How to Care for Your Baby's Umbilical Cord: Pediatrician Tips

This week we are starting some of our newborn care episodes. What do you need to do to take care of that sweet new little babe that you have brought home from the hospital? And this week we're talking about cord, that umbilical cord, and how to take care of it. Now what do you do with that dry little stump in the middle of your baby's belly that's getting in the way of all those diaper changes? Maybe it smells weird. Maybe it's got a funny color. What's normal? What do you need to be concerned about? And how do you take care of it until it falls off? Yes, if this is your first time meeting us, I'm Sarah. I'm a board certified OBGYN and mom of three. I'm Kurt. I'm a board certified pediatrician and dad of three. And we are the Doctors Bjorkman. All right, that umbilical cord, that is what connects baby to mom. So little belly button connects to placenta. That is how baby gets nutrients, gets rid of waste, all the things. Yep, there's one big vein pulling all of that oxygenated blood in from the placenta, carrying nutrients to the baby, and then two little arteries actually coming out, coming back to mom to deliver that blood to the placenta for filtering, and they get come back to the baby again. Yes, so you may find yourself in the delivery room when your OB says, who's going to cut the cord? Which is kind of like this fun opportunity for dad or loved one to be involved to say, oh, like I'm actually like getting to be the person to help separate baby from mom to help this child enter the world. It's kind of this magical, meaningful moment for some people that I have enjoyed, you know. Or if it's not your jam, your OB will also cut the cord, there's no big deal. But they leave the cord with a little clamp or some sort of, if you're, you know, something to keep the cord from bleeding, because really the baby could bleed out if there wasn't something done to tie off the cord to keep it from leaking, because there's those vessels. Going right in with their little belly button. Coming out, absolutely. And so, but then the course over the upcoming days, you're going to see that there's no longer blood flow going through this umbilical cord, and so it's going to dry out. Yeah, it's like a little scab, a big ugly scab. Yeah, and so then the question is going to be, how do you take care of this? How do you keep it clean over the first few days of life? What to expect? And Kurt's always telling you, leave it alone. Honestly, leave it alone is the best thing. One thing that I think is helpful to think about is what is the timeline for a cord to think about? Generally, they're going to fall off somewhere between five and ten days, maybe up to two weeks. It can be pretty normal that it just takes for that cord stump to dry out and fall off on its own. Yeah, so how about you talk about kind of like progression of how it looks. It goes from this like juicy, plump, white cord stump to... Then it's going to dry out. It's going to get darker, darker brown, almost like dark red, black. And then the cord itself. Now, it's important to note that we're talking about the thing that used to be the juicy connection to the placenta. The skin around it should look normal. Like skin. Like skin. Maybe a little normal, like a little bit of redness is okay, but anything more than that is something that we're going to think about terms of like reasons to be concerned. But definitely, you're just going to notice it dry out. One of the things that gets questions comes up is like, what do you do about it? How do you clean it? What should you do? And as Sarah mentioned, just leave it alone. Let it dry. Don't put alcohol swabs on it. Try to keep it dry. Honestly, you don't want that dying tissue to get moist and be infected. You want it to be dry. That means diaper changes. Don't wipe it. Keep it clean. If you should get some diaper poop or pee on it, rinse it with water briefly, pat it dry, but then leave it alone. I think other things that can irritate it come up. So this is like diaper changes. Really important. We talked all about this in like how to change a diaper, trying to keep the diaper away from it. So if you've got bigger diapers, sometimes they'll roll down that top edge. The brand of diapers we really like has a little cutout for that in the newborn diapers, which is also really nice. All things just to say, hey, how do we leave this alone as it's going through that natural process of drying? The inside of there is healing. The belly button is healing. But then when it finally detaches, there's just normal, fully epithelial skin healed in the belly button. Yeah. It's like a healed scab. Also something that at first they'll put a plastic clamp on the cord. And usually about the time you go home from the hospital, they kind of take that clamp off because the cord has just dried and sealed. And so you'll see that little kind of barrette looking imprint on the cord stump scab that's there. But then that little clamp isn't hanging out in the wind as well. Great. Then the process of like, how is this thing actually going to detach from your baby's body? So over the course of the next one to two weeks, you're going to notice it just is dry. It may have a smell to it. I can tell you like Sarah hates the smell of Hank's cord right now. Once you smell it, you just like can't unsmell it. And I held him up to Kurt today and said, do you smell this? And he's like, no, I don't know. Yeah. I don't know. Maybe I'm immune to smells. I don't know. Maybe you smell more baby's stuff than me. But what you'll see is that slowly, almost like a loose tooth, it's going to start to detach and like, don't play with it too much. Just let it do its own thing. It will fall off while you're changing their diaper, while you're changing their outfit. One of these times it is okay to maybe have a small speck of blood at the time that it finally detaches, but there really shouldn't be any significant bleeding at all associated with it. Okay. If there is, if you want to adapt it with some gauze, et cetera, like those are things you can do just to make sure it's clean, but even after it fully detaches, try to keep it dry for another day after that or so, just to make sure that everything is fully healed and allowed to dry as it should. So no baths, fully submerging baby in water until that umbilical cord is completely detached. Maybe even the next day before you fully submerge baby in water, sponge baths are fine. We'll wash their little hair. All wonderful. No submerging baby. Cause again, you want that cord to stay clean and dry. You want it to be dry and you don't need to do other things to dry it out. Again, no alcohol swabs, things like that, et cetera. Yep. Yep. So what are we worried about? Yeah. So a couple of things that I think about worrying. So definitely would be some sort of early detachment, something like that. They're like, it really is not a risk for you going home. But if there was something immediately in the delivery room before it dried out, like, could there be bleeding, et cetera, as something that's going to happen while you're still in the hospital, before you go home. Okay. Other than that, things to think about, two things that I think about would be one would be infection. So the signs of infection. Now, definitely the smell of the kind of drying out umbilical cord tissue itself is normal. But if there's big redness around the belly button, like an infection of this area, because there's that tract that goes deep inside the belly's abdomen, the baby's abdomen is a high risk for a serious infection. So if you are noticing a lot of big redness around the belly button area, that'd be something to talk to your pediatrician about, have them see right away. Yep. Same with a bunch of discharge, like pussy discharge, that's really foul smelling, it's super wet and goopy, and it doesn't, isn't drying up. That's another thing you're going to want to talk to your pediatrician about. Absolutely. And again, fevers, et cetera, your baby not waking to feeds as they should, not responding, all of those things, reason to call your pediatrician right away. Yep. Other potential complications, sometimes there can be a persistent kind of remnant or tract that has the, that like cord, there's something that keeps it from drying out all the way, and it can kind of have some clear drainage that isn't an infection. Also, this is another thing, if you're like, hey, my baby always had the wet spot on their shirt or their diaper here from their belly button, show your pediatrician that too. There's, um, you can do kind of chemical cautery where you just put a little chemical on that place and just, again, helps dry up that area after the cord's attached, if it's still draining. You feel like it's draining, draining, that's definitely something to talk to the pediatrician about. Um, but just to summarize all of this overall, cord care is pretty simple. Leave it, keep it dry. Let it be. Eventually it'll detach. There may be a little bit of drops of blood at the time, but should be very minimal. If anything, um, if you've got concerns for infection, again, lots of redness around the belly button, foul smelling discharge, call your pediatrician. Yeah. Always, always, always with that new fresh baby, call your pediatrician. They do not want you worrying at home. That's why they're there. Call them. Yeah. Okay. Anyway, stay tuned. We've got more newborn care content coming your guys way in the weeks to come. We're doctors, but not your doctors. Anything we've said in this video is for education or entertainment purposes only. It is not medical advice. Any specific medical questions you have should be directed to your provider.