Umbilical cord care

AlaskaKat · Nov 15, 2003

Interesting... We've been tub bathing our babies for years here yet we continue to use alcohol. Guess I need to do a search to find some research.

allnurses Guide · Nov 15, 2003

We stopped using the alcohol and Q-tip method a few years ago but still wipe around the umbilicus with an alcohol wipe. And don't submerge our babes in water when bathed.

I used alcohol on all my older children but not my 2 year old. His cord got infected. The older three did not.

Who knows? I don't think it hurts anything to wipe with alcohol.

We also take the cord clamp off before 24 hours and the cords are hard and dry for the most part. Most of our moms and babes are d/c'd before 24 hours.

steph

bam_bam · Sep 27, 2004

Bringing up this thread to see if anyone has new information on this topic. We still use alcohol TID on our cords. I would love to have some concrete info against alcohol to show our docs since I think it is worthless.

Anyone??

MommyLauraRN · Sep 28, 2004

We now teach parents not to use it. There is one pedi who insists. We teach no full baths until the cord falls off...I wonder if we'll be changing that soon....

RNmommy · Sep 28, 2004

Our orders are to apply alcohol to the cord q shift. We are supposed to tell parents to apply alcohol TID after discharge. However, the written information that we give parents says specifically not to apply alcohol. The peds are supposed to come to an agreement by the end of next month. We also recommed only sponge baths until the stump has fallen off.

BTW why do so many of you send babies home before 24 hours? Do your patients not want to stay or do they not know that they can?

vchan25 · Jan 27, 2005

My name is Vanessa Chandler and I am a junior nursing student at the University of North Dakota. I choose to join this listserv because I am interested in Midwifery and OB/GYN nursing and the different treatments for cord care.

A topic that I have interest in is what the current practices and beliefs are practiced for umbilical cord care in a neonate and the effects it has on infection and time of cord separation. This topic is

currently being researched and I have found that the results are controversial. When looking at your listserv, I noticed that other nurses have been asking what hospitals are currently practicing.

I found some recent information that I would like to share. According to Janssen *et. al (2005), a study showed that although more bacteria was found in the dry care group, such as E. coli and Staphylococcus aureus , only one baby ended up with an infection. This study concluded that if bactericidal care such as alcohol and triple dye are going to be stopped, nurses must know and teach the signs and symptoms of omphalitis.

According to McConnell et. al (2004) more research is needed to conclude what the best treatment for umbilical cords is. This information was confirmed by Ireland et. al (2000), in a study done in Scotland emphasizing the universal interest that exists in finding a standard of care that is the best for the infant.

The questions I have are as follows: Do your hospitals have a standard of care for umbilical cords? If so, what is the basis for their standard? Also, are any hospitals researching this and what have been there findings? Thank you in advance for any information, it is greatly appreciated.

Vanessa Chandler, SN

University of North Dakota

References:

Ireland, J., Rennie, A. M., Graham, W., Hundley, V. A. (2000). Cord Care practice in Scotland. Midwifery, 16, 237-245.

Janssen, P. A., Slewood, B. L., Dobson, S. R., Peacock, D., Thiessen, P. N. (2005). To Dye orNot to Dye: A Randomized, Clinical Trial of a Triple Dye/Alcohol Regime Versus Dry Cord Care. Pediatrics, 111, 15-20.

McConnel, T. P., Lee, C. W., Couillard, M., Sherrill, W. W. (2004). Trends in Umbilical Cord Care: Scientific Evidence for Practice. Newborn and Infant Nursing Reviews, 4(4), 211-222.

mishayla96 · Jan 27, 2005

I don't have anything much to add other than wow...I am a mom of 3 and used alcohol on all of mine because thats what they told me to do (they were born in 97, 00, and 02--all at three different hospitals, delivered by 3 different docs). My 2nd child (born 00) went home with the cord clamp on his naval though so I guess it is not unheard of, right? Anyway sorry to butt in just wanted to share my experience :rotfl:

breastfeedingRN · Jan 27, 2005

We don't use alcohol or teach parents to use it on discharge. I know my friend is a nurse at a different Valley hospital and they use it and teach parents to use it.

Fun2, BSN, RN · Jan 27, 2005

My girls were born in '91 and '97, both at the same hospital.

I was told to sponge bath, use alcohol, and both came home with the clamp attached.

..just my :twocents:

kmrmom42 · Jan 27, 2005

Thanks for the quick replies! Any one else have research for me? I'm going to need to convince the docs...

I didn't read all of the posts because I don't have time right now...but I do have a pretty good bibliography that you can use. Email me at [email protected] and I will send it to you.

kmrmom42 · Jan 27, 2005

Hi Vanessa,

Thanks for these references. I have read them all as well as many others and have come to the conclusion that the recent research seems to indicate that natural drying isn't as wonderful as we would like it to be but that it seems that problems only occur when the parents are either not sufficiently educated or ignore the teaching they get. The cord should be kept clean and dry. Some parents interpret that to mean that they can leave the cord totally alone. In my opinion new parents should be taught to clean the cord at least once a day with a small amount of soap and water or alcohol in order to ensure that they are taking a good look at it. Then they should be taught what is normal and what is not when a cord is drying. A cord that is left to air dry will often smell like stool and may get a bit gooey. Parents need to know that it is okay to wash the area if that occurs as long as they are sure to allow it to thoroughly dry afterward.

This is an interesting topic and one that many OB units are struggling with.

camay1221_RN · Jan 27, 2005

The hospital I used to work postpartum, did not use alcohol, however, some of the peds instructed parents to do so.

The hospital I work at now, doesn't use alcohol on the cord either.

I used alcohol on my 1st and 3rd child. My 2nd, we went with the recommendation of no alcohol, and it got icky and gross, so ped put silver nitrate on it.

I instruct what hospital policy requires and if they question it, I recommend they ask their ped.