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Abstract: A newborn 14-day-old female child, whose umbilical cord had fallen off for 5 days, had accidentally gotten her belly button wet during a bath 2 days ago, and had slight redness and swelling at the location of her belly button without purulent discharge. Local cleaning and disinfection with iodophor were done, and local secretions were taken for bacterial culture, and the diagnosis was neonatal umbilicitis. After 1 week of home care, the navel area was restored to dryness and cleanliness, and the child’s general condition was stable.
Basic information】Female, 14 days
Disease Type】Neonatal umbiliculitis
Hospital】Shanghai Sixth People’s Hospital
Date of Consultation】December 2020
Treatment plan】Topical medication (povidone iodine solution)
Treatment Period】1 week in outpatient clinic
Effectiveness】Dry and clean belly button area, stable condition
I. Initial consultation
The child was born in our obstetrics department at full term, with an APGAR score of 10, and the birth went smoothly without resuscitation. The child was otherwise stable, with no fever, cough or runny nose, normal milk intake and normal bowel movements. A culture of umbilical secretions was given, and the current diagnosis was neonatal umbilicitis.
II. Treatment history
For neonatal umbilicitis, if the manifestation is not serious only local treatment is needed, generally strengthen care as well as prevention of infection, if there is more purulent secretion, or umbilical cord secretion culture results suggest bacterial infection, local antibiotics can be applied topically, or then further antibiotics can be used for systemic treatment. The current treatment recommends using a sterile cotton swab dipped in povidone-iodine solution to gently wipe the affected area to prevent local disinfection and infection, using a waterproof navel patch during bathing to avoid local water exposure, keeping the navel cool and ventilated, and advising the child to follow up in 1 week.
III. Treatment effect
After 1 week of home care, the child’s parents said that the swelling of his belly button had completely subsided, and there was no local exudation or secretion or abnormal odor, while the umbilical cord secretion examination results were normal, indicating that local bacterial infection was ruled out.
IV. Notes
We are glad that after active disinfection, the child’s disease did not deteriorate further, but was cured. Parents should also be advised to keep the local area dry in daily care, especially when bathing, to avoid local water or waterlogging, and to change diapers diligently to prevent urine and feces from contaminating the umbilicus. In case of delayed umbilical cord detachment or local redness, swelling, pus, abnormal discharge, etc., you should consult a doctor in time to avoid more serious diseases.
V. Personal insight
Before delivery, that is, during the fetal stage, the umbilical cord is the channel between the newborn’s body and the mother’s placenta, and there are umbilical veins and umbilical arteries in the middle of the cord, providing a rich blood flow pathway. After delivery, the umbilical cord gradually atrophies and degenerates, but it may still be connected to the body’s blood circulation until it is completely detached.
Fortunately, treatment was timely and no fever or pus flowing from the umbilicus occurred. Therefore, the umbilicus of newborns needs to be carefully observed and cared for.