Though belly button infections in infants are rare in the U.S., they can become a medical emergency if not treated early. The umbilical cord directly connects to the bloodstream, so an infection can spread quickly, becoming fatal in seven to 15% of infants. Stringent aseptic procedures during and after delivery and proper cord care correlate with low risk of umbilical infection. However, some physiological conditions can result in this condition.
The umbilical cord transports blood and nutrients from mother to fetus. The cord is clamped shortly after birth, leaving the umbilicus — the navel or belly button — and a stub. Until the umbilicus closes and the stub falls away, the area is highly susceptible to pathogenic bacteria. Gram-positive bacteria are present in the navel almost immediately after birth. The umbilical tissues promote the rapid growth of these microorganisms. At the same time, nearby blood vessels can facilitate the entry of pathogens into the bloodstream.
An umbilical granuloma is a small round growth in the center of the belly button. It occurs in one out of 500 newborns after the cord falls off. This moist lump is typically red and covered with clear mucus. It does not cause pain, but left untreated, an umbilical granuloma can grow and become infected. If it does not go away on its own, the pediatrician may apply silver nitrate to shrink the growth or tie off the granuloma with surgical thread to block blood supply.
Omphalitis is an extremely rare but dangerous umbilical cord infection. Newborns who are premature or of low birth weight have a greater risk of developing this condition. Genetic defects and immune deficiencies may also play a role. The infection usually arises in the early weeks of life, caused mainly by exposure to bacteria during delivery or when cutting the umbilical cord. Symptoms include foul-smelling discharge, fever, abdominal swelling, and lethargy. Doctors also suggest checking for inflammation and discoloration around the cord. If the infection spreads, the baby may require hospitalization for monitoring and antibiotics or surgery in more severe cases. Proper umbilical cord home care significantly reduces the risk of omphalitis.
The urachus, a primitive structure connecting the umbilical cord to the bladder in utero, normally disappears before birth. However, in some infants, a part of it remains and forms a urachal cyst. This mass becomes tender and swollen when infected. If a urachal sinus, an open connection between the bladder and the belly button, develops, it can lead to drainage of urine from the umbilicus. A physician can confirm this condition with an ultrasound or MRI scan, and the baby may require surgery to remove the cyst.
Doctors typically treat belly button infections with antibiotics first. They administer the medications orally or intravenously, depending on the severity of the infection. If antibiotics are not effective, the pus may be withdrawn with a needle or allowed to drain with an incision, which is often an operating room procedure.
In cases of incision and drainage, the healthcare team will usually pack the wound with gauze. This keeps it open and lets the pus drain. After the draining stops, the gauze is removed so that the incision can heal internally, up to the surface. The skin typically closes within several days with no further issues.
Human breast milk imparts complete nutrition and powerful immunity. This miraculous liquid has also been widely applied in traditional cultures to treat eczema, diaper rash, and umbilical cord separation, all with evidence-backed success. A review in Nutrients noted three studies in which treating the umbilical area with breast milk resulted in significantly shorter cord separation times and less bleeding compared to dry cord care.
Parents should follow their pediatrician's guidelines to reduce the risk of belly button infections. Applying an antiseptic to the cord may reduce the risk of infection and life-threatening complications. Getting the stump wet will not harm the belly button, but sponge baths can help shorten healing time. Parents should allow the stump to fall off on its own and avoid pulling or cutting at it. It is normal to notice a little blood near the stump during healing and after it falls off.
Holding an unclothed newborn against a parent's bare chest helps expose them to normal skin bacteria. Research suggests that this can protect against belly button infections by accelerating the rate of colonization with healthy skin flora. One study found that babies who received skin-to-skin contact are 36% less likely to develop an umbilical cord infection than those who did not.
Parents should immediately reach out to a doctor if they notice their baby's belly button is bleeding and will not stop after twice applying direct pressure for 10 minutes. If a red streak runs from the navel or red skin spreads out from it, this is also cause for medical attention, especially if the baby is less than 12 weeks old or if they have developed a fever. If, after three days of following care advice, the baby's belly button is not dry and clean, parents should speak to a doctor. Any sore, blisters, pimples, or drainage around the navel should receive medical care, as should an umbilical cord stump still attached three weeks after birth.
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