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Cord care

"Simply keeping the cord clean appears to be as effective and safe as using
antibiotics or antiseptics".
I have followed this routine for the last 2 years and so far so good.  David



Topical umbilical cord care at birth (Cochrane Review)

Zupan J, Garner P

ABSTRACT
  Objectives: The objective of this review was to assess the effects of
topical cord care in preventing cord infection, illness and death.

  Search strategy: We searched the Cochrane Pregnancy and Childbirth Group
trials register, the Cochrane Controlled Trials Register (Cochrane Library
issue 4, 1997) and Medline. We also contacted experts in the field.

  Selection criteria: Randomised and quasi-randomised trials of topical cord
care compared with no routine care, and comparisons between different forms of
care.

  Data collection and analysis: Two reviewers assessed trial quality and
extracted data.

  Main results: Ten studies were included, all from developed countries. No
systemic infections or deaths were observed in any of the studies reviewed.
Cord and other skin infections within six weeks of observation were not
affected by use of antiseptics. There was a trend to reduced colonization with
antibiotics compared to antiseptics and no treatment. Antiseptics prolonged
the time to cord separation. Use of antiseptics was associated with a
reduction in maternal concern about the cord.

  Reviewers' conclusions: Simply keeping the cord clean appears to be as
effective and safe as using antibiotics or antiseptics.


  Citation: Zupan J, Garner P. Topical umbilical cord care at birth (Cochrane
Review). In: The Cochrane Library, 1, 2002. Oxford: Update Software.



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1: J Obstet Gynecol Neonatal Nurs 1998 Nov-Dec;27(6):621-7

Alcohol versus natural drying for newborn cord care.

Dore S, Buchan D, Coulas S, Hamber L, Stewart M, Cowan D, Jamieson L

Hamilton Health Sciences Corporation, Ontario, Canada.

OBJECTIVE: To compare alcohol cleaning and natural drying of newborn
umbilical
cords. DESIGN: Prospective, randomized controlled trial. SETTING:
Tertiary-level
university teaching hospital and level II community hospital. PARTICIPANTS:
Of
1,876 singleton full-term newborns enrolled, 1,811 completed the study.
INTERVENTIONS: Newborns, from birth until separation of the cord, were
randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at
each
diaper change or (b) natural drying of the umbilical site without special
treatment. MAIN OUTCOME MEASURES: Umbilical infection, cord separation time,
maternal comfort, and cost. RESULTS: No newborn in either group developed a
cord
infection. Primary care providers obtained cultures for cord concerns in 32
newborns (1.8%), with colonization for normal flora, Staphylococcus aureus,
and
Group B streptococcus proportionately equal in alcohol and air dry groups.
Cord
separation time was statistically significantly different (alcohol group,
9.8
days; natural drying group, 8.16 days; t = 8.9, p = < .001). Mothers
described
similar comfort with cord care and relief with cord separation. Costs of
alcohol
drying while in the hospital were greater than those of natural drying.
CONCLUSIONS: (a) Evidence does not support continued use of alcohol for
newborn
cord care; (b) health care providers should explain the normal process of
cord
separation, including appearance and possible odor; and (c) health care
providers should continue to develop evidence to support or eliminate
historic
practices.

Publication Types:
Clinical trial
Randomized controlled trial

PMID: 9836156