How to Look after your baby’s Umbilical cord stump

What to expect at the birth with the umbilical cord, how to look after it at home. You will feel super confident after reading this!

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So many new parents worry about their baby’s umilical cord. In the past, they used to use all sorts of powders and potions on it, but there’s really no need for anything. In the wild, animals simply chew through the cord or it breaks, and that’s that. You don’t see Giraffes getting out their medical kit! Most parents don’t like the look of them and are afraid of handling them. In this post, I’ll aim to answer some common questions and provide you with all you need to be confident in taking care of your baby’s umbilical cord stump.

What happens with the cord after the birth?

When the baby is born, most care providers will clamp the cord after it has stopped pulsating, most commonly around 3 minutes, whether you’re having an active or physiological third stage, unless the baby needs urgent medical attention. If you’re choosing a lotus birth, where the placenta remains attached to the baby until the cord comes off, then it will simply be left until it falls off. You carry the placenta around with the baby until it does! Clinically, I don’t see any benefit once it’s stopped pulsating, as there’s no more blood to go in and it can pose an infection risk. 

The most common way of clamping the cord is with a plastic clamp, very similar to those food saver clamps. It is very effective. Cutting the cord doesn’t hurt the baby or you, as there are no nerve endings in the cord. Some people choose to use cord ties, which are soft lengths of braided cotton, as they believe it will be more comfortable against baby’s skin. They come in all sorts of colours, often handmade and can even have little hearts or elephants at the bottom. They need to be sterilised first by boiling them and then freezing them before use. They are not so popular amongst health professionals however, as there is a greater risk of them loosening and the baby losing blood and there are concerns about increased risk of infection. They are increasing in popularity and women are now more confident in exercising their right to choose.

Once the cord starts drying though, blood cannot escape and you can remove the plastic clamp then and either tie it or leave it unclamped. Again, in the past, we used to remove the clamps on day 3, but now the practice is that the clamp is left on until the cord stump falls off. They are hard to remove unless you have a tool to remove them.

What will my baby’s cord look like?

The umbilical cord is made up of blood vessels that have been carrying the blood to and from the baby and you to keep them alive inside you. It consists of two arteries and one vein, known as cord vessels. The vein is bigger than the two arteries, and they’re wrapped around each other like those twisted marshmallows. Occasionally the cord can have only 2 vessels (1 artery and 1 vein), which is usually picked up via ultrasound. Your midwife or doctor will check the cord and how many vessels it has. It can be a normal variation, or it could be an indicator of a problem. The whole cord is covered in a casing called Wharton’s Jelly. If your partner is cutting the cord, it will be quite tough cutting through the layers of vessels, jelly, and membrane. It will bleed when cut but doesn’t hurt the baby or you. When the baby is born the cord will have blood still flowing through, most hospitals now practice delayed cord clamping, so that the baby receives the optimal amount of blood; usually, this takes around 3 minutes. Once the blood is no longer in the cord, it looks pale and almost translucent.

umbilical cord care, what to expect and how to look after it

Picture via wikimedia

As it dries, it turns black. Then, the bottom of the cord nearest the belly button will start to separate, looking quite watery and yellowy. Once it falls off you may get some residue in the belly button which will eventually fall out.

detached_umbilical_cord-how-to-look-after

Picture by Greg G (Own work) [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

When will my baby’s cord stump fall off?

It varies. Some fall off within 3 days, others take longer than 2 weeks. Both variations are normal, and it should fall off by 3 weeks at the latest. The ones that fall off early often have a little stump or scab inside the belly button that then comes away later. The average is about 5-7 days.

When you should worry or be concerned about the baby’s umbilical cord stump

You should contact your Midwife or GP if you are worried at all about the baby’s umbilical cord stump, but here are a few normal occurrences:

  • It will smell at the base, it’s rotting away
  • The base of the cord will look yellowy and a bit like pus, but it’s not
  • There may be a small amount of blood

If you notice any of the following, or you’re not sure, contact your Midwife or GP

  • If the skin around the belly button is red or inflamed
  • If the skin around the belly button has a rash
  • If there is bleeding, more than spotting on the nappy
  • If the oozing at the base of the cord is excessively smelly
  • If the baby is unwell, feverish, sleepy, not feeding, not passing urine

How to care for your baby’s umbilical cord stump

Initially, you need to do nothing. When you are changing the baby’s nappy, make sure the clamp (if using) is not pressing against the baby’s skin. Fold down the top part of the nappy before you do up the tapes so that the cord stump is left to dry. Keep doing that until the stump falls off, and longer if there is still some oozing or stump left in. It will dry anyway, even if covered, but doing this helps the process and is more comfortable for the baby. There’s no need to put anything on it, apart from water, which should be cooled boiled water, or sterile water. If there is more than a little muck around the base of the cord, you can clean it.

To clean around the base of the cord, use a clean cotton ball or pad, dip it in sterile water, and gently clean around the base of the cord in a circular motion once all the way round. Then use another cotton ball to avoid possible cross-infection. If it’s quite clean there’s no need to interfere with it. Some health professionals advise not bathing the baby until the cord comes off. This isn’t totally necessary, although the baby doesn’t need a bath and in fact, you shouldn’t bath your baby for the first 8 days at least; you can bath your baby with the cord still on if you think they need it, for example, if they passed meconium on the way out and are covered in it, or there is still a fair amount of blood on them, or if it’s taking it’s time in coming off. Sometimes just a hair wash will do, and mostly a top and tail will suffice. Once the cord stump has come off, bathe the baby in plain water first and gradually introduce a mild detergent specifically for babies.

I hope this guide has helped you and answered any questions you might have. If you’d like to be kept up to date with my blog posts, do sign up for my mailing list below, and stay in touch on Facebook or Instagram via @midwifeandlife.

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