How to Care for Your Baby’s Umbilical Cord

Your newborn’s umbilical cord stump will fall out on its own within one to three weeks after birth. It’s important to know how to care for it properly in order to prevent infection—and to help calm those new-parent nerves.

Umbilical Cord Function

The umbilical cord is a vital part of pregnancy for all mammals, transporting nutrients and oxygen from you to your baby. It’s a narrow, tube-like structure that’s connected to your placenta on one end and baby’s abdomen on the other end. It’s made up of three blood vessels: a large vein that carries oxygenated blood to your baby and two small arteries that return deoxygenated blood back to your placenta.

An umbilical cord can grow to be about 60 centimeters long. This ensures your little one has enough room to move around safely without risking damage to the cord or your placenta.

When does the umbilical cord form?

Your baby’s umbilical cord is formed by around week seven of pregnancy. Also formed that week are lower limb buds that will eventually become legs, and arm buds are starting to take on the shape of small paddles.

What happens to the umbilical cord after birth?

After your baby is born, the umbilical cord is clamped and cut close to your baby’s navel. (The clamp is put into place prior to cutting to help stop the cord from bleeding.) What’s left behind is a short stump on your baby’s belly button that will begin to dry out, heal and eventually fall off over the next couple of weeks.

What is Delayed Cord Clamping?

Delayed cord clamping (DCC) refers to the umbilical cord remaining unclamped for up to five minutes after a baby is born. Waiting to place the clamp on the cord allows for more blood and nutrients to be transferred to your baby, which can increase their blood volume by up to one-third.

Advice varies on exactly how long to delay clamping. The World Health Organization recommends one minute or longer, while the American College of Nurse-Midwives recommends five minutes when doing skin-to-skin (when baby is placed directly on your chest immediately after birth).

When does the umbilical cord fall off?

Your baby’s umbilical cord stump will begin to dry out and start healing immediately after it’s cut. Once it has completely dried out, the umbilical cord stump will fall off. Sometimes it falls off all at once, or it may fall off little by little. If you notice your baby’s umbilical cord hanging even by the smallest bit, do not pull it off; wait for it to fall off on its own, no matter how much you want to just get rid of it. This healing process doesn’t take very long—on average about two weeks or so after birth—and trying to rush the stump’s removal could cause bleeding or an infection.

What if the umbilical cord falls off early?

Like most things with babies, there’s no precise timeline to predict exactly when your newborn’s umbilical cord will fall off. While most babies will lose their umbilical cord stump in about two weeks, some will fall off in less than a week while others will take up to three weeks.

Assuming there’s no active bleeding or signs of infection like redness or swelling, there’s nothing to worry about if your baby’s umbilical cord falls off early. It’s normal for the area to look a bit red and raw at first and then heal over time.

How to Clean the Umbilical Cord

Umbilical cord care is important in order to prevent irritation and possible infection. Since the umbilical cord stump falls out on its own, umbilical cord care is more about keeping the area clean, dry and free from anything that may rub against it and cause irritation.

Follow these tips to care for your newborn’s umbilical cord:

• Keep the area dry. You need to keep your baby’s cord area exposed to the air as often as possible in order to allow the base of the cord to dry and speed up the healing process. Don’t submerge your baby in the bath until after the umbilical cord stump has fallen off; instead, give them a sponge bath. Let the area air out as much as possible by dressing your baby in just a shirt and a diaper when you can.
• Don’t cause irritation. The best way to help your baby’s umbilical cord area heal is to let the stump fall out on its own. Resist the urge to pick at it or pull anything off. Use newborn diapers that have a special cutout for the cord area or fold down a regular diaper to prevent it from irritating the umbilical stump. Some parents also like kimono-style bodysuits since they snap on the side rather than on the bottom and won’t irritate baby’s navel area when you’re taking them on and off.
• Keep the area clean. All you need to keep the area clean is a water-damp wash cloth or Q-tip. No rubbing alcohol, no submerged baths. The most that will likely happen is a bit of dried cord blood may get on your baby’s skin, which can be gently wiped away while giving baby a sponge bath.

Normal vs. Infected Umbilical Cord

The majority of umbilical cord stumps will fall off on their own and fully heal without any issues. However, there are a few signs to be aware of that may indicate an infection that needs to be treated.

Here’s what to look out for when you’re caring for your newborn’s umbilical cord:

• Foul-smelling yellowish discharge from the cord
• Redness or swelling around the base of the cord
• Crying when you touch the cord or the area around it
• Active bleeding around the cord area (a few drops of blood is normal, but active bleeding is not)

If you notice any of these symptoms, reach out to your pediatrician immediately. If your doctor determines there’s an infection, they’ll be able prescribe medication to stop it from spreading.

How much bleeding is normal for a healthy umbilical stump?

If you see a small amount of blood around baby’s umbilical stump, try not to panic. “Some bleeding is normal for a stump that is healing,” says Dr. Krupa Playforth, the voice behind The Pediatrician Mom and member of the Babylist Health Advisory Board. It’s just like any other scab, Dr. Playforth says: if any part of it is pulled off, a little bleeding is likely to happen. “In the case of umbilical stumps, this often happens because a diaper or baby clothes accidentally catch the cord and it gets pulled,” she says. If irritation or pulling is the cause of the bleeding, it should stop quickly. But if the bleeding lasts longer than a few minutes, it could be something more serious and you should call your baby’s pediatrician.

Why does the umbilical stump smell bad?

“In many cases, a bad odor does indicate omphalitis (umbilical stump infection),” Dr. Playforth says. “Typically, you will also see other signs such as fever, redness, fussiness or oozing/drainage from the stump.”

You may notice a bad smell without any other signs of infection. In this case, it’s still important to talk to a doctor about it, Dr. Playforth says, since infection can be serious. But keep in mind that it doesn’t definitely mean the stump is infected. Drying umbilical stumps can sometimes smell like rotting/decaying flesh “because it IS decaying flesh–and it smells horrid,” Dr. Kay Anderson writes. And all you can do is keep monitoring for any signs of infection and wait for it to fall off (and plug your nose).

What is an umbilical granuloma?

Your baby’s umbilical stump dried up with no infection and fell off cleanly, hooray! But then you notice a shiny, bright red or pink lump that seems to be growing out of baby’s belly button. It can be unnerving to see, but don’t panic; it’s totally treatable. “Sometimes, as [an umbilical stump] is healing, the area forms a moist lump called a granuloma,” Dr. Playforth says.

Granulomas are basically scar tissue caused by the umbilical stump’s healing process. It’s a lot like the shiny patch of skin you might see after a scab falls off.

An umbilical granuloma may dry up and fall out on its own in a few days. If it takes longer than that, or if you’re worried it could become infected, your baby’s pediatrician can treat it. “Both salt treatments and silver nitrate can be used, and neither method is painful,” Dr. Playforth says. “Salt treatments are more typical internationally. The treatments help to dry out the tissue and facilitate healing.”

Once the granuloma has dried up and fallen out, your baby will be left with a healthy (empty) belly button, and you can go ahead and give them a full bath (unless baby has just had a circumcision, in which case you should wait a few more days).

Sources:

• Johns Hopkins Medicine: Anatomy: Fetus in Utero
• American Pregnancy Association: Delayed Cord Clamping
• World Health Organization Sexual and Reproductive Health and Rights: WHO recommendation on delayed umbilical cord clamping
• American College of Nurse-Midwives: Delayed Cord Clamping
• Cleveland Clinic: Umbilical Cord Appearance and Care
• Mayo Clinic: Umbilical cord care: Do’s and don’ts for parents
• American Academy of Pediatrics: Umbilical Cord Care
• Dr. Krupa Playforth
• Dr. Kay Anderson
• Healthline: Umbilical Granuloma