Caring for your baby’s umbilical cord

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New parents often really worry about their baby’s cord stump, especially as it dries and prepares to fall off. Caring for your baby’s cord is fairly straightforward and you should always take your baby to their doctor if you think it has become infected or sore.

What is the umbilical cord?

The umbilical cord is the tube that runs from your baby’s abdomen and attaches his blood supply to your placenta. This allows a continual transfer of oxygen, nutrition and waste products between your baby’s blood and yours. Everything your baby needs to survive and grow is passed down the cord and into your baby’s bloodstream from you.

After your baby is born his cord continues to pulsate.  New evidence recommends that the cord should not be clamped until after it stops pulsating. This allows blood from the placenta to return to the baby’s blood supply and is thought to reduce anaemia in newborns.

When should my baby’s cord fall off?

To separate the cord from your baby a small clamp is put around the cord, a few centimetres from his belly button.  Then the cord is cut, this is a symbolic moment to many new parents and often the dad or birth partner cuts the cord. What is left is called the cord stump and this can then be allowed to dry and fall off naturally, usually sometime between seven and 14 days (although it can also be a little earlier or later).

Sometimes midwives leave the clamp on until the cord falls off naturally. Sometimes they take the clamp off after a few days. The cord will shrivel up, turn dark and fall off. The place where it’s fallen off heals to become your baby’s tummy button, which might be an ‘inny’ or an ‘outy.’

How do I clean my baby’s cord?

It’s important to keep the cord and umbilical stump dry and clean to help make sure it doesn’t get infected. First things first – wash your own hands carefully!

You don’t have to give your baby a full bath to do this – just a top and tail is fine. It’s best to use cooled boiled water – and not any creams or powders. Gently pat the stump with a soft towel or cloth – keeping your baby warm while you do this. You don’t need to use antiseptic on the stump – just water is fine.

However, if your baby is premature and staying in NICU or SCBU, ask the nurses for special advice on looking after your baby’s umbilical cord stump. They might recommend a gentle antiseptic if the staff don’t recommend bathing your baby for a while.

Can I gently pull the cord to help it come off?

Never pull on your baby’s cord. It will fall off when it’s ready.

What do I do if my baby’s cord gets covered in poo?

If the cord gets dirty from the nappy, this is not a problem and you can simply clean your baby in the normal way.

Should my baby’s cord be inside or outside the nappy?

Due to the placement of the cord it can be tricky deciding whether to place the cord and clamp inside or outside your baby’s nappy. This is entirely your choice and depends on however you and your baby feel most comfortable. However, if you do choose to keep the cord inside the nappy, make sure that the nappy waistband is not too tight as this may press the clamp into your baby’s tummy, which may be uncomfortable.

Some nappies have a special gap cut out for the cord – specially designed for newborns. But it’s just as easy to fold an ordinary nappy down if you want to.

My baby’s cord smells, is this normal?

As the cord shrivels and prepares to detach, it is normal for it to be a little smelly.

How can I tell if my baby’s cord is infected?

If the smell from the cord becomes very strong, and there is redness or swelling or some oozing from the base of the stump you should get it assessed by a doctor as this may indicate an infection. Your GP might prescribe a short course of antibiotics in a severe case.

Other signs to look for:

  • If your baby develops a fever, it might mean he is mounting a fever to fight an infection in the cord
  • If your baby becomes lethargic, doesn’t want to feed, or just doesn’t seem well, it also might indicate an infection

It’s always better to show it to your visiting midwife or health visitor if you are concerned, as this is one of the things they check on a home visit.

Will the cord falling off hurt my baby?

Though it can be a concern that the cord is hurting your baby there are no nerve endings present in the cord itself and so you can be sure that this will not be worrying your baby.

What do I do if my baby’s stump doesn’t heal?

Just sometimes, a baby’s stump may take longer to heal than normal. If this is the case, ask your health visitor or midwife to check it for you. They might suggest taking your baby to your GP to see whether it needs to be sealed. Sealing is called ‘cauterisation’. It’s a simple and fairly common procedure and doesn’t hurt the baby.

Has my baby got an umbilical hernia?

An umbilical hernia happens when there is a gap in the muscles of a baby’s abdomen.  When the baby coughs or cries you may see the tummy button appear to stick out or it might stick out all the time.

Umbilical hernias are more common in:

  • Premature babies
  • Baby boys
  • Babies of African descent

Most of the time, as the muscles develop, the hernia will disappear naturally.  However, some babies need help from a doctor to help correct them, either by manually closing the gap (do not try this yourself) or by a simple bit of surgery.

If you are concerned that your baby may have a hernia you can show your midwife, health visitor or GP and they will assess it and decide if any further medical care is required at this stage.