The umbilical cord

Cutting the umbilical cord is a symbolic gesture that marks the beginning of your baby’s autonomy. From then on, they breathe and feed on their own. When the umbilical cord detaches, it leaves a unique scar: the belly button.

Characteristics of the umbilical cord

The umbilical cord is a yellowish-white, rope-like tube with a gelatinous appearance. It’s what connects the growing fetus to the mother. The blood that circulates through the umbilical cord performs several essential functions for the well-being of the fetus, such as supplying nutrients and oxygen and carrying away waste products.

At the end of pregnancy, the umbilical cord measures, on average, 2.5 cm in diameter and 55 cm in length. However, it can be as long as 100 cm (1 m). If the cord is too long, it can sometimes wrap around the baby’s neck. Most of the time, this does not harm the baby.

When it’s time to cut the umbilical cord, two clamps are used to stop the flow of blood. Once the cord is cut, a small plastic clamp is placed 2 to 3 cm from the baby’s belly. It’s removed two or three days later, when the cord has sufficiently dried out.

When should the umbilical cord be cut?

Experts long believed that the cord should be cut immediately after the baby was born to reduce the risk of the mother losing too much blood following delivery. However, the most recent studies on the subject indicate that this is not the case.

The World Health Organization (WHO) recommends delaying clamping the umbilical cord because waiting 1 to 3 minutes has proven to be beneficial for the baby. It appears to result in a higher birth weight, higher hemoglobin levels, and better iron stores in the baby’s first 6 months of life. These benefits have also been observed in premature babies. Delayed cord clamping may slightly increase the risk of jaundice in newborns, but this is a condition that is easily treated.

How do you clean the umbilical cord?

It’s important to keep the umbilical cord clean and dry to prevent infection. Because there are blood vessels in the cord, it is an entry point for bacteria. Don’t worry, touching the cord doesn’t cause your baby any pain. You may see a small amount of slightly blood-tinged discharge during the first few days. The important thing is to clean the base of the stump thoroughly.

Umbilical cord care at home

• Wash your hands thoroughly before you begin.
• Clean the base of the stump daily with a cotton swab soaked in warm (ideally boiled) water or a saline solution, and gently clean all the way around the cord to remove any debris.
• Dry the cord thoroughly using the dry end of the cotton swab.
• Fold down the edge of your baby’s diaper so it doesn’t rub against the base of the stump. Some brands of disposable baby diapers have a little cutout designed for this purpose.
• Do not apply rubbing alcohol, creams, or ointments to the umbilical cord, as these products can delay the time it will take to fall off. In the past, parents were told to moisten the umbilical cord daily with a 70 percent rubbing alcohol solution, but this is no longer recommended.
• Do not cover the cord with a compress or bandage. It’s best to keep the cord exposed to air as much as possible.
• Once the cord has fallen off, continue to clean the belly button with warm (ideally boiled) water or a saline solution, drying it thoroughly, until it is completely healed.

When will the umbilical cord fall off?

After the umbilical cord is cut, the remaining stump will dry up and fall off naturally by the age of 1 month, typically during the second week of life. When it’s ready to fall off, the cord will have turned a blackish colour, though the base of the stump usually remains more gelatinous and pale.

What should you do if the umbilical cord folds over?

As the umbilical cord dries, it can sometimes fold over, covering the base of the stump completely. This can cause the base to remain humid and more likely to become infected. The cord may also take longer to fall off.

Parents are sometimes afraid to move the cord for fear of hurting their baby or causing the wound to bleed. But the stump can be safely moved by first moistening it with a little warm (ideally boiled) water or saline solution. Next, clean and dry the cord using the method described above.

What should you do if the umbilical cord is accidentally torn off?

If the cord is accidentally torn off, there may be some bleeding. If this happens, apply a compress until the bleeding stops and go to a CLSC or walk-in clinic. A doctor will examine your baby and the part of the cord still attached to the belly button.

When should you consult a doctor?

If your baby is less than 1 month old and develops a fever, even if they show none of the symptoms listed below, see a doctor.

Consult a doctor if you notice:

• Persistent redness around the base of the cord.
• Swelling around the base of the cord.
• Discharge at the base of the cord (blood, pus, or oozing).
• An unusual smell coming from the cord.
• That the cord is still attached after 1 month of life.
• That the cord has been accidentally torn off.
• Persistent bleeding after the cord has fallen off.
• That the belly button is not healing properly after the cord has fallen off. In this case, there will be a small pink or reddish bump in the belly button that tends to ooze. The bump will need to be cauterized with silver nitrate. This is a very simple procedure that won’t hurt your baby.

Things to keep in mind

• The umbilical cord falls off naturally before 1 month of age, typically by the second week of life.
• It’s important to clean your baby’s umbilical cord every day. Don’t worry, this doesn’t hurt.
• You can give your baby a bath even if the cord is still attached. Just be sure to dry it well afterwards.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and copywriting: The Naître et grandir team Updated: February 2020

Photo: iStock.com/pidjoe