Belly Button 101: Umbilical Care in Newborns

The umbilical cord has an important job prior to the birth of your baby. It carries oxygen and critical nutrients from mother to baby… and delivers waste products from baby to mother… all by way of the placenta. Following birth, the umbilical cord is clamped and cut, and your baby begins relying on their lungs and gut for these duties. The clamped stump remains attached to the belly button before shriveling up and falling off during the first weeks of life.

Caring for the Umbilical Stump

The umbilical stump does not require much care. In the past, parents were encouraged to wipe the base of the stump with alcohol to facilitate drying. However, now we know this may delay separation of the stump from the belly button. Instead, expose the stump to air as often as possible to encourage drying. Keep the diaper folded over in the front so that it does not cover the stump and leave clothes loose and open to air. Brief baths are okay but dry the stump well following the soak. Eventually, the stump will shrivel and detach from the belly button. There is no need to pull or cut the stump… just let time and nature do their job. If the stump has not separated by three weeks of age, contact your child’s doctor.

Possible Problems

While care of the umbilical stump is easy, there are some possible problems to keep in mind.

• Bleeding - The umbilical stump may leave behind some drops of blood on your baby and the diaper when it separates. If the stump bleeds before or after separation… or if bleeding is anything more than a few drops, let your child’s doctor know!

• Infection - Belly button infections are uncommon, but they can become serious quickly, so it’s important to know the early signs. Watch for red skin around the base of the stump, foul-smelling discharge and crying associated with touching the umbilical stump or surrounding skin. If any of these occur, have your child seen right away.

• Granuloma - As the umbilical stump separates, sometimes it leaves behind a mass of scar tissue that drains a small amount of yellowish fluid. Small granulomas generally resolve on their own, but larger ones may require medical treatment. Let your doctor know if this occurs.

• Hernia - An umbilical hernia is caused by a gap in the muscle wall underneath the belly button. Increased pressure in the abdomen (from crying or straining to have a bowel movement) causes the intestine to bulge out through the opening. These usually correct themselves in the first couple years of life. If an umbilical hernia remains by three to five years of age, surgery may be required to close it. If the bulge seems stuck, and your child is unusually fussy, it may be a sign of the muscle wall cutting off blood supply to the intestine. This is a very rare event, but one that needs immediate attention. Do not use tape or a coin to prevent the hernia from bulging out. They will not help the hernia heal and may result in a rash or break down of skin.

If the thought of caring for your baby’s umbilical stump produces anxiety, remember that you are not alone. This is a common worry for new parents. Fortunately, most umbilical stumps take care of themselves. If you have any questions or concerns about the way it looks, your baby’s doctor is just a phone call away!