Q. I’m expecting my second child and I need a refresher course: How do I care for the umbilical cord stump?
A. Keeping the cord stump (the remnant that is left when the umbilical cord is clamped and cut after delivery) clean and dry helps prevent infection and speeds healing. The most common advice is to apply rubbing alcohol to the base and stump of the cord several times a day. While this process usually makes the baby cry because the cold alcohol touches his tummy, the procedure isn’t painful as there are no nerve endings in the umbilical cord. Here’s how to keep the cord area clean:
Use a sterile, alcohol-soaked cotton ball or a packaged alcohol pad to wipe away any crusty, yellowish material that accumulates where the cord stump joins the skin. (You’ll need to gently lift the dried stump to expose the base of the cord.) Don’t be alarmed if you see a tiny spot of blood on the diaper as the cord is healing, but any active bleeding should be reported to your baby’s doctor.
Fold your baby’s diaper below the navel to prevent it from rubbing against the stump and to keep urine away from it. When possible, fold shirts up to expose the cord to the air. Don’t give your baby a bath until several days after the cord falls off. If the cord becomes wet, dry it with a sterile cotton ball and clean it with alcohol.
Don’t ever attempt to loosen or pull the cord off. Accidentally or deliberately pulling the cord off before it is ready can result in active bleeding. The cord should fall off on its own between one and two weeks after birth.
Contact your pediatrician immediately if you notice signs of infection, such as a foul smell, yellow pus, or redness of the surrounding skin. You should also let her know if the cord has not fallen off by 3 weeks of age, if there is any discharge from the cord, or if the base fails to heal a week or two after the stump falls off.