How to Care for Your Baby’s Umbilical Cord Stump

This topic comes up quite frequently with new parents – the cord stump can look a little weird and is often a cause for worry as it goes through its process of drying and falling off (the process is called dry gangrene – eww, even the name is worrisome!). We wanted to take a few minutes to provide reassurance about umbilical cord care, and to talk about the current recommendations.

The great thing about umbilical cord stumps is that they pretty much take care of themselves. It used to be the standard recommendation to swab the stump with rubbing alcohol at diaper changes, but this practice has since been shown to slow down the drying process and cause the stumps to take longer to fall off. Instead, all that needs to be done, in most cases, is to leave the cord stump open to air, and to keep it clean and dry. Only if your care provider recommends it for your particular circumstances, hydrogen peroxide is considered a preferable option for cleaning over rubbing alcohol.

We already recommend keeping baby skin to skin with you as much as possible in the first days of life, and this naturally allows air to get to the cord stump. Make sure that the baby’s diaper is folded down so that it isn’t rubbing on or covering the stump. This also helps to prevent the stump from becoming contaminated by urine and stool. If the stump does come in contact with urine or stool, simply wash it with soap and water and dry with a sterile gauze. Any time the cord gets wet, make extra sure to allow plenty of airing out time to get it nice and dry.

It is a good idea to do a quick check on the cord stump at diaper changes to monitor for signs of infection, which include:

  • red streaks in the skin around the base of the stump
  • red, swollen skin around the base of the stump
  • white or green discharge (puss). Sticky yellow “goo” is normal.
  • fever
  • offensive odor (keep in mind that normal umbilical cord stumps can be a little stinky as they dry up – infection smells worse).

To help prevent infection, follow the steps as outlined above to keep the cord clean and dry, and make sure your hands are freshly washed with soap and water before handling the cord stump.

Most umbilical cord stumps fall off within 7-14 days, but many fall off in under a week when they are left alone. While it is our usual routine to remove the cord clamp at around 24 hours just because it can be kind of a nuisance, if the cord clamp has not been removed, it may only take a couple of days for the stump to fall off. It is not a concern if the stump falls off early – all you need to do is keep the cord site clean and dry, just like the stump.

After the stump falls off, there may be some more of that yellow “goo” mentioned above, which is normal. There may also be a little bit of bloody ooze, which you can clean, if you need to, with water on a gauze. This is also normal, unless it appears to be actual frank bleeding. If you suspect your baby is actually bleeding from the cord site, or is showing signs of infection, contact your care provider.