Umbilical cord care.

The four steps

That is genuinely all of it. Tap through the steps, or press play and watch them.

1. Wash your hands Soap and clean water before and after you touch the cord or change a nappy. This is the single biggest thing you can do.
2. Fold the nappy down Keep the waistband below the stump so urine cannot reach it and so nothing rubs.
3. Let air get to it Loose clothing. Air dries it, and a dry stump separates faster and infects less.
4. Clean only if it is dirty If stool or urine gets on it, clean gently with clean water, then pat, do not rub, completely dry.

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What not to put on it

This is where most harm happens, and almost always with loving intentions. Nothing goes on the stump unless a clinician has told you to use it by name.

• No hot compresses or heated cloths. This is common advice from older relatives and it causes burns.
• No powder, ash, cow dung, palm oil, toothpaste, engine oil or herbal preparations. Substances like these are a leading cause of newborn tetanus and cord infection in Nigeria.
• No methylated spirit unless you were specifically told to use it. Routine spirit dries the skin and delays separation.
• No bandage or plaster over it. It needs air.
• Do not pull it, even when it is hanging by a thread. It comes away on its own.

Chlorhexidine. Some babies in Nigeria are prescribed 7.1% chlorhexidine gel for the cord, particularly after a birth outside a hospital. If you were given it, use it exactly as instructed. If you were not, do not buy it and start on your own — ask us first.

What normal looks like

• The stump darkens from yellow-green to brown to black over several days.
• It shrinks, hardens and may twist.
• It smells slightly — dry and musty, not foul.
• A few drops of blood or a little sticky yellowish fluid when it separates.
• It falls off somewhere between five and fifteen days. Later than that is usually still fine, but mention it at your next visit.
• A small red or moist patch underneath for a day or two after it drops off.

You can bathe your baby normally. There is no need to keep the stump dry at all costs during a bath, just dry it properly afterwards rather than leaving it damp inside clothing.

Common questions