Umbilical Infection in Newborns: Newborn Care Series

Newborn Care Series
Umbilical infection in newborns

The umbilicus is a dangerous entry point for infection, which can easily pass
through the cord into the babys body and lead to sepsis and death.
This video will show how to evaluate and treat the baby with an umbilical
infection.
Wash your hands. Then, as you take the babys temperature, gather
important background information; especially evidence of danger signs.
Did the mother receive tetanus immunization during her pregnancy?
What was used to cut the cord?
Was anything put on the cord?
Was the cord covered?
Ask about other danger signs such as poor feeding and convulsions.
The parents report that there is some redness around the cord. The baby is
otherwise normal and feeding well.
Now check the baby: First observe that the baby is alert and active.
Look for a moist cord and any drainage of pus. Check the cord for a bad odor.
Look at the skin on the stump and at the base for redness and swelling. See
the redness around the umbilicus.
Wash your hands, then, gently palpate the belly. A distended abdomen is a
dangerous sign that the baby may be developing sepsis.
Then check from head to toe for other danger signs such as jaundice or
breathing problems.
The health worker has determined that the baby has a localized umbilical
infection. There is just a little redness around the cord. The babys belly is
soft and there are no other danger signs.
The baby can be treated at home with amoxicillin by mouth. The cord needs
to be cleaned and treated with gentian violet twice a day for 5 days. Teach
the mother how to do this.
First have her wash her hands.
Gather clean cloths, soap and clean water that has been boiled and cooled.
Put on gloves. Teach the mother to gently wash the cord with soap and
water. Dry the area with a clean dry cloth. Guide her to carefully apply
Gentian violet 0.5% (point 5 percent) to the cord stump and surrounding
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Newborn Care Series

skin. Let her know that it stains. Advise her to keep the cord open to the air
and not to put anything else on it.
Safely dispose of your gloves. Remind the mother to wash her hands before
and after caring for the baby.
The cloths should be washed after each use and dried in the sun.
The parents should return in 2 days. Ask them to bring the baby sooner if
there is more redness and swelling around the umbilicus, if the skin becomes
hardened, or any danger signs develop.
This baby has a serious umbilical infection. There is redness and swelling
around the umbilical stump and a bad odor. He has several danger signs:
jaundice, poor feeding, and a low body temperature.
The signs of an infected umbilicus are redness -- often in a flare -- swelling,
and pus discharge. The belly can be distended.
This yellow appearance is part of the normal decaying process of the cord. It
may be confused for pus; but pus can be removed with a cotton swab.
Serious umbilical infections can cause babies to die very quickly (within 24
hours), so immediate referral is very important.
Before the baby leaves, give the first doses of antibiotics. The baby will need
intramuscular injections of gentamicin plus either ampicillin or cloxicillin.
Notify the facility, arrange transportation, and write a referral note.
The baby should be fed every 2-3 hours by breast or cup.
Keep the baby warm through skin to skin contact throughout the trip.
Every effort should be made to refer the baby urgently. But if referral is not
possible, do your best to care for the baby in your clinic though realize that
this care is not the same.
When treating the baby at your clinic, effective treatment options are
intramuscular gentamicin plus either cloxicillin, ampicillin, or procaine
penicillin. Procaine penicillin has the advantage of being given once daily.
Secondline treatment is gentamicin IM plus oral amoxicillin.
Continue to wash the umbilicus and apply gentian violet twice a day.
Treat the baby for 7 days.

Discharge the baby when the umbilicus is healed, she is feeding well, and
there are no other problems. Be sure the baby receives the full 7 days of
treatment.
Newborn Care Series

Remember:
The healing umbilicus is an entry for infection.
Treat a localized umbilical infection with oral amoxicillin and gentian

violet.
An umbilicus that is red or draining pus with any danger sign is a

severe infection and needs to be referred urgently.


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Newborn Care Series

Umbilical infection in newborns

Newborn Care Series

Secondline treatment is gentamicin IM plus oral amoxicillin.

Treat the baby for 7 days.

Newborn Care Series

The healing umbilicus is an entry for infection.

Treat a localized umbilical infection with oral amoxicillin and gentian

An umbilicus that is red or draining pus with any danger sign is a

Global Health Media Project, 30 Common Road, Waitsfield, VT 05673 U.S. |

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