CARING FOR YOUR BABY'S UMBILICAL CORD STUMP

Introduction
The umbilical cord is a unique tissue, consisting of two arteries and one vein covered by a mucoid connective tissue called Wharton's jelly and a thin mucous membrane. During pregnancy, the placenta supplies all material for foetal growth and removes waste products. Blood flowing through the cord brings nutrients and oxygen to the foetus and carries away carbon dioxide and metabolic wastes. To separate the newborn from the placenta, the cord must be cut. After your baby is delivered their umbilical cord will be clamped with forceps and then cut with scissors, a few centimetres away from the belly button. There aren't any nerves in the cord so this won't hurt your baby at all.

The few centimetres of cord that are still attached to your baby make up the stump. This will shrivel up and turn black within a few days and then drop off completely in about a week. Sometimes the cord falls off in pieces rather than at once - if this happens don't worry it's quite common. The devitalised tissue of the cord stump can be an excellent medium for bacterial growth, especially if the stump is kept moist and unclean substances are applied to it. Keeping the stump clean and dry is therefore very important in order to prevent infection.

How To Keep It clean
It's important to keep the stump clean so that it doesn't get infected. Fold the baby's diaper below the stump so that it is exposed to air and not to urine. It's normal to see a few spots of blood or even a small discharge after the stump has fallen off. If however, the area around the belly button starts to look red and inflamed and the skin feels hot, then you need to see the doctor or mid wife.

While waiting for the cord to heal, avoid tub baths for about 7 to 10 days after the stump falls off. In warm weather, keep your baby only in a diaper and T-shirt to let air circulate and aid the drying process. Avoid bodysuit-style undershirts until the cord has fallen off.

How To Clean The Stump
There are a number of different ways to clean the cord stump. We are going to explain the most common.

What you will need
1. Sterilised bowl
2. Cooled boiled water
3. Cotton wool
4. Clean Towel
5. Changing mat

What to do
1. Make sure the room is warm enough so that your baby doesn't get cold and upset

2. Lie your baby on the changing mat and take off enough of his clothes to get to the cord stump

3. Dip a cotton wool ball in the cooled boiled water and gently wipe the whole area around the stump. Use a new cotton wool ball every time to keep it as clean as possible.

4. Don't rub or pull at the stump itself. Any of the black stump residue which remains should be left to fall off in it's own time.

5. Use more cotton wool or the clean towel and thoroughly dry the whole area around the belly button.

6. Leave the stump exposed to the air as long as you can - it needs to be kept as dry as possible so that it can heal and fall off.

Some Facts
Over the years, mothers have been advised not to immerse an infant in a tub for bathing until the cord has separated because it has been assumed that immersing the cord in water would promote infection, prevent drying and delay separation. Daily baths in the form of sponge baths are, however, common practice in many hospitals because they are considered infection control measures. A study comparing daily bathing with no bathing has shown no difference in umbilical cord colonization or infection between the groups, and that immersing the newborn in a tub is not harmful to the cord. However, the main issue here is thermal protection since bathing the newborn can induce hypothermia. The newborn should not be bathed before six hours after birth, or longer if possible, and measures should be taken to ensure that no heat loss occurs. Current recommendations direct that newborns should not be bathed routinely.