Epidemiology and control // Lancet. – 1958. – Vol. II. – P. 1075-1084.

18. Gluck L., Simon H. J., Yaffe S. J. Effective control of staphylococci in nurseries // Am. J. Dis. Child. – 1961. – Vol. 102. – P. 737-739.

19. Gluck L., Wood H. Effect of an antiseptic skin-care regimen in reducing staphylococcal colonization in newborn infants // N.Engl. J. Med. – 1961. – Vol. 265. – P. 1177-1181.

20. Hardyment A.F., Wilson R.A., Cockcroft W. Observations on the bacteriology and epidemiology of nursery infections // Pediatrics. – 1960. – Vol. 25 .– P. 907-918.

21. Hurst V. Transmission of hospital staphylococci among newborn infants: I. Observations on the contamination of a new nursery // Pediatrics. – 1960. – Vol. 25. – P. 11-20.

22. Jellard J. Umbilical cord as reservoir of infection in a maternity hospital // Br.Med. J. – 1957. – Vol. 1. – P. 925-928.

23. Simon H.J., Yaffe S.J., Gluck L. Effective control of staphylococci in a nursery // N. Engl. J. Med. – 1961. – Vol. 265. – P. 1171-1176.

24. Williams C.P.S., Oliver T.K. Nursery routines and staphylococcal colonization of the newborn // Pediatrics. – 1969. – Vol. 44 .– P. 640-646.

25. Mendenhall A.K., Eichenfield L.F. Back to basics: Caring for the newborn’s skin // Contemp. Pediatr.- 2000. – Vol. 17. – P. 98-114.

26. Czarlinsky D.K., Hall R.T., Barnes W.G. Staphylococcal colonization in a newborn nursery, 1971-1976 // Am. J. Epidemiol. – 1979. – Vol. 109. – P. 218-225.

27. Pildes R.S., Ramamurthy R.S., Vidyasagar D. Effect of triple dye on staphylococcal colonization in the newborn infant // J. Pediatr. – 1973. – Vol. 82. – P. 987-990.

28. Barrett F.F., Mason E.O., Fleming D. Brief clinical and laboratory observations: The effect of three cord-care regimens on bacterial colonization of normal newborn infants // J.Pediatr. – 1979. – Vol. 94. – P. 796-800.

29. DeLoache W.R., Cantrell H.F., Reubish G.K. Prophylactic treatment of umbilical stump: Comparison of techniques // South. Med. J. – 1976. – Vol. 69. – P. 627-628.

30. Perry D.S. The umbilical cord: Transcultural care and customs // J Nurse Midwifery. – 1982. – Vol. 27. – P. 25-30.

31. Cloherty J.P., Eichenwald E.C., Stark A.R. Manual of Neonatal Care. 6th ed. – Lippincott Williams and Wilkins, 2008.- P. 297-298.

32. Seidel H . M ., Rosenstein B.J., Pathak A., McKay W.H. Primary Care of the Newborn. 4th ed. – 2006. – P. 391-393.

33. Novack A.H., Mueller B., Ochs H. Umbilical cord separation in the normal newborn // Am. J. Dis. Child. – 1988. – Vol. 142. – P. 220-223.

34. Medves J.M., O ‘ Brien B.A.C. Cleaning solutions and bacterial colonization in promoting healing and early separation of the umbilical cord in healthy newborns // Can.J. Public Health. – 1997. – Vol. 88. – P. 380-382.

35. Howard R. The appropriate use of topical antimicrobials and antiseptics in children // Pediatr. Ann. – 2001. – Vol. 30. – P. 219-224.

36. Spray A., Siegfried E. Dermatologic toxicology in children // Pediatr. Ann. – 2001. – Vol. 30. – P. 197-202

37. Paes B., Jones C.C. An audit of the effect of two cord-care regimens on bacterial colonization in newborn infants // Qual.Rev. Bull. – 1987. – Vol. 13. – P. 109-113.

38. Gladstone I.M., Clapper L., Thorp J.W. Randomized study of six umbilical cord care regimens: Comparing length of attachment, microbial control, and satisfaction // Clin. Pediatr. – 1988. – Vol. 27. – P. 127-129.

39. Verber I.G., Pagan F.S. What cord care: If any? // Arch. Dis. Child. – 1993. – Vol. 68. – P. 594-596.

40. Darmstadt G.L., Dinulos J.G. Neonatal skin care // Pediatr.Clin. North Am. – 2000. – Vol. 47. – P. 757-782.

41. Stark V., Harrisson S.P. Staphylococcus aureus colonization of the newborn in a Darlington hospital // J. Hosp. Infect. – 1992. – Vol. 21. – P. 205-211.

42. Watkinson M., Dyas A. Staphylococcus aureus still colonizes the untreated neonatal umbilicus // J. Hosp. Infect. – 1992. – Vol. 21. – P. 131-135.

43. Andrich M.P., Golden S.M. Umbilical cord care: A study of bacitracin ointment vs.triple dye // Clin. Pediatr. – 1984. – Vol. 23 .– P. 342-344.

44. Taquino L.T. Promoting wound healing in the neonatal setting: Process versus protocol // J. Perinat. Neonat. Nurs. – 2000. – Vol. 14. – P. 104-115.

45 McConnell T. P., Lee C. W., Couillard M. et al. Trends in Umbilical Cord Care: Scientific Evidence for Practice NBIN. – 2004. – Vol. 4, No. 4. – P. 211-222. © 2004 W.B. Saunders.

46. Mullany L.C., Darmstadt G.L., Khatry S.K. et al. Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster-randomized trial // Lancet. – 2006. Mar. 18. – Vol. 367, N 9514. – P. 910-918.

47. Capurro H. Topical umbilical cord care at birth: RHL commentary (last revised: 30 September 2004). The WHO Reproductive Health Library. – Geneva: World Health Organization, 2004.

48. Sanitary and epidemiological rules and regulations.SanPiN 2.1.3.2630 – 10

49. Resolution of the Chief State Sanitary Doctor of the Russian Federation of May 18, 2010 No. 58, IV, pp.76-95.

Umbilical treatment. Umbilical cord falling off.

Everyone knows that the umbilical cord connects the fetus to the placenta, which is placed in the uterus, and that the embryo receives nutrition through this umbilical cord, which enters its body through the navel.

At the moment of birth, the umbilical cord pulsates, because arteries and veins pass through it, blood continues to flow into it through the placenta, then it stops pulsing, and then it is cut and a special clamp is applied, which is called the “Bar clamp” and remains there until then until the remainder of the umbilical cord falls off.

Indeed, this stump dries up and falls off on the 5th or 6th day after birth, and the umbilical fossa will begin to heal, although it may become wet for several days.

At the same time, the blood vessels that were in the umbilical cord, and now have lost all physiological necessity for the newborn’s body, begin to clog, narrow and retract into the center of the navel.

In a very young child, the navel is formed by a kind of small fibrous ring, inside of which the little finger pad can fit; in the future, this ring will gradually narrow and close, giving the navel the same shape that it has in an adult.

Now 2 small problems may arise.

The navel really heals only on the 12-15th day of a child’s life. Until then, you need to take care of it, wipe it with an alcohol solution or disinfectant solution and constantly cover it with a sterile dressing, fixing it with an elastic mesh bandage.If the navel continues to get wet, this usually means that granular tissue is formed there, which the doctor cauterizes with 5% nitrate solution silver to speed up healing.

Even if the navel does not stop getting wet, you should not postpone the first bath for more than 15 days of life, because without this it is impossible to properly observe the baby’s hygiene.

It often happens that the umbilical ring closes rather slowly, and a small, about 1 cm in diameter, umbilical hernia occurs. The ring can close completely only by the end of the first year of a child’s life. Sometimes, even after reaching this age, the navel remains convex and finally retracts after a few years, when the abdominal muscles get stronger.This small hernia, as you can see for yourself on any beach, is quite common in babies, but rarely seen in older people.

If the diameter of the umbilical hernia remains much more than 1 cm and after the child is one year old, you should consult a surgeon.

Within 1 or 2 months of life, you can apply a simple method of treating a hernia, which consists in stitching a coin clearly larger than the umbilical ring into the tissue and securing it with an elastic bandage.This will prevent areas of the intestine from remaining inside the umbilical ring, preventing it from closing, which, recall, occurs naturally.

I have often observed in 3 month old children an umbilical hernia, which completely disappeared by 6-8 months. Therefore, it is very rarely necessary to offer surgical treatment for this.

ago – 18. Sleep. Awakening. How does your baby move? How to stack it?

further – 20.Eye, nail, scalp care.

90,000 Fungus navel in newborns – causes, symptoms, diagnosis and treatment

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape. The cause of the disease is prolonged healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis. It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch.Uncomplicated fungus proceeds without pain or discomfort. For diagnosis, a visual inspection is sufficient. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

General

Belly button fungus is a common neonatal problem that affects 1 in 500 babies, and is equally common in boys and girls. The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue.The disease itself does not pose a risk to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a prolonged healing process of the umbilical wound caused by improper skin care of newborns or inflammation of the navel. Omphalitis ranks first among the purulent-inflammatory processes in children of the first month of life, but it does not always end with the development of fungus.A risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to a pediatrician, when omphalitis has become widespread and passed into a phlegmonous form. There are studies confirming that navel fungus is more common in post-term babies or in babies with congenital abnormalities and reduced reactivity of the body.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers.After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – young connective tissue, which has a granular surface and contains a large number of capillaries. Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life. With a sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of blood vessels begins to form.The formation grows outward and is not covered with epithelium. This is how the fungus is formed.

Symptoms

Fungus is distinguished by specific visual signs by which parents can easily recognize it. At 2-3 weeks of life, an excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns. In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base.Fungus sizes vary from a few millimeters to 1 cm.

Growth does not cause discomfort in newborns. In the normal state, fungus is painless and does not manifest itself in any way. If the formation reaches a large size, the child shows anxiety when swaddling or carelessly handling the umbilical wound. Uncomplicated forms of the disease proceed without general symptoms, do not disturb the state of health and represent only an aesthetic problem.

When fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the granulation surface are observed.A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, does not gain weight well. When turning over and changing the diaper, the newborn cries out loudly, as touching causes pain.

Complications

Granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins. Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues.In the absence of timely treatment, the disease turns into a necrotic form.

Active bacterial inflammation of the navel tissues is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can be carried throughout the body. As a consequence, in newborns with reduced immune responses, there is a risk of manifestation of umbilical sepsis.

Diagnostics

The child is examined by a pediatrician.Fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of the newborn are sufficient to make a diagnosis. Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is performed:

• bacterial sowing of the discharge from the wound;
• general analysis of blood and urine;
• Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Small fungus can be successfully treated with medication.To destroy excess granulation, the doctor cauterizes the umbilical wound with silver nitrate. After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and accelerate healing.

With the development of phlegmonous inflammation in the area of ​​the fungus, systemic antibiotic therapy is carried out in newborns, with reduced immune reactivity, the introduction of immunoglobulins is possible.For local treatment of purulent wounds, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus from 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgery is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines.Necrotizing inflammation requires extensive excision within healthy tissue.

Forecast and prevention

Fungus is not a life-threatening disease, the prognosis for newborns is favorable. After the removal of the overgrown granulations and the healing of the navel, the cosmetic defect does not remain. Complicated forms with inflammation of the phlegmonous type, in which bacterial pathogens may enter the bloodstream, are of concern. The success of treatment in this case depends on the timeliness of the visit to the doctor.

The basis of prevention is the proper care of the umbilical residue in the neonatal period: it is important to avoid contamination of the wound with urine or feces, wash and dry the navel area daily, do not cover it with a diaper to give air access, accelerating healing. Preventive measures include early detection and treatment of catarrhal omphalitis to eliminate the risk of granulation formation.

90,000 Fungus navel in newborns – causes, symptoms, diagnosis and treatment

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape.The cause of the disease is prolonged healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis. It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch. Uncomplicated fungus proceeds without pain or discomfort. For diagnosis, a visual inspection is sufficient. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

General

Belly button fungus is a common neonatal problem that affects 1 in 500 babies, and is equally common in boys and girls. The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue. The disease itself does not pose a risk to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a prolonged healing process of the umbilical wound caused by improper skin care of newborns or inflammation of the navel. Omphalitis ranks first among the purulent-inflammatory processes in children of the first month of life, but it does not always end with the development of fungus. A risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to a pediatrician, when omphalitis has become widespread and passed into a phlegmonous form.There are studies confirming that navel fungus is more common in post-term babies or in babies with congenital abnormalities and reduced reactivity of the body.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers. After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – young connective tissue, which has a granular surface and contains a large number of capillaries.Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life. With a sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of blood vessels begins to form. The formation grows outward and is not covered with epithelium. This is how the fungus is formed.

Symptoms

Fungus is distinguished by specific visual signs by which parents can easily recognize it.At 2-3 weeks of life, an excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns. In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base. Fungus sizes vary from a few millimeters to 1 cm.

Growth does not cause discomfort in newborns. In the normal state, fungus is painless and does not manifest itself in any way.If the formation reaches a large size, the child shows anxiety when swaddling or carelessly handling the umbilical wound. Uncomplicated forms of the disease proceed without general symptoms, do not disturb the state of health and represent only an aesthetic problem.

When fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the granulation surface are observed. A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, does not gain weight well.When turning over and changing the diaper, the newborn cries out loudly, as touching causes pain.

Complications

Granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins. Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues. In the absence of timely treatment, the disease turns into a necrotic form.

Active bacterial inflammation of the navel tissues is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can be carried throughout the body. As a consequence, in newborns with reduced immune responses, there is a risk of manifestation of umbilical sepsis.

Diagnostics

The child is examined by a pediatrician. Fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of the newborn are sufficient to make a diagnosis.Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is performed:

• bacterial sowing of the discharge from the wound;
• general analysis of blood and urine;
• Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Small fungus can be successfully treated with medication. To destroy excess granulation, the doctor cauterizes the umbilical wound with silver nitrate.After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and accelerate healing.

With the development of phlegmonous inflammation in the area of ​​the fungus, systemic antibiotic therapy is carried out in newborns, with reduced immune reactivity, the introduction of immunoglobulins is possible. For local treatment of purulent wounds, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus from 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgery is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines. Necrotizing inflammation requires extensive excision within healthy tissue.

Forecast and prevention

Fungus is not a life-threatening disease, the prognosis for newborns is favorable.After the removal of the overgrown granulations and the healing of the navel, the cosmetic defect does not remain. Complicated forms with inflammation of the phlegmonous type, in which bacterial pathogens may enter the bloodstream, are of concern. The success of treatment in this case depends on the timeliness of the visit to the doctor.

The basis of prevention is the proper care of the umbilical residue in the neonatal period: it is important to avoid contamination of the wound with urine or feces, wash and dry the navel area daily, do not cover it with a diaper to give air access, accelerating healing.Preventive measures include early detection and treatment of catarrhal omphalitis to eliminate the risk of granulation formation.

90,000 Fungus navel in newborns – causes, symptoms, diagnosis and treatment

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape. The cause of the disease is prolonged healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis.It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch. Uncomplicated fungus proceeds without pain or discomfort. For diagnosis, a visual inspection is sufficient. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

General

Belly button fungus is a common neonatal problem that affects 1 in 500 babies, and is equally common in boys and girls.The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue. The disease itself does not pose a risk to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a prolonged healing process of the umbilical wound caused by improper skin care of newborns or inflammation of the navel.Omphalitis ranks first among the purulent-inflammatory processes in children of the first month of life, but it does not always end with the development of fungus. A risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to a pediatrician, when omphalitis has become widespread and passed into a phlegmonous form. There are studies confirming that navel fungus is more common in post-term babies or in babies with congenital abnormalities and reduced reactivity of the body.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers. After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – young connective tissue, which has a granular surface and contains a large number of capillaries. Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life.With a sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of blood vessels begins to form. The formation grows outward and is not covered with epithelium. This is how the fungus is formed.

Symptoms

Fungus is distinguished by specific visual signs by which parents can easily recognize it. At 2-3 weeks of life, an excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns.In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base. Fungus sizes vary from a few millimeters to 1 cm.

Growth does not cause discomfort in newborns. In the normal state, fungus is painless and does not manifest itself in any way. If the formation reaches a large size, the child shows anxiety when swaddling or carelessly handling the umbilical wound. Uncomplicated forms of the disease proceed without general symptoms, do not disturb the state of health and represent only an aesthetic problem.

When fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the granulation surface are observed. A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, does not gain weight well. When turning over and changing the diaper, the newborn cries out loudly, as touching causes pain.

Complications

Granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins.Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues. In the absence of timely treatment, the disease turns into a necrotic form.

Active bacterial inflammation of the navel tissues is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can be carried throughout the body. As a consequence, in newborns with reduced immune responses, there is a risk of manifestation of umbilical sepsis.

Diagnostics

The child is examined by a pediatrician. Fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of the newborn are sufficient to make a diagnosis. Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is performed:

• bacterial sowing of the discharge from the wound;
• general analysis of blood and urine;
• Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Small fungus can be successfully treated with medication. To destroy excess granulation, the doctor cauterizes the umbilical wound with silver nitrate. After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and accelerate healing.

With the development of phlegmonous inflammation in the area of ​​the fungus, systemic antibiotic therapy is carried out in newborns, with reduced immune reactivity, the introduction of immunoglobulins is possible.For local treatment of purulent wounds, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus from 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgery is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines.Necrotizing inflammation requires extensive excision within healthy tissue.

Forecast and prevention

Fungus is not a life-threatening disease, the prognosis for newborns is favorable. After the removal of the overgrown granulations and the healing of the navel, the cosmetic defect does not remain. Complicated forms with inflammation of the phlegmonous type, in which bacterial pathogens may enter the bloodstream, are of concern. The success of treatment in this case depends on the timeliness of the visit to the doctor.

The basis of prevention is the proper care of the umbilical residue in the neonatal period: it is important to avoid contamination of the wound with urine or feces, wash and dry the navel area daily, do not cover it with a diaper to give air access, accelerating healing. Preventive measures include early detection and treatment of catarrhal omphalitis to eliminate the risk of granulation formation.

90,000 Fungus navel in newborns – causes, symptoms, diagnosis and treatment

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape.The cause of the disease is prolonged healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis. It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch. Uncomplicated fungus proceeds without pain or discomfort. For diagnosis, a visual inspection is sufficient. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

General

Belly button fungus is a common neonatal problem that affects 1 in 500 babies, and is equally common in boys and girls. The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue. The disease itself does not pose a risk to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a prolonged healing process of the umbilical wound caused by improper skin care of newborns or inflammation of the navel. Omphalitis ranks first among the purulent-inflammatory processes in children of the first month of life, but it does not always end with the development of fungus. A risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to a pediatrician, when omphalitis has become widespread and passed into a phlegmonous form.There are studies confirming that navel fungus is more common in post-term babies or in babies with congenital abnormalities and reduced reactivity of the body.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers. After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – young connective tissue, which has a granular surface and contains a large number of capillaries.Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life. With a sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of blood vessels begins to form. The formation grows outward and is not covered with epithelium. This is how the fungus is formed.

Symptoms

Fungus is distinguished by specific visual signs by which parents can easily recognize it.At 2-3 weeks of life, an excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns. In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base. Fungus sizes vary from a few millimeters to 1 cm.

Growth does not cause discomfort in newborns. In the normal state, fungus is painless and does not manifest itself in any way.If the formation reaches a large size, the child shows anxiety when swaddling or carelessly handling the umbilical wound. Uncomplicated forms of the disease proceed without general symptoms, do not disturb the state of health and represent only an aesthetic problem.

When fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the granulation surface are observed. A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, does not gain weight well.When turning over and changing the diaper, the newborn cries out loudly, as touching causes pain.

Complications

Granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins. Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues. In the absence of timely treatment, the disease turns into a necrotic form.

Active bacterial inflammation of the navel tissues is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can be carried throughout the body. As a consequence, in newborns with reduced immune responses, there is a risk of manifestation of umbilical sepsis.

Diagnostics

The child is examined by a pediatrician. Fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of the newborn are sufficient to make a diagnosis.Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is performed:

• bacterial sowing of the discharge from the wound;
• general analysis of blood and urine;
• Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Small fungus can be successfully treated with medication. To destroy excess granulation, the doctor cauterizes the umbilical wound with silver nitrate.After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and accelerate healing.

With the development of phlegmonous inflammation in the area of ​​the fungus, systemic antibiotic therapy is carried out in newborns, with reduced immune reactivity, the introduction of immunoglobulins is possible. For local treatment of purulent wounds, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus from 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgery is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines. Necrotizing inflammation requires extensive excision within healthy tissue.

Forecast and prevention

Fungus is not a life-threatening disease, the prognosis for newborns is favorable.After the removal of the overgrown granulations and the healing of the navel, the cosmetic defect does not remain. Complicated forms with inflammation of the phlegmonous type, in which bacterial pathogens may enter the bloodstream, are of concern. The success of treatment in this case depends on the timeliness of the visit to the doctor.

The basis of prevention is the proper care of the umbilical residue in the neonatal period: it is important to avoid contamination of the wound with urine or feces, wash and dry the navel area daily, do not cover it with a diaper to give air access, accelerating healing.Preventive measures include early detection and treatment of catarrhal omphalitis to eliminate the risk of granulation formation.

Daily care of a newborn “KGBUZ” Taimyr MRB “

Basic procedures

What is daily newborn care, how to wash your baby and take care of the umbilical wound, how to change diapers, take care of your nails, feed your baby and walk with him – we will tell you about these basic procedures for caring for a newborn in our article.

When it comes time to return home with a newborn from the hospital, every mother begins to worry about how she will take care of the baby without the help and competent advice of the medical staff.

Without exception, all mothers are worried whether they can provide their child with the care necessary for his healthy growth: to bathe the baby correctly, cut off his nails, treat the umbilical wound.

Therefore, before the mothers have time to cross the threshold of their home, they have many questions about caring for the child: is it worth washing the baby after each urination, what is the best way to treat the navel: brilliant green or calendula tincture?

Today we will try to find answers to the main questions about baby hygiene and talk about the basic procedures of daily baby care.
Morning toilet for a newborn

Like every person, a baby should wash in the morning, of course, his mother should help him with this.

After the newborn wakes up, strip him naked, let him lie naked for a while – this is good for the baby’s skin. Then carefully examine the baby, check for redness on the skin, prickly heat. If so, prepare a baby cream to lubricate problem areas after washing your baby.

The baby is washed with cotton pads dipped in warm boiled water.Washing the newborn is carried out from top to bottom.
Wipe your baby’s eyes from the outer edge to the inner edge. For the hygiene of each eye, it is recommended to take a new cotton pad.
Gently wipe the baby’s face with a damp cotton pad, the ears – outside, the skin behind the ears, the neck.
Listen to the baby’s breathing, it should be free. If breathing is difficult, clear your baby’s nose. To do this, you can use a special saline solution for children under one year old and an aspirator (a device that helps to suck out mucus).
You can also remove crusts from the spout using two small cotton balls dipped in baby oil. The flagella must be carefully inserted into each nostril of the child’s nose and rotated several times. If your baby’s nose is breathing well, then it doesn’t need to be cleaned.
Then you need to wipe all the folds of the baby’s skin with a damp cotton pad, replace the baby’s dirty diaper with a clean one by washing the baby or using baby wipes to cleanse the skin.

Umbilical wound care

During the neonatal period, a special place on the child’s body is the umbilical wound, which requires careful care.
As a rule, the umbilical wound is treated once a day, you can do this after bathing, when all the crusts are soaked from the water and the mucus is washed out.

How to treat a newborn’s navel? There are several ways to treat the umbilical wound, each of them is quite effective:

• caring for the navel with boiled water – for this, once a day, moisten a cotton pad with boiled water and wipe the umbilical wound thoroughly so that it becomes clean, then for dry the navel for a few minutes;
• treatment of the navel with hydrogen peroxide and antiseptic (chlorhexidine, baneocin, levomekol, iodine, brilliant green, alcohol-based chlorophyllipt) – to treat the navel, take two cotton swabs, dip one in peroxide, the other – in the antiseptic , with which we wash all the crusts from the navel, and then with an antiseptic.

Recommendations regarding the choice of a particular method of navel treatment are usually given by nurses in the maternity hospital, as well as by the visiting nurse who will come to your baby during the first month of life.

Important! If you notice that the skin around the umbilical wound is inflamed, be sure to see your doctor.
If you see that the umbilical wound does not heal within a month, it is better to take the child to the doctor. Usually, up to 14 days of life, the umbilical residue falls off and the wound heals.

Washing the newborn

It is necessary to wash the baby under running water after each bowel movement.

It is convenient to wash the newborn as follows:
Place the baby with his stomach on your left palm facing you or with his back on your forearm with his head facing you.
Place your child’s lower torso under running water.
Lather the baby’s buttocks and genitals with baby soap (it is better to choose liquid soap for children, it is more convenient to use it).
Then wash off the soap thoroughly with water, pat the baby’s skin with a towel or diaper.
If the baby has just urinated into the diaper, then you do not need to wash it, but when changing the diaper, use wet wipes.Choose special baby wipes without fragrances and alcohol.
Changing diapers

Most often, mothers use disposable diapers to care for their children. There are a few simple rules that are important to follow in this case:

When using them, remember that the child should not be in one disposable diaper for more than 4 hours.
It is necessary to put on a diaper on a newborn so that the umbilical remains are not covered. This is necessary for the fastest healing of the umbilical wound.

It is advisable that for several hours a day the baby just lay on the diaper without a diaper so that the skin can breathe.

It is also important to ensure that diaper rash does not form on the skin under the diaper. To prevent diaper rash, it is necessary to dress the baby according to the weather, that is, do not overheat him, and you can also use a special diaper cream.

If diaper rash has already formed, you need to see a doctor, he will recommend a remedy for their healing, most likely it will be a cream containing dexpanthenol – an effective healing medicine.

Of course, it is better to prevent diaper rash, as it can be very painful and disturb the baby.
Bathing a newborn

All mothers are interested in the question: when can you start bathing your baby after leaving the hospital?

“You can bathe the child immediately after discharge, but if you have been vaccinated with BCG, but within a day or two after the vaccination, it is better not to bathe the child, so as not to wet the injection site.”

After the umbilical wound heals, you can bathe the child in a regular bath in tap water, gradually increasing the bathing time from 5 minutes to 30-40.

Every day while bathing the child, it is necessary to wash his genitals and buttocks, 1-2 times a week, you need to wash the entire baby with soap, and also wash the child’s head with a special baby shampoo.

Important! Always bathe your child with the door open in the bathroom, thanks to this, the child will not be so cold after you take him out of the water, since the temperature difference will not be too great.

Each time the baby should be lowered into the water slowly, starting with the legs. The whole body of the child must be supported in the water.If water gets into your baby’s ears or eyes while bathing, it’s not scary, it’s quite natural!

From the very first days of life, you can begin to lightly harden your child. To do this, before you start bathing the baby, prepare and place a vessel with water in the bathroom, the temperature of which will be 0.5-1 degrees lower than the temperature of the water in the bath. At the end of the bath, pour this container over the child.

After bathing, the baby should be blotted with a diaper or towel, but do not wipe it off, as this procedure can damage the delicate baby skin.

You also need to prepare two small cotton filaments and screw them gently into the baby’s ears so that the cotton absorbs the water that gets into the ears during bathing. After the baby’s skin is dry, it is advisable to treat the folds with baby oil.
Newborn’s nail care

It is necessary to take care of baby’s nails 1-2 times a week, as the nails grow very quickly in children. To cut nails, you need to purchase special scissors with rounded ends.On the legs, the nails need to be cut evenly, and on the hands – rounding the edges.
Walking with your baby

In summer, you can walk with your baby the next day after leaving the hospital. It is advisable to protect the child from direct sunlight. It is better to go for a walk in the summer either in the morning (before 10 am), or in the evening (after 6 pm), at this time it is not so hot.

In winter, it is recommended to start walking 2-3 days after leaving the hospital. If the temperature outside is below 10 degrees, it is better not to go out with the baby.

The first walk should be very short – 10-15 minutes. Then walk 10 minutes longer every day.

When preparing for a walk with the baby, mothers usually wonder if they have dressed the baby correctly.