Umbilical Cord Care

Expert Pediatrics Q & A - Umbilical Cord Care in the Newborn

Close up of clamped umbilical cord
Close up of clamped umbilical cord. Getty Images/MedicImage

What is the best way to care for your baby's umbilical cord? If you've heard the controversy ranging from "dry care" to applying alcohol, you're likely wondering what to do as a parent.

Umbilical Cord Care Controversy

You may have been told to put alcohol (70% isopropyl alcohol or rubbing alcohol) on your baby's umbilical cord until it falls off, but you may just as likely have been told not to use alcohol at all.

You may have been told how to care for an umbilical cord one way with your first baby, and another way now.

Why The Change?

Some experts think that too much alcohol can actually make the umbilical cord stump stay on longer, which most parents definitely don't want. And studies have shown that alcohol doesn't have as much of a protective effect against infections over simply allowing an umbilical cord to dry on its own (dry care).

Triple Dye vs Hexachlorophene vs No Treatment

Immediately after birth, the site of your baby's umbilical cord may, or may not, be treated with a substance to lower the risk of infection. Some hospitals use triple dye on a newborn's umbilical cord. (If you've noticed purple stuff around your baby's umbilical cord, that's what causes this.) Some hospitals use chlorhexidine. Some hospitals use other substances such as bacitracin, silver sulfadiazine, and hexachlorophine.

Which is best? Apparently there are advantages and disadvantages to each method - a common one being that they may decrease the number of bacteria present around the umbilical cord. At the same time, the treatments often result in a greater amount of time before the umbilical cord falls off.

A recent review of studies to date found that chlorhexidine decreased the risk of umbilical cord infections (omphalitis) and infant mortality, but that these concerns are probably much greater in developing than in developed countries.

Umbilical Cord Care Managment

When go home, your doctor may or may not recommend applying alcohol to your baby's cord stump. If using alcohol to care for your baby's umbilical cord, it is usually best to apply it with a cotton swab or cotton ball a few times a day.

More frequently these days, you may be told to skip the alcohol. Parents who are told that they don't have to use alcohol often take this advice too far though. They may never clean, or even touch, their baby's umbilical cord at all. Keep in mind that with umbilical cord dry care, you are actually supposed to wash the cord with soap and water when it becomes soiled, wipe it with a dry cotton swab, and then allow it to air-dry.

What You Need To Know

Despite some research on the subject, we still don't have a clear understanding of optimal cord care practices. Fortunately, umbilical cord infections are not very common and often easily treated when recognized quickly. Until more research is done, ask your pediatrician what he or she recommends concerning umbilical cord care.

Personally, I like to use alcohol on the umbilical cord stump about twice a day. This helps remove any discharge that has accumulated around the stump, keeps it clean, and is unlikely to make the cord stay on any longer than simply doing nothing at all.

Keep in mind that the alcohol isn't supposed to help the cord come off sooner. It is just supposed to prevent any infections from developing until it comes off on its own, and it may even lengthen the time until it falls off.

Caring for a Newborn with an Umbilical Cord Stump at Home

Your baby's umbilical stump should fall off by the time he is one to four weeks old. Some sources recommend calling your doctor if the cord is still attached at four weeks, while others recommend eight weeks. Ask your pediatrician what he recommends, and err on the side of calling sooner rather than later with any concerns you have as a parent.

When diapering, fold the diapers so that they do not cover the umbilical stump. You can buy diapers for newborns. or cut away diapers so this region doesn't rub on the stump. As long as it is warm enough, leaving the umbilical region open to the air may help it dry out sooner. Check out these pictures that describe visually what the umbilical cord is like beginning with clamping, and ending when it falls off.

Until your baby's umbilical cord stump falls off, be sure to keep it clean and dry.  Remember that your baby will only need sponge baths until his cord falls off, and that the umbilical stump should not be submerged in a tub until that has occurred. There may be a few drops of dried blood around the stump when it falls off, but any real bleeding should alert you to call your pediatrician right away.

Umbilical Cord Infections - Omphalitis

Signs of umbilical cord infection include redness around the area, a foul odor and discharge, or discomfort when you touch the area around the umbilical cord.  Call your pediatrician right away if any of these symptoms or signs should develop.

Umblical Cord Granulomas

Sometimes a granuloma - a pinkish appearing nodule which drains a small amount of yellow-green material - may occur after the cord follows off. This is very common and usually resolves within a week. If it persists your pediatrician may cauterize the area with silver nitrate.

More About Your Newborn Baby

What else should you know about your newborn baby?  Check out these tips for newborn baby care. And, since another very common newborn question is about weight gain, check out this information on normal weight gain in a newborn.


American Academy of Pediatrics. Umbilical cord care. Updated 11/21/15.

Mullany, L., Darmstadt, G., and J. Tielsch. Role of antimicrobial applications to the umbilical cord in neonates to prevent bacterial colonization and infection: a review of the evidence. The Pediatric Infectious Diseases Journal. 2003. 22(11):996-1002.

Palazi, D., and M. Brandt. Care of the umbilicus and management of umbilical disorders. UpToDate. Updated 12/02/15.

Sinha, A., Sazawal, S., Pradhan, A., Ramji, S., and N. Opiyo. Chlorhexidine skin or cord care for prevention of mortality and infections in neonates. Cochrane Database of Systematic Reviews. 2015. 3:CD007835.

U.S. National Library of Medicine. Medline Plus. Umbilical cord care in newborns. Updated 12/04/13.

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