From the Stump: Umbilical Cord Care

Once my daughter was out of the NICU, one of my biggest preoccupations was with her umbilical cord stump. The NICU nurses told me to keep it dry and leave it alone - it would fall off in due time. My mother told me they gave her Gentian Violet for the care of my and my sister's stumps. My sister in law was told to put alcohol on it. I had heard through the grapevine that breastmilk was the best for cord care.

So many opinions on what to do! In the end, I followed the NICU nurses' advice and left it alone. It fell off in about 2 weeks and now my little girl has a perfect baby "innie". I was still left wondering, however, what is the best way to care for a cord stump?

An article published last year in the Iranian Journal of Pediatrics touts breastmilk as "an easy, cheap and non invasive way for cord care" (1). They found that stumps fell off faster if treated with breastmilk as compared to no treatment (just left dry). An additional study found no correlation between the prevention of stump infection and treatment with breastmilk as opposed to iodine or dry treatment, but did note that stumps treated with breastmilk or left alone fell off sooner than stumps treated with iodine (2). Both of these studies indicate a 'less is more' approach.

In developing areas, it seems to be a different story. A study conducted on a population in Bangladesh found that repeated treatment of umbilical cord stumps with chlorhexidine, an antiseptic effective against many types of bacteria, decreased the amount of time a stump stayed attached and increased infant survival rate by lowering infection rates (3).

The official stance of the American Academy of Pediatrics is to keep the stump dry and let it fall off on its own. How did you care for your infants stump?

1.Aghamohammadi, A., Zafari, M., & Moslemi, L. (2012). Comparing the effect of topical application of human milk and dry cord care on umbilical cord separation time in healthy newborn infants. Iranian Journal of Pediatrics, 22(2),2.Vural, G. and Kisa, S. (2006), Umbilical Cord Care: A Pilot Study Comparing Topical Human Milk, Povidone-Iodine, and Dry Care. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35: 123–128. doi: 10.1111/j.1552-6909.2006.00012.x3. Mullany et al., (2013),Chlorhexidine cleansing of the umbilical cord and separation time: a cluster-randomized trial., Pediatrics, 131(4).