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How should you take care of your newborn's umbilical cord?  Conflicting instructions confuse new parents.  But proper care is not difficult.

The most important technique is to expose the base of the cord.  If the base is not exposed to air, then bacteria can thrive in the wet, low oxygen environment; this may lead to infection.

Hydrogen peroxide, wetted on a gauze or cotton ball, is perhaps the best choice for cleaning.    A little mildly soapy water can also be used. (Rubbing alcohol was recommended in the past, but it tends to cause rashes).

Grasp the cord with your fingers, and pull up gently.  At the same time, pull the skin away from the cord, all around the cord, to expose the yellow base.  Then you can clean, all around, with the gauze wetted with hydrogen peroxide.  If the cord smells bad or seems infected, you can smear a little antibiotic ointment (such as Neosporin®) around and on the base of the cord.

You can clean the cord as often as needed, perhaps 3 or 4 times a day.  You may be instructed not to bathe your baby in the tub until the cord falls off; but we don't feel strongly about this.  If your baby seems dirty or sticky, you may give a quick (warm) tub bath, then dry the infant thoroughly; then open up the base of the cord (as above) to allow drying.

Textbooks say that the umbilical cord usually falls off by two weeks of age.  But our experience is that the cord may stay attached longer, sometimes as long as 4 weeks.  It may be that families take such good care of the umbilical cord that it takes a while to deteriorate!

If you see the skin around the umbilical cord getting red, it should be examined to rule out infection.  But this is unusual.

     --  Copyright © David Epstein MD, 2009