What is umbilical cord? – Umbilical cord refers to a tubelike structure which connects the baby to the placenta. Its function is to transport blood from the placenta to deliver oxygen and nutrient to the baby and metabolic waste products from the baby back to the placenta. The placenta, in turn, attaches to the uterus to exchange metabolic waste for oxygen and nutrient with the mother.

Why is umbilical cord cut at delivery?

The work of the placenta ceases after the baby is born, as the baby can now take in air directly and extract oxygen from it. It can also eat directly in order to obtain nutrients and energy. Therefore, at birth, the umbilical cord, which provided these services in pregnancy, is clamped and cut close to its attachment to the baby. The clamp closes the cut end to prevent the baby from losing blood through it.

How long does it take the umbilical cord stump to fall off?

The umbilical cord stump normally dries up and falls off within two to three weeks after the birth of a baby. It changes colour and texture from its grey and gelatinous texture at birth to brown, and finally black and coarse texture when dry.

How is the umbilical cord stump cared for?

The following steps may help in caring for the umbilical cord stump while waiting for it to fall off:

1. Wash with soft sponge and soap – Bathe baby with soft sponge and soap. Wash the umbilical cord stump along while bathing the baby. Then, allow it to airdry.
2. Keep the umbilical cord stump dry – Keep the cord stump dry by exposing it to air. The diaper should not be allowed to cover the stump at any time to avoid it getting soiled by faeces. Any fluid around the stump should be cleaned as soon as possible.
3. Keep the cord clean – This helps to prevent infection of the cord stump. Fold the diaper down and away from the umbilical cord stump to avoid it being soiled by faeces. Any soiling on or around the cord should be cleaned immediately to avoid infection.
4. Do not clean the cord with alcohol – Using alcohol (e.g. methylated spirit) to clean the cord is not encouraged as this has been shown to kill the healthy bacteria that feed on the stump to make it dry and fall off. Using it may delay the cord stump falling off. It is enough to clean the umbilical cord with soap and water and allow it to dry.
5. Allow the umbilical cord stump to fall off on its own – Avoid pulling off the cord before it falls on its own even if it is being held by a tiny strand of tissue. Pulling it off forcefully may make the baby bleed and lose blood. This may also create wound around the navel, which may get infected if proper care is not taken.

What problems can result from umbilical cord stump?

The following are some of the problems that may be noticed on umbilical cord stump:

1. Bleeding from the stump – This may be minimal or heavy. Small bleeding around the cord may occur if anything rubs against the stump or when it falls off. This usually stops spontaneously and is of no consequence. If the bleeding increases in quantity or persists for longer than necessary, then, there may be need to see a healthcare professional.
2. Infection of the umbilical cord stump – If the stump starts discharging yellowish or milky fluid or the area becomes red, swollen or painful or the child starts having fever, lethargic and feeding poorly, then, infection should be suspected. A healthcare provider should be seen for prompt and proper treatment of the infection.
3. Cord persisting for more than three weeks – This may be a pointer to an underlying medical condition in the baby or a result of poor cord care. Whichever it is, any cord stump that has not fallen off after three weeks should be taken to a healthcare professional for proper evaluation.