The umbilical cord is your baby's lifeline until birth.
After birth, the umbilical cord and placenta are no longer needed.
While it isn't needed after the birth, many parents today are choosing to wait until the cord has stopped pulsing before having it clamped and cut. This is called delayed cord clamping, and it ensure baby receives all of it's blood from the placenta.
Studies have shown many years of benefits for babies who have had delayed cord clamping.
Cutting the cord doesn’t hurt your baby, as there are no nerves inside the umbilical cord. Once the cord has has been cut, your baby will be left with a 2-3cm long cord stump.
Everything You Need To Know About Umbilical Cord Care
It's important to care for the stump to ensure that it is clean and doesn’t get infected before it falls off. Separation of the cord stump happens as a result of the natural process of dry gangrene.
Different Type of Clamps
The standard method of cord clamping is to use a plastic clamp or tie that has been kept in sterile packaging. The clamp is placed on the cord a few centimetres away from the baby’s stomach and remains attached until the stump has dried and sealed or has fallen off.
Some parents prefer to use alternatives to the plastic clamp such as specially made cord ties. Cord ties are usually made from embroidery thread but sometimes are made from ribbon or even string. The World Health Organization recommends sterilising material used for cord clamping when possible.
Does The Cord Have To Be Cut?
From the time partners were involved as birth support to birthing women, it has been common practice in our culture for the partner to cut the cord. This may be a symbolic gesture in involving them in the birth or perhaps initiating the separation of baby and placenta and welcoming the baby as a new person into the world.
In a hospital setting, cord cutting often happens very quickly without any recognition that this is the moment the baby begins life untethered to all that has so far nourished and sustained them. In a home birth setting, parents often take time to reflect on the physical connection between mother and baby that is about to end.
Lotus birth is a recent tradition that parents are turning to, allowing the placenta and cord to come away over time naturally rather than actively severing the cord. Lotus birth allows the cord to completely come away, so no stump is left behind. The process takes between 3 to 5 days. You can read more about lotus birth here.
Other parents wish to burn the cord either as a ceremonious practice or because it reduces infection risk. Cord burning involves using candles to cauterise and separate the cord. It usually takes about 5 to 10 minutes and isn’t always possible at hospital, so keeping the placenta and cord intact until returning home may be necessary.
How Long Does My Baby Have A Stump?
If the cord has been severed and a stump is left behind, it takes between 5 – 14 days for it to completely fall off although the average is 2 weeks and sometimes even longer.
The umbilical cord consists of two arteries and one vein covered by a special connective tissue known as Wharton’s Jelly. After birth the cord begins to dry and harden, becoming brittle. The stump will turn yellow-green, then brown and finally black. This process is called dry gangrene. The stump should come away by itself.
How Do I Care For The Stump?
Keeping the stump area dry and clean is the best way to avoid infection. Normal bacteria colonises the stump area and you may see some sticky fluid or even a small amount of pus at the base of the stump.
Air exposure helps to speed the natural separation process. You might like to give your baby nappy free time as much as possible. Folding down your baby’s nappy so that the stump is exposed to the air (even under a singlet or clothes) will also help and can prevent the stump being rubbed. Some newborn nappies have a special cut out area on the front to allow for the cord.
It is best to only use water when cleaning the area around the stump rather than any antiseptics. Using antiseptics has been shown to delay stump separation as it kills off the good bacteria that is part of the process. If your baby was born prematurely or spent time in a special care nursery, antiseptic may be used to clean the stump. Be sure to check with your baby's doctor for any special care instructions.
It is safe for the stump area to get wet as it won’t increase infection or delay separation. Always make sure the area dries properly after a bath or wash.
When caring for the cord stump:
- Always wash your hands before touching the area to prevent transferring bacteria to the cord stump
- If your baby’s poo or wee gets on the cord stump, wash it off carefully with water. Sometimes this is easiest by giving your baby a bath
- Never pull on the cord stump although you may notice eventually it becomes quite loose and barely attached
- Fold down nappies and clothes to avoid rubbing and allow air circulation
- Make sure clothes that are touching the area are kept clean.
What Are The Signs Of Infection?
It is rare for a cord stump to become infected. Signs to watch out for are:
- Red, swollen appearance at the base of the stump
- Excess, oozing pus or any smelly discharge (it’s normal for the stump to smell a little)
- Bleeding from the stump (dried blood is normal)
- Any signs of fever or pain in your baby.
Speak to your care provider or maternal health nurse if you have any concerns about your baby’s cord stump.
What Happens After The Stump Falls Off?
When the stump finally separates you may not even notice. You might discover your baby has a belly button when changing the next nappy!
It is not uncommon for the belly button to bleed a little and you might notice some blood on the front of your baby’s nappy or clothes. This is normal but if the bleeding is excessive or won’t stop it would be best to contact your care provider or maternal health nurse to check.
The area may take another few days to weeks to completely heal after the stump has fallen off. Keep the area dry and clean as much as possible.
Very occasionally the cord stump does not separate or heal for a long time. If this happens, your care provider might decide to seal the stump, using a method called cauterisation. This happens at your doctor’s clinic and uses a silver nitrate stick. It is safe and will not hurt your baby.
Will My Baby’s Belly Button Stick Out?
Not all belly buttons stick out. Most ‘outie’ belly buttons happens because of excess scar tissue. About 20% of outies are caused by an umbilical hernia. After your baby is born, the abdominal opening where the umbilical cord entered usually heals and closes on its own. The opening may not close occasionally and is causes a bulging belly button.
Hernias usually heal by themselves by the time your baby is 1 and will cause few problems. Sometimes it takes longer for umbilical hernias to fully heal, but it still rarely poses a health concern. If the area becomes tender, swollen or discoloured you should seek medical attention immediately. Very rarely a part of the intestine can be caught in the abdominal opening and this cuts off the blood supply. If this happens surgery is required immediately.
If you're a first time parent, it might seem that a newborn is full of hygiene surprises you never thought of before. While caring for a cord stump can feel like new territory, fortunately it doesn't require much special attention and it lasts but a few days or weeks.