Umbilical infection in newborns The umbilicus is a dangerous entry point for
infections which can easily pass through the cord into
the baby's 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 baby's temperature, gather import background information.
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? As 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 pump 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 baby's 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 five 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 the gentian violet
.5 percent to the stump and the surrounding skin.
Let her know that it stains. Advise her to keep the cord open to the air
and not put anything else on it. Safely dispose of your gloves.
Remind the mother to washer 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 two 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. 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 cloxacillin. Notify the facility.
Arrange for transportation and write a referral note. The baby should be fed every two to
three 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. But realize that this care is not the same.
When treating the baby at your clinic effective treatment options are intramuscular gentamicin
plus either cloxacillin, ampicillin, or procaine penicillin. Procaine penicillin has the advantage
of being given once daily. Continue to wash the umbilicus and apply gentian violet twice
a day. Treat the baby for seven 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 seven days
of treatment. 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.