Evidence based care of the new born cord

The umbilical cord is a vital structure that connects the fetus to the placenta during pregnancy and provides oxygen and nutrients to the baby. After birth, the cord is clamped and cut, and the stump is left to dry and fall off. Here are some evidence-based guidelines for the care of the newborn cord:

Immediate Care

  1. Clamping and cutting: The cord should be clamped and cut as soon as possible after birth, ideally within 1-2 minutes. This helps to reduce bleeding and prevent infection (WHO, 2017).
  2. Cord care: The cord stump should be kept clean and dry to prevent infection. Gently wipe the stump with a clean, damp cloth or gauze, and pat it dry with a clean towel (AAP, 2019).

Cord Care Recommendations

  1. No powder or ointment: There is no evidence to support the use of powder or ointment on the cord stump, and it may even increase the risk of infection (AAP, 2019).
  2. No bathing: The cord stump should not be bathed or submerged in water until it has fallen off, usually within 1-3 weeks. This helps to prevent infection and promote healing (AAP, 2019).
  3. Keep the cord stump dry: The cord stump should be kept dry and away from soiled diapers or clothing to prevent infection (AAP, 2019).
  4. Monitor for signs of infection: Monitor the cord stump for signs of infection, such as redness, swelling, or pus. If you notice any of these signs, consult with your healthcare provider (AAP, 2019).

When to Seek Medical Attention

  1. Fever: If the baby has a fever above 100.4°F (38°C) and the cord stump is red, swollen, or has a foul odor, seek medical attention (AAP, 2019).
  2. Discharge or pus: If the cord stump is discharging pus or has a foul odor, seek medical attention (AAP, 2019).
  3. Redness or swelling: If the cord stump is red, swollen, or has increased in size, seek medical attention (AAP, 2019).

Additional Tips

  1. Keep the cord stump clean: Gently wipe the cord stump with a clean, damp cloth or gauze, and pat it dry with a clean towel (AAP, 2019).
  2. Avoid tight clothing: Avoid dressing the baby in tight clothing that may irritate the cord stump or increase the risk of infection (AAP, 2019).
  3. Monitor for cord separation: Monitor the cord stump for signs of separation, such as a gap or a bulge. If you notice any of these signs, consult with your healthcare provider (AAP, 2019).

By following these evidence-based guidelines, you can help promote healthy cord care and reduce the risk of infection or other complications.

References:

American Academy of Pediatrics (AAP). (2019). Umbilical cord care. Pediatrics, 143(3), e20191744.

World Health Organization (WHO). (2017). Care of the umbilical cord. WHO Recommendations for the Prevention and Treatment of Newborn Infections.