‘The cord still hasn’t fallen off my baby’s belly button, and it looks really awful. Could it be infected?’
Healing belly buttons almost always look and smell worse than they actually are. What constitutes ‘perfectly normal in medical terms van actually send the weak-of-knee to the floor as fast as the climactic scene in a horror film.
Infection of the cord stump is unlikely, especially if you’ve been taking care of keep it clean and dry. Some doctor still recommend using alcohol swabs to promote healing and prevent infection, but studies show that the cord heals as well, and, in some cases, even faster, without the alcohol.) If you note redness in the surrounding skin (which could be due to irritation from alcohol applications as well as infection) or a discharge from the navel or from the base of the umbilical cord particularly a foul-smelling one, check with your doctor. If infection is present, antibiotics will probably be prescribed to clear it up.
The cord, which is shiny and moist at birth, usually dries up and falls off within a week or two, but the big event can occur earlier, or even much later – some babies don’t seem to want to give them up. Until it does drop off, keep the site dry (no tub baths), exposed to air (turn nappy down so it doesn’t rub), and cleaned with alcohol if recommended (but try to protect the surrounding skin, perhaps coating with a baby lotion prior to swabbing or applying alcohol just to the base of the cord – not to the skin – with a cotton swab). When it does fall off, you might notice a small raw spot, or see a small amount of blood-tinged fluid oozing out. This is normal, and unless it doesn’t dry up completely in a few days, there is no need for concern. If it is not completely closed and dry two weeks after the stump falls off, call the doctor. Occasionally, an umbilical granuloma (a small piece of scar tissue that looks bright red and moist) can develop after the cord has fallen off. It’s usually treated with silver nitrate (to dry it out), tied off with a suture, and allowed to wither and drop off. If it doesn’t, it can be removed (a very minor procedure).
‘Every time she cries, my baby’s navel seems to stick out. What does that mean?’
It probably means that your baby has an umbilical hernia – which (before you start worrying) is absolutely nothing to worry about.
Prenatally, all babies have an opening in the abdominal wall through which blood vessels extend into the umbilical cord. In some cases (for black babies more often than white), the opening doesn’t close completely at birth. When these babies cry, cough or strain, a small coil of intestine bulges through the opening, raising the umbilicus and often the area around it, in a lump that ranges from fingertip to lemon size. While the appearance of such lump (especially when it’s tagged with the term hernia) might be alarming, it’s rarely cause for concern. The intestine almost never strangulates (resulting in ten blood supply to the intestine being cut off) in the opening, and in most cases, the hernia eventually resolves without intervention, Small openings usually close or become inconspicuous within a few months, large ones by age two.
The best treatment for an umbilical hernia is usually no treatment at all. Home remedies that press the lump down (such as bellybands or binders) are ineffective and in some cases potentially harmful. Surgery to correct umbilical hernias is not recommended unless the openings in the abdomen is very large, is growing larger or brothers baby. Often the pediatrician will suggest waiting until the child is six or seven before considering surgery, because most hernias will have closed by then. If, however you see signs of strangulation – the lump does not recede after crying, can’t be pushed in, suddenly becomes larger, is tender, baby is vomiting – go to A & E. Immediate surgery may be needed.