Normal Vs Infected Umbilical Cord

What To Do When The Umbilical Cord Is Wet

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Bath Time And Umbilical Cord Care

Until the stump falls off and your baby’s belly button heals, it’s best to stick with sponge bathing so that you avoid soaking the stump in water. You don’t need to sponge bathe your baby every day two or three times a week is usually enough.

You may wish to use sponge bath time to gently clean the umbilical cord stump as well.

To give your little one a sponge bath, get everything ready that you’ll need like

• a bowl of warm water

• a wet cotton swab or cotton ball

Lay your baby down on a padded flat surface â like the changing pad on the changing table, or on the floor on a soft towel â with your supplies within reach. Never leave your baby unattended during the sponge bath if she’s on a raised surface, such as the changing table, keep the safety strap fastened and a hand on her at all times.

Keep your little one covered in a towel so she doesn’t become chilled, exposing only the parts of the body that are being washed. Start with her face, using the damp washcloth but no soap so that you don’t get soap in her eyes. Then add soap to the water and continue to gently clean the rest of her body, especially the folds of her skin around her neck, ears, and genital area.

For the umbilical cord stump area, follow the umbilical cord care tips listed above. You may wish to use a wet cotton ball or a swab to clean the skin around the stump area, being careful not to get the stump itself wet.

Skin Irritation From Dry Cord

The redness superior to the umbilical cord in this photo is simply irritation from the hard, dry umbilical stump rubbing against the abdomen. Because omphalitis is a dangerous condition, redness in this area should be carefully evaluated. However, the localized nature of the redness here, along with the fact that it is somehat removed from the actual insertion of the cord and appears very superficial is reassuring that infection is not the underlying etiology.

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What Is The Umbilical Cord Stump And When Will It Fall Off

The umbilical cord delivered nutrients and oxygen to your baby in the uterus. Soon after your baby is born the cord is clamped and cut. Your baby wouldnât feel this as the umbilical cord has no nerves in it.

The clamp is usually kept in place for 24 to 48 hours. It is removed once what remains of the cord has dried and no longer bleeds.

Once the clamp is removed, what will remain on your little oneâs belly is a little stump. As the umbilical cord stump dries, shrivels, and hardens, it will go from a yellow color to a brownish black.

The umbilical cord stump usually falls off within a few weeks of your babyâs birth. Contact your babyâs healthcare provider if it hasn’t fallen off by the time your little one is 2 months old.

In some cases, there may be an underlying cause for the umbilical cord stump not falling off, such as an infection or an immune system disorder, which your provider will investigate.

After the stump falls off, the skin underneath should be healed. Sometimes, the skin may be a little raw, and a little fluid may seep out. Continue to keep your little oneâs belly button dry and clean and it should soon heal completely. Contact your healthcare provider if it hasnât healed within two weeks of the stump falling off.

Who Is At Risk For Omphalitis

Omphalitis strikes in the days and early weeks following delivery, but it’s rarely seen outside of the neonatal period.

While research doesnt point to babies having an increased risk of infection based on their sex, there are some things that can make a newborn more susceptible, including:

• Birth outside the United States or a home birth

• Chorioamnionitis

• Prolonged rupture of the membranes

If your baby has omphalitis, you will most likely notice the telltale signs of infection three to five days after birth in a preemie, and five to nine days in a full-term baby.

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Helpful Tips To Care For The Umbilical Cord

Follow these helpful guidelines to help protect your baby’s cord stump.

• Whenever you change your baby’s diaper, pay special attention to the area at the base of the cord, nearest to the belly button. Wipe it gently but thoroughly to clean out any moist debris that may have collected. A cotton-tipped applicator works well for this. Don’t worry about hurting your baby â there are no nerve endings in the cord stump.

• Try to allow air to reach the cord stump. This will help it heal and dry faster.

• Try to prevent diapers from rubbing against the stump. You can fold the diaper down under the cord stump, or you can use diapers with a cut-out notch at the top.

• Let the cord stump fall off on its own. In the past, cleaning the stump with rubbing alcohol was often suggested. New data suggest that natural drying will allow the cord to fall off faster.

• Babies are born with ‘innies’ or ‘outies’. Some parents try to cover the umbilical area with coins, bandages or wraps to change what your baby was born with â this won’t work and may irritate the area more.

• While your newborn still has their umbilical cord, it’s best to give a quick top and tail bath rather than submerging the cord stump. Once the cord has fallen off, feel free to bathe your little one in a baby tub or sink.

Caring For Babys Umbilical Cord Stump

Here are a few things to keep in mind until the cord comes off:

• Be gentle. Keep your hands off of it, and donât ever pull on it.
• Keep the cord clean and dry at all times. Skip the tub and sink and give your baby sponge baths instead.
• Leave the cord alone until it falls off by itself.
• Fold diapers so that they rest below the cord to shield it from your little oneâs pee. You can look for diapers that have an area cut out for the cord or cut a spot out of a regular diaper. Just place a piece of tape around it to seal the edges.

If your baby has a messy bowel movement and some stool gets on the cord, clean it gently with soap and water.

Check the cord often for infections. Call your doctor if you see:

• Blood on the end of the cord
• A white or yellow discharge
• Swelling or redness around the cord
• Signs that the area around the cord causes your baby pain

If your baby had a low birth weight because they were born prematurely or had another health issue, they may be more likely to have an infection, so itâs good to keep an especially close eye out for any of these signs.

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Gas Exchange Between Mother And Fetus

All human beings including the fetus inside the uterus before birth depend on two gases, oxygen, and carbon dioxide are being exchanged, oxygen enters the body and carbon dioxide exits the body. After birth, this exchange of gases happens in the lung, oxygen entering the body through inhaling and the lungs, and carbon dioxide leaving through exhaling and the lungs.But before birth, the fetus does not use its lungs the same way we use after birth. The fetus does not breathe in the same way humans do outside the womb . Instead, the exchange of gases, breathing occurs in the placenta where oxygen is transported from the mother’s blood vessels into the placenta and then from the placenta through the umbilical cord to the fetus and carbon dioxide is exchanged from the fetus to the mother.

The placenta is an organ which is attached to the inside of the uterine wall and connects the fetus through the umbilical cord and allows for nutrient exchange, waste elimination and gas exchange via the mothers blood supply.

What Is The Umbilical Cord

The umbilical cord is the lifeline between you and your baby during pregnancy. The cord allows oxygen and nutrient-rich blood to flow to your baby. The cord also carries away the babys waste products. The umbilical cord connects your baby to your placenta and contains two arteries and one vein. After your baby is born, they don’t need the umbilical cord any longer. Your provider will cut the umbilical cord, leaving a short piece of it, called a stump, attached to your babys belly button. The stump will naturally dry up and fall off within a few weeks after birth.

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When To Seek Help

The umbilical cord has direct access to the bloodstream, so even a mild infection can become serious quickly. When an infection enters the bloodstream and spreads , it can cause life-threatening damage to the bodys organs and tissues.

Contact your childs pediatrician immediately if you notice any of the above signs of an umbilical cord infection. Umbilical cord infection is fatal in up to about 15 percent of babies with an umbilical cord infection, so its considered a medical emergency.

Premature babies are at increased risk for severe complications from this type of infection because they already have a weakened immune system.

When To See A Doctor

Any type of infection in a newborn can be an emergency. UCIs require prompt treatment to prevent the risk of complications.

A person should call their doctor immediately if their baby develops signs of an infection. If they cannot get in touch with them, a person should take the baby to their nearest emergency room or urgent care center.

After initial treatment for a UCI, a person should call a doctor if the baby develops any of the following:

• symptoms that do not improve within a day or two
• symptoms that get worse

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Instincts In New Babies

Babies are born knowing how to suck. During the first few days they learn to co-ordinate their sucking with their breathing during feeding.

Newborn babies also automatically turn towards a nipple or teat if it’s brushed against their cheek, and they’ll open their mouths if their upper lip is stroked.

Blood Supply And Lymphatics

The umbilical cord, together with the placenta, contributes to the flow and regulation of fetal circulation. The two umbilical arteries arise from the internal iliac arteries of the fetus and enter the umbilical cord before further branching at the level of the placenta. At the placental level, each umbilical artery bifurcates into smaller arterioles that continue to branch further to distribute blood to the chorionic villi. The capillaries of the villi fuse to form venules that converge to form the umbilical vein. The umbilical vein carries oxygenated blood and nutrients from the mother to the fetus.

As fetal growth ensues, both placental intervillous circulation and umbilical circulation develop gradually, until maturation is complete at the end of the first trimester. At midgestation, the percentage of umbilical blood in fetal circulation is about 30% of the fetal cardiac output. During the last trimester of pregnancy, umbilical blood flow declines significantly as it becomes inversely proportional to the fetal weight measured in kilograms. That percentage decreases considerably during the last trimester till it reaches less than 20%. The umbilical vein enters the abdominal region of the fetus. It carries the oxygenated blood with nutrients to the fetal liver parenchyma and ductus venosus. Then, blood flows to the inferior vena cava and foramen ovale of the fetal heart.

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How Long Does It Take To Recover

When the serious infection is caught early, most babies recover fully within a couple of weeks. But they usually need to stay in the hospital while they receive intravenous antibiotics.

If your baby had surgery to drain the infection, the opening may have been packed with gauze. The gauze will keep the cut open and allow the pus to drain. Once the draining stops, the gauze is removed and the wound will heal from the bottom up.

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.

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Check For Any Sign Of Infection

You should be knowledgeable about the difference between normal vs infected umbilical cord. You should always check for any signs of infection like the umbilical cord smell , umbilical cord bleeding, fever, redness, lethargy, irritation and poor feeding. Once you notice any of these signs while you are cleaning your babys umbilical cord, then it is best to consult your doctor immediately.

What Are The Signs Of Omphalitis

Keep a careful eye on your little one’s belly button, checking for inflammation and discoloration around the umbilical cord area during your baby’s first few weeks of life.

Here are omphalitis signs and symptoms to watch for:

• Pus or a fluid-filled lump on or near the umbilical cord stump

• Red skin spreading from around the navel

• Abdominal swelling

• Cloudy foul-smelling discharge from the infected region

• Bleeding around the umbilical cord stump

• Irritability, lethargy and decreased activity

Since any of these symptoms can occur early on or late in the infection, it’s important to see your pediatrician right away if you suspect a problem.

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Storage Of Cord Blood

The blood within the umbilical cord, known as cord blood, is a rich and readily available source of primitive, undifferentiatedstem cells . These cord blood cells can be used for bone marrow transplant.

Some parents choose to have this blood diverted from the baby’s umbilical blood transfer through early cord clamping and cutting, to freeze for long-term storage at a cord blood bank should the child ever require the cord blood stem cells . This practice is controversial, with critics asserting that early cord blood withdrawal at the time of birth actually increases the likelihood of childhood disease, due to the high volume of blood taken in relation to the baby’s total supply . The Royal College of Obstetricians and Gynaecologists stated in 2006 that “there is still insufficient evidence to recommend directed commercial cord blood collection and stem-cell storage in low-risk families”.

The American Academy of Pediatrics has stated that cord blood banking for self-use should be discouraged , while banking for general use should be encouraged. In the future, cord blood-derived embryonic-like stem cells may be banked and matched with other patients, much like blood and transplanted tissues. The use of CBEs could potentially eliminate the ethical difficulties associated with embryonic stem cells .

What Happens When The Stump Comes Off

Itâs normal to see a few drops of blood in your babyâs diaper. But if thereâs a lot of blood as the cord separates, call your doctor right away.

If the cord hasnât come off after 3 weeks, be patient. Keep the area dry and make sure itâs not covered by your childâs diaper. If it hasnât come off in 6 weeks, or you see signs of fever or infection, call your doctor.

Once the cord is gone, continue to keep the area clean and dry. You might notice a yellow, sticky fluid that oozes out. This is normal. It sometimes happens when the cord comes off. Itâs not pus, and itâs not an infection.

You might also see a scab over the navel. This is normal, too. But if your babyâs stomach gets red, they run a fever, or you notice a cloudy discharge, call your doctor.

Sometimes, a little scar tissue may form a red mass on the belly button. This bump is called an umbilical granuloma. If you see this and it doesnât go away in about a week, let your doctor know. Theyâll apply silver nitrate to it. Itâll burn the area so the tissue dries up. But remember, the cord has no nerves, so your baby wonât feel it.

At some point, youâll probably wonder what kind of belly button your child will have. Will it be an âinnieâ or an âoutieâ? Youâll have to wait until the stump is gone to know for sure. But know that the way your babyâs navel will look has nothing to do with how the doctor cut the umbilical cord.

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Before The Stump Falls Off

Until your baby’s umbilical cord stump falls off:

• wash your hands before and after you touch the cord
• clean around the base of the cord if needed with cotton wool and cooled boiled water
• keep the belly button area dry after you clean it
• inspect the umbilical cord at every nappy change to make sure there is no redness there
• fold your baby’s nappy down, away from the stump
• make sure that the nappy is not covering the cord

Collecting Umbilical Cord Blood Gases

There are several steps involved in collecting umbilical blood cord gases:

The purpose of cord blood gas analysis is to determine the acid-base status of the neonate at the moment of delivery. Since acid-base status is in flux during the perinatal period, the timing of isolating a sample for analysis is crucial.

Immediately after birth, ideally before the babys first breath, an approximate 20-cm segment of the cord must be isolated between two sets of two clamps. Delay in clamping may result in significant change in acid-base parameters the longer the delay, the greater is the change. The change is a progressive decrease in pH and base excess, and an increase in pCO2 and lactate.

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