My son is now two weeks old and the umbilical cord fell off when he was about eight days old. However, it looks like the wound has refused to heal. I have tried to keep it dry at all times but it is still a wound. What can I do? Sandy

Dear Sandy,

Accept my heartiest congratulations on the arrival of the new baby. The umbilical cord is the connection between a mother and her baby in the womb. One to two weeks after child birth, usually it shrivels off and falls. Sometimes, it may take longer up to three weeks or fall before a week is over.

After it falls off, it is important to keep the cord stump and surrounding area clean and dry to prevent any infection. Good hygiene also keeps the surrounding navel clean and dry and free from infection.  The stump does not look clean and very good, immediately after the cord falling off. You may notice a red, raw-looking spot right after the stump falls off. A small amount of fluid sometimes tinged with blood may ooze out of the navel area. It is normal for this to last up to two weeks after the stump falls off. Though the raw stump area may look like a raw fresh wound, it does not necessary indicate an infection. It becomes dry within 10 to 14 days and one has to continue with good cleaning of this area till then. However, if it doesn’t heal or dry completely within two weeks, show it to a doctor.

You should also call a doctor if there are any signs of infection in the umbilical cord area. These include, dirty yellowish fluid at the base of the stump and around it, indicating presence of pus, red, swollen stump which is painful to touch, and high fever. The stump may be swollen due to umbilical hernia, but then it looks cleaner and is not painful to touch.  If the baby is irritable, crying without apparent explanation, is refusing feeds, the presence of one or more of these signs also indicates presence of infection, necessitating medical advice. Treatment would include only use of antiseptic dressings to incising the wound and removing pus. It depends on the severity of infection and presence or absence of pus.

For good cleaning of the stump of umbilical cord and surrounding area, soak a cotton swab in warm water and mild soap and squeeze out the excess water. Gently wipe around the sides of the stump and the skin around it. A soft clean piece of cloth can also be used instead of swab for cleaning. Good cleaning involves wiping away any sticky or dirty substance around as well. Gently pat dry the area with a soft cloth. While tying the diaper of the baby, make sure that it lies below the naval area. This prevents it from being contaminated with the baby’s pee, which can become a source of infection. Use of alcohol should be avoided as it may delay healing of the wound.

Dr. Rachna   Pande is a specialist in internal medicine.