By Dr. Catherine Gant

UMBILICAL INFECTION

The umbilicus is clamped off soon after birth. It dries up over the next few days and usually falls off in the first week to 10 days. As it separates, there is an area of stickiness on the remaining stump, this is normal and should be treated with regular cleaning with boiled, cooled water and cotton wool. It may be necessary to do this at every nappy change for a few days after the cord has dropped off.

Signs and Symptoms of Umbilical Stump Infection.

If there is a yellowish discharge, often smelly, and any redness of the surrounding skin then there may be an umbilical stump infection. This will need antibiotics, often topical (a cream), but occasionally by mouth or injection, as the infection can quickly spread up the umbilical vessels to the liver.

If in doubt ask your doctor or midwife, particularly if the skin around the stump is red or hot or swollen. This is an emergency, as infections can spread quickly in small babies. The baby may also have other signs of infection - jaundice, poor feeding, fever, irritability or sleepiness.

UMBILICAL HERNIAS AND DIASTASIS RECTI

An umbilical hernia is a protrusion of abdominal contents through the umbilical ring (where the umbilicus joins the abdomen). It is very common, and causes a bulge under the skin around the umbilicus. It can be gently pushed back into the abdomen. It is more common in girls. It practically always resolves spontaneously in the first year of life, and no treatment is usually needed. Get your doctor or midwife to check it at your next visit.

It is also common for babies to have a slim gap between the muscles of the anterior abdominal wall, called diastasis recti, that again resolves spontaneously. The gap, running from the sternum to the umbilicus and then down to the pelvis, can be felt when the stomach muscles are clenched e.g. during crying, and it can look like a soft swelling.

Neither of these two conditions causes pain, fever, tenderness or feeding problems.