Umbilical Cord Care After the First Day From Birth: A Case Control Study in a Northeastern Italian Hospital

Abstract

Background: Recently the use of antibacterial agents to clean and dry the stump of the newborns’
umbilical cord (UC) after birth has been abandoned by many neonatal units. Aim of this study
was to compare the occurrence of adverse events (AEs), time to UC separation and caregivers’
satisfaction among newborns treated with dry cord care versus 70% alcohol after one day from
birth in an Italian Hospital.
Methods: From June 2014 to September 2014, 100 infants were enrolled for the study. Soon
after birth, all the newborns were treated in the same way: their UC was cleansed with 70%
alcohol, using a sterile gauze. One day after the birth, in the control group the UC was regularly
cleansed with 70% alcohol twice a day, while in the case group, from the first nappy change,
dry cord care was performed cleansing the UC with sterile saline solution (NaCl 90%), using
a sterile gauze twice a day. In all cases UC was left without any dressing upon it as well. The
time to UC separation and any AEs (local and systemic infections, haemorrhage, granuloma
formation) were reported by mothers. Carers’ perception regarding the two procedures were
collected by a questionnaire between 6 and 24 hours after birth, and 1 month later.
Results: We found a significant difference in the mean cord separation time between the two
groups [dry cord care: 9.1 days (standard deviation (SD)=3.1] versus 70% alcohol: 11.3 days
(SD=4.6); p<0.01], while no significant AEs and carers’ satisfaction on the procedures resulted.
Instead, change of treatment at home was more frequent in dry cord care group (23.9% versus
6.1%; p<0.01).
Conclusions: This study confirms that dry cord care is an easy, accepted and safe method of
handling the UC in healthy newborn infants born in a high-income hospital setting.
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