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Before you blow raspberries on your baby’s adorable tummy or ask your silly goose toddler to show you their belly button, you’ll have to contend with the icky precursor to your little one’s darling belly button: the umbilical cord stump. It’s a weird color, it protrudes from your newborn’s midsection, it may even ooze fluids…and you need to learn how to care for it before it falls off within the first few weeks of your baby’s life. Here’s all you need to know about caring for your newborn’s umbilical cord stump.

What is the umbilical cord stump?

The umbilical cord was a vital structure during your bub’s entire stay in the womb, carrying food and oxygen to them—and waste away from them. Once your baby is born, the cord is then clamped (to help stop bleeding) and cut, leaving a tube-like nub, called the umbilical cord stump. That nub remains attached to your newborn for a short period of time before falling off. Don’t worry, the umbilical cord—and stump—has no nerves, so your baby won’t feel any pain when the cord is cut or when the cord stump dries and finally falls off.

When will my baby’s umbilical cord stump fall off?

As your baby’s umbilical cord stump dries, it’ll shrink and change color from yellowish-green, then to brown, then to black before falling off between 5 and 15 days after birth. If your newborn’s umbilical cord stub is still hanging on once they reach 4 weeks old, it’s a good idea to inform your baby’s healthcare provider, as this may indicate an issue with your baby’s anatomy or immune system. Regardless, don’t attempt to pull the stump off yourself…even if it’s barely hanging on! This could cause your baby’s stump to bleed.

How to Care for Baby’s Umbilical Cord Stump

Your baby’s umbilical cord stump is considered a healing wound, which means there’s a risk that an infection could enter your baby’s bloodstream via the stump if it’s not cared for properly.

Here’s how to care for your baby’s umbilical cord stump:

  • Keep the stump dry. This helps prevent infection.

  • Expose the stump to air. Doing so will help dry the stump so it’ll fall off.

  • Cover loosely when needed. If the stump is catching on your little one’s clothes, it’s okay to loosely cover it with sterile gauze.

  • Gently clean. If your baby’s cord stump becomes soiled, gently clean it with a baby-safe cleanser and sterile water.

  • Practice kangaroo care. While there’s not a lot of research on the topic, one study out of Nepal found that newborns who received skin-to-skin care were 36% less likely to have umbilical cord infection. It’s thought that there may be a protective factor associated with Mom’s skin flora.

  • Let the stump fall off on its own. Resist the urge to help the process along! This will simply make the stump bleed.

Can I use alcohol for umbilical cord care?

According to the American Academy of Pediatrics (AAP), there’s no need to use alcohol on your baby’s umbilical cord stump. While swabbing the stump with an antiseptic such as rubbing alcohol used to be standard practice, research has shown that this is unnecessary in developed countries, such as the United States. In fact, using alcohol for umbilical cord care may even destroy healthy bacteria that naturally help separate the stump from your baby’s body.

Bath Time and Umbilical Cord Care

While the AAP notes that it’s okay to give your newborn a “quick submersion bath” before their cord stub falls off (as long as the stump is thoroughly dried afterward), most other children’s health organizations and hospitals suggest parents give their newborns sponge baths until their umbilical cord stump falls off and heals. (Learn all about how to give your newborn a bath.)

Diaper Changes and Umbilical Cord Care

To help keep your newborn’s umbilical cord stump clean and dry, pay extra attention during diaper changes. That means always folding your baby’s diaper below the cord stub to keep urine from soaking it. While some newborn diapers have special cut-outs for the cord area, you can just as easily fold down the top edge of the diaper. If some pee or poop does get on the stump, promptly clean it with a gentle cleanser and sterile water.

Can umbilical cord care influence if your baby has an innie or an outie?

Nope! The difference between an innie and an outie belly button has nothing to do with how the umbilical cord was cut—nor how the stump was cared for. And taping a coin over your baby’s navel will not ensure an innie belly button! In fact, doing so may give your bub a rash! The truth is most babies who have an outie were either born with a tiny umbilical hernia or they experienced a mild infection at the base of the cord that went unnoticed.

Signs of an Infected Umbilical Cord Stump

Since your baby’s umbilical cord stump works its way from yellowish to black, it can be hard to know what’s a sign of an infection—and what’s completely normal. For example, during the healing process, it’s not unusual to see a little blood near the stump. While this is nothing to worry about, there are other red flags that signal an infection is brewing. An umbilical cord stump infection called omphalitis is fairly rare, but it can spread quickly, so it’s important to promptly contact your healthcare provider if your baby’s stump exhibits any of the following warning signs:

  • Foul-smelling yellowish discharge

  • Red and swollen

  • Tender skin around the stump

  • Crying when the cord or surrounding skin is touched

  • Navel bleeds continuously after cord falls off

  • Stump hasn’t fallen off by 4 weeks old

  • Poor feeding

  • Fever of 100.4 degrees Fahrenheit or higher

  • Lethargy

  • Floppy, poor muscle tone

Other Umbilical Cord Stump Issues

In addition to infection, keep an eye out for these umbilical cord stump issues:

  • Umbilical hernia: If your little one’s umbilical cord area protrudes when they cry, they may have an umbilical hernia. This occurs when the muscle around your baby’s belly button doesn’t close, leaving a small opening where a portion of the intestine can pop out. The good news? Although about 1 in 5 newborns experience an umbilical hernia, it’s usually not serious and resolves itself by the time your baby reaches 18 months old, or a bit longer for Black babies. (The reason for the discrepancy is unknown, according to the AAP.)

  • Umbilical granuloma: When your baby’s stump falls off, scar tissue may form an umbilical granuloma, which is a small pink bump on your baby’s belly button than may also leak a yellow or clear fluid. An umbilical granuloma is the most common umbilical problem in infants and is most often a reaction to a mild infection. The bump itself—and the leaking—usually fades after a week. If it doesn’t, however, reach out to your baby’s healthcare provider who may need to remove the tissue with a simple in-office procedure.

What To Do When the Umbilical Cord Falls Off

When your baby’s umbilical cord stub falls off, you might notice a few drops of blood on the areas of their diaper closest to their navel. This is perfectly normal. Just be sure to check your infant's new belly button and gently clean off any lingering blood or secretions and pat it dry. While you can keep doing sponge baths for a bit longer, know that It’s perfectly safe to graduate to the baby tub now. (Your baby only needs two to three baths a week, as long as their diaper area is completely cleaned during each diaper change.)

 

More Newborn Advice

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REFERENCES

  • Cleveland Clinic: Umbilical Cord Care
  • MedlinePlus: Umbilical cord care in newborns
  • 70% Alcohol Versus Dry Cord Care in the Umbilical Cord Care. Medicine (Baltimore). April 2016
  • Umbilical Cord Care in the Newborn Infant. Pediatrics. September 2016
  • Risk Factors for Umbilical Cord Infection among Newborns of Southern Nepal. American Journal of Epidemiology. October 2006
  • American Academy of Pediatrics (AAP): Umbilical Cord Care
  • Dry Care Versus Antiseptics for Umbilical Cord Care: A Cluster Randomized Trial. Pediatrics. January 2017
  • Le Bonheur Children’s Hospital: Innies Vs. “Outies”
  • Children’s Hospital of Philadelphia:  Umbilical Cord Care
  • Mayo Clinic: Umbilical cord care: Do's and don'ts for parents
  • National Library of Medicine, StatPearls: Omphalitis
  • AAP: Umbilical Hernia in Babies & Children
  • American Academy of Dermatology Association: How To Bathe Your Newborn

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.