Babies in the womb receive nourishment and oxygen through the placenta, which is attached to the inner wall of the mother’s uterus. The placenta is connected to the baby by the umbilical cord, which attaches to the baby through an opening in the baby’s abdomen. New Born babies need extra care as they enter this world leaving the protective cocoon of their mother’s womb. One of the many infections that babies are prone to is Omphalitis.
The infection is mainly caused by the bacteria of the Staphylococcus strain and attacks babies who have a weekend immune system or have been subjected to invasive procedures. Premature babies, normal babies with prolonged birth period and also cases of placental infection and umbilical catheters are prone to this type of infection.
Although the fatality rate is not very high due to Omphalitis but proper care needs to be taken of the Umbilical stump during the Neonatal period. One of the reasons why Umbilical cord care can turn fatal is when the symptoms of the Umbilical infection are not recognised.
Symptoms of Umbilical Infection
Drainage from the Umbilical cord which may be puss or in extreme case of infection the blood vessels of the cut stump do not dry and blood may ooze out continuously. Another symptom is redness and swelling of the skin, in and around the umbilical cord.
The skin around the Umbilical stump becomes very tender and soft. Baby gets fussy and reacts to any kind of touch. The cord care needed for new babies in order to prevent these symptoms, can be divided in to sections- Firstly, immediate cord care after the birth of the baby and secondly, cord care to be taken after discharge by the parents.
Immediate cord care taken during the neo natal period
The first step that is taken in modern obstetric practice immediately after the baby is born is that the cord gets clamped with the help of two haemostats and cut in between them. A sterilized plastic clip is used to be placed near the abdomen of the baby and the edge of the cord is cut.
Care is taken that the umbilical stump left behind does not get infected during the first hours of the baby’s birth as this is the time when the baby’s immune strength remains the lowest. Antiseptic lotions get directly applied on to the cord stump to prevent infections. It is usually advisable that the clamp gets removed before the baby gets discharged by expert nurses as at the time of removal of the clamps from the stump they might get entangled causing grievous injury to the baby.
Cord care after the baby gets discharged
The pattern of cord care that is suggested to new parents once the bay and the mother gets discharged are –
The Umbilical stumps are advisable to be washed two to three times a day with alcohol. This helps in sterilizing the cut stump and also helps the blood vessels present in the cut part to dry out. Researchers are of the view that the stump left alone has a higher rate of safe recovery than when washed repeatedly. Therefore even if the stumps are washed then hold a soft, sterilized and clean absorbing cloth around the stump. In any case no rubbing of the wet stump should take place. Fanning it dry is another means of keeping the stumps dry and moisture free.
The stump should be exposed to ample amount of air. This will facilitate the drying out of the stump faster. For this diaper ends should be rolled down and if possible, avoid the use of diapers at all. Diapers should be changed repeatedly as soiled or wet diapers are more prone to carry infections with them than any other agents. A clean diaper will not prevent infection but will also help the Umbilical stump to dry out fast.
Sponge baths are the best means of making the baby take bath until the stump falls of itself. After the stump falls off no need to panic even when a little dried blood appears at its base. This is natural. The compulsion to take out the cord even if it hangs by a single tissue should be avoided. Natural dropping off of the cord is safer than artificially pulling it off.
Followed in cord care
The clamp that is used for cutting the cord is usually a plastic one. Metal clamps are also used but care should be taken that the material used for clamping is well sterilized before use. Cord care can be done during diaper changes but care has to be taken that soft cotton balls are used when applying the antiseptic on the Umbilical stump.
There are two benefits of using cotton balls, firstly cotton swabs absorb more of the antiseptic solution and secondly in case swapping the inside of the umbilical cord seems too difficult a task then applying drops of the antiseptic solution with the help of cotton balls will also do the job.
For greater access to the inside of the cord, cotton swabs should be used. When holding the cotton swab with one hand, use the other hand to gently press down the sides of the excess skin around the umbilical stump. While the umbilical cord has not fallen off naturally, care should be taken as to how the baby is held in the arms. Since the cord is so delicate a matter, therefore when a baby is held there should be no rubbing of the cord with the clothes of the parents or even with their own body.
Try to prevent diapers from rubbing against the stump. You can fold the diaper down under the cord stump, or you can use disposable diapers with a cut-out notch at the top.
The umbilical cord is the source of nutrition supply to the baby when it resides inside the mother’s womb. Once outside the womb the cord needs to be separated to help the baby feed itself with its mouth. This is the reason why the cord is cut after birth. Baby care during the neo natal period gets complete only after proper cleaning and clamping of the cord has taken place. Cord care is therefore an important aspect of paediatric care and is much important in case of new born babies.
When cleaning the cord the hands should be washed with a disinfectant to keep off germs from causing any kind of infection. Finally, new parents should be well aware of the symptoms related to Umbilical infections. Guidance from the concerned doctor will help in keeping a track of the Umbilical cord health. Any kind of discharge or foul smell should not be ignored and immediate medical assistance should be sought.