How do I care for my newborn's umbilical cord stump?
Once the umbilical cord is cut, your baby is left with a stump that dries out, shrinks and eventually falls off on its own over a few days. Current WHO recommendations from 2022 and Polish neonatologists agree: clean, dry care is best, meaning the stump is above all kept clean and dry, without routinely putting anything on it. In practice it looks like this:
- Once a day, and more often if the stump gets soiled with wee or poo, wipe it with a gauze pad dampened with clean water. If it is more soiled, use soap and water.
- After washing, dry the stump and the skin around it thoroughly with a clean gauze pad.
- Leave the stump uncovered or cover it loosely with a sterile gauze pad. Do not tape it with a plaster or put on a tight dressing.
- Fold the top of the nappy down below the belly button so it does not cover or rub the stump and wee does not soak it from below.
- Do not pull the stump off, even if it is hanging on by just a thin strip. It should fall off on its own.
- Glance at the belly button at every nappy change so you notice any redness or discharge quickly.
What should I clean my newborn's belly button with?
Clean water is enough, and soap and water if it is dirty. The WHO recommends clean, dry cord care and advises daily application of 4 per cent chlorhexidine only where harmful traditional substances, such as animal dung, are often put on the cord. A 2026 Cochrane review confirms that in countries with a high level of medical care, antiseptics offer no clear benefit over keeping the stump clean and dry, and probably delay it falling off. Surgical spirit lengthens this time by about 1.6 days on average.
In Poland, until just over a decade ago, parents were told to clean the stump with 70 per cent surgical spirit, often at every nappy change, so you may hear this advice from family. In 2014 the then national consultant in neonatology, Prof. Ewa Helwich, wrote that this kind of cleaning is unjustified and that research shows spirit does not speed up drying of the stump at all. The then president of the Polish Neonatal Society, Prof. Jerzy Szczapa, advised against using spirit, gentian violet, iodine products and antibiotic ointments on the belly button.
- Do not use iodine products, because iodine is absorbed through a newborn's skin and can temporarily disturb thyroid function and the result of newborn screening tests.
- Gentian violet stains the skin and makes it harder for the midwife and doctor to judge whether the belly button is healing well.
- Prof. Helwich recommends antiseptics with octenidine or chlorhexidine mainly in hospital, for newborns separated from their mothers, who are more exposed to hospital bacteria. For a healthy baby who is with their mum, ordinary washing is the basis of care.
If you were told on discharge from hospital to clean the belly button with an antiseptic, do not change this on your own; instead, ask the midwife at the first wizyta patronażowa (the free postnatal home visit) whether there is a specific reason for it in your baby's case.
When does the umbilical cord stump fall off?
According to Prof. Szczapa and the US medical database MedlinePlus, the cord stump usually falls off between days 5 and 15 of life. Putting antiseptics on it can lengthen this by 1-2 days. If the stump is pulled off too early, it may start bleeding, so do not help it come off, even when it is hanging on very loosely.
Sources differ on when a stump that stays on longer needs checking. Prof. Szczapa advises showing your baby to a doctor if the stump has not fallen off by day 15. The American Academy of Pediatrics (AAP) says it should fall off by 3 weeks, and MedlinePlus advises contacting a doctor after 4 weeks. The simplest approach: if the stump is still on after 2 weeks, show it to your midwife, and she will judge whether a doctor's visit is needed.
Can I bath my newborn before the cord stump falls off?
Advice differs here. Polish neonatologists consider that getting the stump wet in the bath is not dangerous, and gently washing it with soap and water is actually a good idea, as long as you dry it thoroughly afterwards. The AAP and MedlinePlus, on the other hand, advise only sponge-bathing your baby, without putting them in a baby bath, until the stump falls off. Both approaches share the same rule: after bathing, the stump should be clean and dry.
- If you bath your baby in a baby bath, wash the base of the stump with soap and water, and after the bath dry the stump and the skin around it thoroughly with a clean gauze pad.
- If you prefer to sponge-bath your baby, wipe the area around the belly button with a damp gauze pad and dry it thoroughly too.
- After the bath, put on a nappy folded down below the belly button straight away.
The WHO recommends delaying the first bath of a healthy, full-term newborn until at least 24 hours after birth and making sure the baby does not lose heat during the bath.
What does a normally healing belly button look like, and what should worry me?
The stump gradually dries out and shrinks. According to the AAP, a few drops of blood on the nappy around the day the stump falls off are normal. Signs of an infected belly button, meaning inflammation of the skin and tissues around it, are a cause for concern, as it needs prompt treatment.
| Normal healing | Reason to contact a midwife or doctor | |
|---|---|---|
| Stump | Dries out, shrinks and falls off on its own, usually between days 5 and 15 | Moist, oozing pus or smelly, or still attached after 2 weeks |
| Skin around the belly button | The same colour as the rest of the tummy, no swelling | Red, swollen, warm, redness spreading across the tummy |
| Blood | A few drops on the nappy when the stump falls off | Bleeding that does not stop or is heavy |
| Discharge | None, or a trace that soon disappears | Pus, yellow discharge with a bad smell, oozing that continues |
| Baby's behaviour | Touching the area around the belly button does not hurt them | Cries when the belly button or the skin nearby is touched, has a fever, feeds poorly, is drowsy |
My newborn's belly button is oozing pus: midwife or doctor?
Pus, watery or bloody discharge, redness, swelling and warmth of the skin around the belly button may mean omphalitis (an infection around the belly button). According to Prof. Szczapa, it needs urgent antibiotic treatment, often in hospital. Do not put home remedies or antibiotic ointments on a belly button oozing pus without a doctor's advice. The table will help you judge how quickly to seek help. If in doubt, choose the more urgent option.
| What to do | Symptoms |
|---|---|
| See a doctor urgently, and if that is not possible, go to the SOR (hospital emergency department) | Bleeding from the belly button that does not stop. A temperature of 38°C or higher. Your baby feeds poorly, is drowsy or floppy. Redness, swelling and warmth of the skin around the belly button that is spreading. A bulge at the belly button that has become hard, painful or changed colour, especially if your baby is vomiting. |
| Call your midwife or doctor the same day | Yellow discharge with a bad smell from the stump or the base of the belly button. Red skin at the base of the stump. Your baby cries when you touch the belly button or the skin nearby. A belly button that keeps oozing after the stump has fallen off. |
| Ask at your midwife's next visit | The stump is still attached after 2 weeks. A pink, moist lump in the belly button after the stump has fallen off. A soft bulge at the belly button that sticks out more when your baby cries. |
Heavy bleeding from the belly button can be a sign of a clotting disorder, so do not wait for a postnatal home visit. If your baby is very drowsy, floppy or hard to wake, call 112.
What is an umbilical granuloma and an umbilical hernia?
"Dziki pępek" (literally "wild belly button") is the everyday Polish name for an umbilical granuloma. According to the AAP, it is a small red or brownish lump of scar tissue that can remain in the belly button after the stump falls off and may ooze a light yellow fluid. It usually goes away on its own in about a week. If it persists, a doctor can dry it out or cauterise it with a chemical. Do not try to remove it yourself; show it to your midwife, and she will decide whether a doctor is needed.
An umbilical hernia is a soft bulge around the belly button that sticks out more clearly when the baby cries. The NHS says many babies are born with an umbilical hernia and it usually goes away as the child grows, and complications in children are very rare. According to the AAP, an umbilical hernia is not dangerous and usually closes on its own within the first 12-18 months. Show it to a doctor if it gets bigger, and urgently if it has become hard, painful or discoloured or your baby is vomiting.
Who checks the belly button after we leave hospital?
The belly button is checked by a POZ midwife (a primary care midwife funded by the NFZ, Poland's public health insurer) during free postnatal home visits, called wizyty patronażowe. Under the perinatal care standard, she makes at least 4 visits, the first no later than 48 hours (excluding Saturdays, Sundays and public holidays) after receiving notice of the baby's birth or the mother's discharge from hospital. During the visits she assesses and records the state of the stump (dry, moist, oozing pus) and the base of the belly button, including granulation tissue, inflammation around the belly button and any hernia, and shows you how to care for the stump and belly button.
This is a good time to ask about anything that worries you and to ask the midwife to show you how to do the care on your own baby. If you need advice sooner or would like an extra, longer visit, on MyMidwife you will find midwives who come to your home.
