How to treat umbilical cord?

Specialties NICU

Published

HI!

I my unit we use alcool 70º once a day, after the bath, but i´ve been reading some contradiction literature... Some says to dont apply anything, others to apply iodopovidone, clorhexidine, ...

Wthats your experience on this?

And when they have umbilical catethers with briges,do you apply anything?

Specializes in Range of paediatric specialties.

The roting process of a cord is slowed by pickling them with antiseptics and alcohol. Recently following up newborns in the community I have had to treat some very large umbilical granuloma with silver nitrate. I think there is a correlation with use of plastic coated disposable nappies and warm humid weather we are currently having. i would be tempted to go back to treating moist cords with alcohol to prevent granuloma.

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Specializes in OB L&D Mother/Baby.

We use alcohol once a day, unless it gets wet or soiled. Sponge baths. We dont' treat cords with lines except the intial betadine.

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Specializes in NICU.

Occasionally we'll find a granuloma under the little stump that's left after the baby has had lines. By the time the baby is two or three weeks old, alcohol is not going to help at all. That's when we have to get an order for silver nitrate sticks, tx by the doc.

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Specializes in NICU, PICU, educator.

Nothing on them here either.

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Specializes in nursery, L and D.

hi to all, does anyone know of any studies supporting the no treatment to cords? We still do tripledye q day and alcohol with diapers and it talkes forever for them to fall off! Nevermind the complaints we get from parents about the "blue stuff" all over the babies bellies....and sometimes in other places!

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Specializes in Med onc, med, surg, now in ICU!.

All we do on our cords here is give them a quick swish with water at each nappy change. We tell the parents to keep the top of disposable nappies folded down so the cord is exposed to air, and suggest they use a Q-tip to wipe around the base of the stump. We tub-bath from the word go. Our bubs are generally problem-free (cord-wise, anyway); I haven't seen any infections in cords yet.

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The AWHONN recommendation is for NO antiseptic treatment at all; it actually shortens cord drop off time and does not increase rate of infection/omphalitis in developed countries. The evidence has been there since 2001, but because of our attending's concerns, we just changed practice this year.....sounds like some other people need to come into the present day of evidence -based nursing care too!

I still can't find any evidence about whether anything should be done for "cord care" if there is a UAC/UVC in place....any thoughts?

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Specializes in NICU, NSY, LD/OB.

I dont remember seeing a cord problem in the three years I have worked at my current facility. We don't put anything on them and we do tub baths every three days. We don't treat them with anything when they have lines in either.

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Specializes in NICU, Post-partum.

We use alcohol twice a shift...nothing else.

We do not use anything if there is a UAC or UVC....because one of the physicians found evidence that repeated exposure to alcohol and break down the catheter and make it more likely to snap during withdrawal...and well know how serious that is.

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Our policy is nothing if lines are in place. If no lines then we are suppose to trim and treat with triple dye then alcohol. I understand that research now points to letting it dry naturally but what should be done if you find a cord that has been "neglected". For example I had a 8 day old baby in an isolette whose cord was still as long as his arm! (cords are left long in delivery in case the baby needs lines; this baby didn't need lines but his cord was never trimmed). It was nice and dry, but the clamp was causing redness on his chest. I removed the clamp, trimmed the cord a little bit with scissors and placed him supine. (turns out he was happier supine anyway). Was it ok to trim the cord? There was no risk of bleeding because it was so old. Also what should be done to cords that have been soaked in urine? Sometimes I find a cord that was dry has become moist again because it has been allowed to "marinate" in a urine filled diaper. Is alcohol appropriate to dry it back out?

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Does anyone have a link to the AWHONN statement? I went to their site but the only thing I could find was CNEs that you had to pay for to read.

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We do nothing to the cords. Using alcohol actually dries the cord and turns it hard. That can make it take longer to fall off.

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