When you have a baby, you’re faced with the question of the umbilical cord. What’s normal? What’s not? When do I worry? After years of having parents try to describe what the belly button looks like over the phone, I decided to compile some pictorial examples.
When the baby is first born, a clamp is placed and the cord is cut. The cord has a sort of wet, gelatinous feel and appearance to it. It soon starts to dry up and shrivel a bit. When you take your baby home, the cord will look like this.
Normal newborn umbilical cord
You can see how the end is crimped from the clamp. The key at this stage is to keep the belly button clean and dry, and not knock it off prematurely.
This next pic is of a normal healing belly button that is just starting to separate. Notice the glistening yellow tissue. This is not pus. This is not infection. It is normal.
Upclose of normal separation of the cord
The following picture is the remains of a cord that was knocked off prematurely. You’ll see the slight amount of blood and the glistening base. This cord was not quite ready to come off yet. (This one got caught on the diaper and ripped off). It is a common occurrence and not something to get too worried about. The body will create a new scab (a little black scab right at the base) that will then fall off again when it’s ready. In the meantime, keep the area clean and dry. With a cord like this, there will be a little spotting of blood on the onsie, which is perfectly normal.
Cord that came off too early
This picture is to demonstrate the hyperpigmentation (or dark skin coloring) that can occur at the base of some belly buttons. This is entirely normal and very common. Incidentally, I see it much more commonly in people whose skin coloring is naturally darker. In this case, the child’s belly button is not dirty and you shouldn’t go digging to get it out.
Normal Hyperpigmentation at the base of the belly button
The final picture below is to show you what to worry about. The cord is a direct connection to the inside of the body. While rare, the cord can get infected, and the infection can spread to the inside of the abdomen. The term for this is omphalitis. The key to this kind of infection is that the redness has spread onto the abdomen. The cord can get a little red and irritated if it gets knocked or red routinely. However, in this case, the redness is on the abdomen itself. Look closely and you can see a clear red outline a couple inches beyond the cord stump. If your child’s cord looks like this, you need to seek immediate medical attention (I’m talking Emergency Room).
An example of an infected belly button (omphalitis)
As always, if you are uncertain whether your child has something to worry about, you are always better playing it on the safe side and seeking medical attention. Most of the calls and visits I get about umbilical cords are normal, and I hope these pics help shed some light on the often confusing and stressful situation of umbilical cord care.