Baby belly buttons are possibly one of the most adorable things ever…but they don’t start out that way. Belly buttons are essentially scars caused by detachment of the umbilical cord after birth. During pregnancy, an umbilical cord supplies nutrient-rich blood and oxygen to the growing infant. It also carries away the baby’s waste products. After delivery, the umbilical cord is no longer necessary so it is clamped and cut, leaving behind a short stump. The stump will naturally dry up and fall off in about three weeks, leaving behind a cute little belly button.

Proper umbilical cord care for newborns is essential to preventing infection and keeping your little one healthy. Here’s how to care for your newborn’s umbilical cord stump and how to spot signs of a potential problem.

How to Care for Your Newborn’s Umbilical Cord

The first few weeks after your baby is born, it’s important to keep the stump of the umbilical cord clean and dry as it withers and ultimately falls off. Allow the area to air dry. Rubbing alcohol and other topical substances are unnecessary. New research shows that this could destroy healthy bacteria that naturally help separate the stump from your baby’s body. Fold the baby’s diaper below the cord and in toward their tummy to prevent the area from being drenched in urine.

While the American Academy of Pediatrics says a quick submersion bath is acceptable before the cord falls off, many experts agree that a sponge bath is simpler at this stage. Periodically wiping the cord area with plain water and allowing it to air dry may be necessary at times, especially if there’s urine or feces on the cord.

Be patient, and wait for the stump to drop off on its own. Avoid “helping” even if it seems to be barely hanging on. Tugging on the cord may cause bleeding and injury to your infant. You may also notice a tiny bit of blood when the stump finally does drop off. This is not uncommon and is similar to a scab falling off. However, if you notice active bleeding, seek medical attention immediately.

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Risks and Complications

Careful umbilical cord care prevents infections from developing and helps your baby stay healthy. Your baby may have an infection if they develop any of the following symptoms: 

1. The stump oozes pus, a transparent to yellowish fluid that has an odor.
2. The skin around your child’s umbilical cord becomes inflamed and sore to the touch.
3. Your baby has a fever of 100.4°F (38°C) or higher.
4. Your baby is excessively tired or sluggish (fatigue).
5. Your baby isn’t feeding well.
6. Your baby has a weak muscle tone (hypotonia).

Infections can grow rapidly. Contact your baby’s pediatrician if you observe any signs of an infection in your infant.

Umbilical granuloma

When your baby’s umbilical stump drops off, occasionally there’s a tiny bit of tissue that remains on their skin (called a granuloma). This looks like a pink or reddened bump of scar tissue on the belly button. The granuloma may drain pus and then go away after a week. If it remains for longer than a week, your pediatrician may need to burn off (cauterize) the granulomatous tissue.

Umbilical hernia

If your infant’s umbilical cord looks like it’s pushing outward when they cry, they may have an umbilical hernia. An umbilical hernia is a small lump or protuberance beneath your baby’s belly button, giving it an “outie” appearance. This happens when part of your baby’s intestines get stuck in the opening of the abdominal wall, allowing the tissue to bulge when there is increased abdominal pressure. Umbilical hernias are not painful and will normally heal on their own within 18 months. If the hernia doesn’t heal on its own by five years of age, your pediatrician may need to surgically repair that part of your child’s abdominal wall.

Recovery Time

Your newborn’s stump should dry and fall off by the time your baby is 5 to 15 days old. Once the stump falls off and no bleeding is present, you can freely proceed with tub baths. You can also stop folding the front of your baby’s diaper. Visit your baby’s pediatrician if you notice their belly button is inflamed or if their stump hasn’t fallen off after three weeks. This might be a sign of an underlying issue, such as an infection or immune system disorder.

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The Takeaway

The most effective way to care for your newborn’s umbilical cord is to keep it dry and clean. Keep your baby’s diaper folded down in the front so that it doesn’t cover the stump and make it more difficult to dry. Don’t “help” your child’s cord by pulling on it. Consult your baby’s pediatrician if you notice signs of an infection, particularly swelling, fever, or difficulty eating normally.

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