Umbilical cord care: keeping the stump clean and dry

Your baby's umbilical cord stump is the dried remnant of the cord that connected them to the placenta. It dries out, shrinks, and falls off on its own — usually within 7 to 21 days, though up to four weeks is entirely normal.¹ Your job is to keep it clean and dry until it does.

The current guidance: dry cord care

Both the NHS and the WHO recommend dry cord care — keeping the stump clean and dry and leaving it alone to fall off naturally.¹² In settings with access to clean water and good hygiene, no antiseptic or alcohol is needed. Earlier practice involved routinely swabbing the stump with antiseptic or alcohol; current evidence indicates this can slow detachment without reducing infection rates in low-risk settings.²

Some midwives or health visitors may recommend chlorhexidine solution if local infection rates are higher — follow their specific guidance over general recommendations.

What to do:

• Keep the stump dry and exposed to air where possible
• Fold the front of the nappy down below the stump to prevent urine contact
• Give sponge baths only until the stump falls off — no full immersion baths
• If the stump gets dirty, clean it gently with plain water and pat fully dry
• Let it fall off naturally — don't pull or twist it, even when it looks ready to detach

What normal looks like

In the first few days, the stump is yellowish-green and slightly soft. Over the following week or two it dries out and turns brown or black — this looks alarming but is completely normal. A thin red line at the very base where the stump meets the skin is also common and does not indicate infection.¹

A small amount of dried blood or light spotting at the base when the stump separates is normal. After it falls off, the navel may look slightly pink or raw for a day or two before healing fully.

The stump may have a mild odour as it dries and degrades. Smell alone — without redness, swelling, pus, or fever — is not a reliable sign of infection.

Signs of infection: act immediately

Omphalitis — infection of the umbilical cord stump — is uncommon in clean settings but is a serious condition that can spread rapidly into the abdominal wall.³ Know the signs and act on them the same day.

The critical sign is redness spreading outward from the base of the stump onto the belly skin. This is different from the normal fine pink border at the attachment site. If the red area is growing, don't wait to see your GP — go to A&E.

When the stump is taking longer than expected

If the stump hasn't fallen off after four weeks, mention it at your next health visitor or GP appointment. Most of the time it's simply taking a little longer than average. Occasionally your midwife may notice a small granuloma — a pinkish, moist tissue nub that can form after separation. Granulomas are common, not infections, and are easily treated in primary care.

Do not attempt to speed up separation by pulling, twisting, or applying substances to the stump.

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Also in this cluster: The first two weeks · The fourth trimester

Sources

1. NHS. "Baby cord care." NHS, 2024. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/baby-cord-care/
2. American Academy of Pediatrics. "Umbilical Cord Care." HealthyChildren.org, 2024. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Umbilical-Cord-Care.aspx
3. World Health Organization. "WHO recommendations on postnatal care of the mother and newborn." WHO, 2013. https://www.who.int/publications/i/item/9789241506649