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Key messages

  • Current evidence supports the use of standard infection control procedures only, in this area of practice.
  • Wash hands before handling the umbilical cord and where possible avoid touching the cord stump.
  • Explain to mothers that there might be slight bleeding at the time of separation of the cord.

When caring for the newborn’s umbilical cord, current evidence supports the use of standard infection control procedures only.

Alcohol, antibiotic sprays, physolex or chlorhexidine should be used with caution and under medical direction.

Universal precautions to be maintained

Follow these precautions when caring for the umbilical cord:

  1. Wash your hands.
  2. Place cord clamp x 1 approximately 2 cm from skin.
  3. If LUSCS or high-risk baby, cord is clamped 4-5 cm from skin
  4. Cord is checked for ooze hourly for two hours after birth.
  5. Midwife to check cord area daily and record cord status.
  6. The area around cord stump is washed carefully with water and dried when bathing the baby. If it is moist, encourage mothers to fold nappy and plastic under cord area, leaving cord exposed to air.
  7. Educate parents to observe and report any signs of infection (redness, stickiness or offensive odour).
  8. Clamp the cord with sterile clamps and cut it with sterile scissors.
  9. The recommended length of the stump after cutting is 2-5 cm.
  10. Use rooming in where possible, with the mother as primary carer.
  11. Keep the cord dry and exposed to air.
  12. The nappy should allow for the cord to sit out of it.
  13. Wash hands before handling the umbilical cord and where possible avoid touching the cord stump.
  14. The cord clamp will fall off between days 5-10, you do not need to remove the clamp on discharge from hospital.
  15. Educate parents regarding separation of the cord.
  16. Explain there might be slight bleeding at the time of separation of the cord.

Nursing consideration

Issue to consider:

  • The umbilical cord remnants provide an excellent medium for culture of organisms. The cord remnant separates by a process of dry gangrene, usually 5-10 days.
  • Cord remnants separate earlier and mothers have few problems when cords are not treated, but simply washed and dried.
  • Mothers need to demonstrate an adequate technique in cleaning the cord, as many are reluctant or worried about cleaning the area.
Umbilical cord care
Source: umbilicalcordcare.net

 

More information

  • National Institute for health & Clinical Excellence 2006. www.nice.org.uk p. 1 1.4.24
  • Zupan J, Garner P. Topical umbilical cord care at birth (Cochrane Review). The Cochrane Library, 2, 2001. Oxford World Health Organization, Reproductive Health (Technical Support) Maternal and Newborn Health/Safe Motherhood, Geneva. Care of the Umbilical Cord, A review of the evidence, 1999
  • Dore, Sharon et al. Alcohol Versus Natural Drying for Newborn Cord Care. JOGGN Vol 27(6) November/December 1998.
  • Umbilical cord fall off cycle (2013). http://umbilicalcordcare.net/wp-content/uploads/2013/04/Umbilical-cord-care-rev-rs.jpg

Get in touch

Maternity and Newborn Clinical Network
Safer Care Victoria

Version history

First published: April 2014

Last reviewed: October 2018

Review by: February 2021

Uncontrolled when downloaded

Page last updated: 23 Nov 2018

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