New parents have a lot of things to keep track of when your newborn first comes home. You need to make sure you have diapers, baby blankets, baby bottles, and more. One more thing you need to think about (that most new parents may not have accounted for) is how to care for your baby’s umbilical cord. For many new parents, umbilical cord care is a source of anxiety. That’s understandable–it’s not like you have much experience with it!

It may be comforting to know, then, that for the most part, the umbilical cord will take care of itself. In that regard, most parents won’t have to worry–or do much of anything. After all, nature has been helping humans shed their umbilical cords for a few hundred thousand years. 

Still, questions can come up! And it’s almost just as important to know what not to do as it is to know what to do. This guide is intended to help parents navigate any questions they might have–and know when to contact their provider if they need to.

What is the Umbilical Cord?

The umbilical cord is a tube of tissue that connects a fetus to its parent during pregnancy. There are three major blood vessels within the umbilical cord. One of these blood vessels supplies your baby with oxygen and food. The other two blood vessels move waste out of your baby and into the placenta. Because your child can’t eat, drink, or breathe in the womb, the umbilical cord is responsible for providing all of this to your baby. 

Once your baby is born, the umbilical cord no longer serves this purpose. Your baby will have lungs and a digestion system and a mouth–so they can eat, drink, and breathe on their own. Because the umbilical cord serves no purpose, it essentially dries up and falls off (with some help from your provider). 

(As a side note: some parents will decide to preserve the umbilical cord–or the blood from the umbilical cord–for a variety of purposes.)

What Happens to the Umbilical Cord After Your Baby is Born?

After your baby is born, your doctor will cut the baby’s umbilical cord. However, there will still be a noticeable stump (usually a few inches or less) coming out of your baby’s belly button. Over time–typically somewhere between 1-4 weeks–the remaining stump will dry out and fall off on its own. This means that parents do not need to do anything to remove the last remnants of the umbilical cord.

Umbilical Cord Care After Your Baby is Born

After your baby is born and you return home, umbilical cord care will primarily involve ensuring the area is clean and well cared for. For most parents, umbilical cord care will look something like this:

• Give your baby a sponge bath when it’s bath time. To do this, wrap your baby in a towel, and then use a sponge to wash each body part one at a time. This will keep your baby warm and get them clean at the same time!
• This means you should avoid giving your baby a full bath until after the umbilical cord has fully detached and the area is healed. 
• When putting diapers on your baby, ensure that the diaper is folded down below the umbilical cord. (Some newborn diapers even have this feature built in.) Essentially, you don’t want the umbilical cord to be trapped under the diaper or in a position where the diaper could pull on the cord.
• If the umbilical cord gets dirty (for example, if urine or fecal matter from your newborn manages to get on the umbilical cord), it’s okay to wash the umbilical cord with a sponge. This will not slow down the drying process.
• Then all you have to do is wait. The umbilical cord should fall off all on its own as it air dries over that 1-4 week span. 
• Once the umbilical cord falls off, you can simply throw it away (or dispose of it any way you see fit)!

As the umbilical cord falls off, there may be some minor, low level bleeding that occurs. This is normal! The umbilical cord is basically creating a scab as it falls off, so it may bleed in the same way that a scab does. (If there is noticeably more bleeding, however, you should contact your provider.)

Is There Anything I Should Avoid While Caring for my Baby’s Umbilical Cord?

For many parents, it will be difficult to resist the urge to try to speed up the process. However, it’s important that you don’t attempt to force the umbilical cord to shed before it may be ready. For the health and wellness of your baby, there are some things you should avoid doing while caring for your newborn’s umbilical cord:

• As noted, avoid giving your child a full bath until after the cord has fallen off and the belly button has healed on its own. (You can talk to your child’s pediatrician if you have any questions.)
• Avoid using alcohol or other topical substances that are designed to dry out the umbilical cord faster. This used to be a common piece of family wisdom. However, there’s no evidence that this actually helps (and using alcohol could in fact harm our baby). 
• Avoid pulling or tugging on the umbilical cord.
• Avoid trying to remove the umbilical cord before it has fallen off naturally. Even if the cord is hanging on by a thread, that’s okay–it’s part of the natural process. Attempting to remove the umbilical cord early could result in bleeding or infection and could harm your newborn.

If you have any questions about what you should or should not do, contact your child’s pediatrician to get some guidance.

When Should I Call My Newborn’s Pediatrician?

There are some rare instances in which this process does not go according to plan. In these cases, you’ll want to contact your baby’s pediatrician and, sometimes, arrange prompt medical attention for your newborn. Never hesitate to call your provider if you have questions or concerns about your newborn’s umbilical cord.

Some instances in which you will want to contact your provider may include the following:

Infection

An infection of the umbilical site can be serious and may require immediate medical attention. The symptoms of an infection can include the following:

• If your child has a fever (typically above 100.4 degrees F).
• Your child stops feeding or does not feed well.
• There is redness or swelling around the umbilical cord site.
• You notice pus or fluid that’s yellow or clear around the umbilical cord site.
• Your child seems overly fatigued.
• Your newborn’s muscle tone seems droopy or floppy.

If your newborn experiences any of these symptoms, it’s important to contact your provider right away. Infections can spread very quickly, so they need to be treated promptly.

Umbilical hernia

An umbilical hernia occurs when the umbilical cord does not heal quite properly and part of the intestine gets stuck in the abdominal wall. This can create a bulge around the belly button (and also the appearance of an “outtie” belly button).

Most parents don’t need to worry too much about an umbilical hernia, as usually this condition will go away on its own. However, that process could take several years. If the hernia has not corrected itself by age 4 or 5, your pediatrician may recommend surgery to repair the abdominal wall and place the intestine in a better position.

Umbilical granuloma

In some cases, your newborn’s umbilical cord may detach–but leave a small amount of itself behind. This small bit can ooze pus or cause some slight swelling. If it hasn’t resolved itself within a week, you should call your pediatrician to see what the next steps should be. 

Bleeding

A small amount of bleeding as your baby’s umbilical cord is detaching should be expected. However, if your newborn experiences any bleeding around the umbilical cord site and the bleeding doesn’t stop, you should contact your provider to see what your next steps should be. 

The Umbilical Cord Doesn’t Detach on its Own

If your baby’s umbilical cord still hasn’t fallen off on its own by week four or five, make sure to contact your newborn’s pediatrician. This can sometimes be a sign of an autoimmune disease or other anatomical issue. Either way, you’ll want to figure out the cause and talk to your provider about next steps.

A Normal Part of Growing Up

For most new parents, umbilical cord care will be easy and natural. Your baby’s umbilical cord should fall off on its own within four weeks. Often, it happens much faster. But if there are any bumps in the road or you have concerns along the way, you can contact your baby’s pediatrician to receive guidance and answers. In the meantime, you get to enjoy all those memories with your newborn–and cherish those precious moments (while trying to get a few hours of sleep at the same time).

The pediatricians at Children’s Healthcare Associates are here to help! You can contact our Chicago or Northbrook offices today to schedule an appointment for your newborn’s needs!