Umbilical Cord - Mother's e-Guide

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Neonatal

Umbilical Cord: Care and Management.

…For both the Mother and Health Care Provider.

Clean delivery and cord care practices are essential to ensure that contamination of the cord does not put the new born at risk.

Umbilical cord infection and neonatal tetanus contribute significantly to high neonatal mortality rate in Nigeria.

This can be reduced by practicing clean delivery and clean cord care at birth and in the days following birth and by avoiding harmful practices. Hence, it is important to:

Always wash hands with clean water and soap and wear gloves before delivery, after any vaginal contamination, and before tying and cutting the cord
The new born should be laid on a clean surface (e.g. the mother’s abdomen)
The cord must always be tired up or clamped at the baby’s side prior to cutting.
This is important to avoid excessive bleeding,
Use a sterile and sharp instrument such as new razor blade or scissors to cut the cord
The recommended length of the stump after cutting is usually 2 or 3 cm.
Daily application of 7.1% chlorhexidine gel immediately after birth for seven days or until the cord separates.
Other practices that may reduce the risk of cord infections are use of 24-hour ‘rooming-in’ (where the baby’s crib is kept by the side of the mother’s bed)
Keep the cord dry and exposed to air or loosely covered with clean clothes.
Ensure the baby’s diaper or napkin is folded below the navel.
Avoid touching the cord, applying unclean substances to it and covering it with bandages.

Healing Process of the Cord

Umbilical Cord Stump

After a baby is born, the cord is clamped close to the body, which is left as a stump. The stump needs fresh air to heal up hence baby nappy should not cover it. At this early birth period, avoid tub baths rather make use of sponge bath till the cord stump detaches completely. Sponge bath involves washing and rinsing the whole body; one part at a time (before another) while the baby is on the bed using clean towels, washcloth, soap and water. Sponge bath is also good when circumcision has taken place and the incision has not healed up.

In ten to twenty-one days, the stump will get dried up and fall off; within this period, the stump should always be dry and clean. A navel will remain after the fall off and will also heal up after few days. In a situation that the weather is warm, it is advisable to dress the baby in free clothing/ breathable fabrics that allow fresh air so as to assist the drying process. While the navel heals, be attentive to any strange signs that may point to an infection, such should be reported at the health centres. Besides, umbilical cord stump that does not fall off in 21 days should also be duly reported.

Beware!!!

To prevent contamination of the cord and putting new born at risk, ensure you avoid these harmful practices.

Avoid the use of dirty instrument to cut the stump
Avoid the use of hot knife to burn the stumps
Avoid the application of harmful items/ objects on the cord including:

1. Herbs

2. Toothpaste

3. Sand

4. Human and animal faeces

5. Gentian violet (that is antiseptic dye used to treat fungal infections of the skin)

6. Hot fomentation with hot water, lantern, knife and application of menthol containing creams,

(a fomentation means the application of a compressed item such as a folded towel which has been squeezed from hot water, or made hot by sliming and placing it on the chest, abdomen etc.).

Only an anti-microbial such as 7.1% Chlorhexidine gel is recommended to replace the harmful substances. It should be applied immediately after birth.