AAP Clinical Report: Umbilical Cord Care in the Newborn Infant

The Clinical Report, Umbilical Cord Care in the Newborn Infant, is being published in the September 2016 issue of Pediatrics.

From the report: “This clinical report reviews the evidence underlying recommendations for care of the umbilical cord in different clinical settings.

Implications for Clinical Practice:

  1. Application of select antimicrobial agents to the umbilical cord may be beneficial for infants born at home in resource-limited countries where the risks of omphalitis and associated sequelae are high.
  2. Application of select antimicrobial agents to the umbilical cord does not provide clear benefit in the hospital setting or in high-resource countries, where reducing bacterial colonization may have the unintended consequence of selecting more virulent bacterial strains. In high-resource countries, there has been a shift away from the use of topical antimicrobial agents in umbilical cord care for this reason.
  3. For deliveries outside of birthing centers or hospital settings and in resource-limited populations (eg, Native American communities), the application of prophylactic topical antimicrobial agents to the umbilical cord remains appropriate.
  4. At the time of discharge, parental education regarding the signs and symptoms of omphalitis might decrease significant morbidities and even associated mortalities.
  5. Of paramount importance is the need for all primary care providers to be diligent in reporting infections associated with umbilical cord care. The development of a local reporting system regarding the occurrence of omphalitis and/or its morbidities to the health care providers at the site of delivery will create more robust data, allowing for improvement in treatment paradigms in the future.”

Reference: Stewart D, Benitz W, AAP COMMITTEE ON FETUS AND NEWBORN. Umbilical Cord Care in the Newborn Infant. Pediatrics. 2016;138(3):e20162149

DOI: 10.1542/peds.2016-2149