Topical umbilical cord care at birth

No evidence that applying sprays, creams or powders are any better than keeping the baby's cord clean and dry at birth.

The umbilical cord connects the baby to its food and oxygen supply in the womb, and is clamped and cut at birth. The cord stump dries, shrivels and becomes black before falling off the baby's belly button, five to 15 days after birth. Without proper care, the baby may become infected through the stump. Usually the cord is kept clean and dry by loosely covering it with clean clothes. Hand washing is critical. The review found that not enough trials had been done to show if antiseptics or antibiotics were any better at keeping infection away. More research is needed.

Authors' conclusions: 

Good trials in low-income settings are warranted. In high-income settings, there is limited research which has not shown an advantage of antibiotics or antiseptics over simply keeping the cord clean. Quality of evidence is low.

Read the full abstract...

Umbilical cord infection caused many neonatal deaths before aseptic techniques were used.


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 (September 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003). We also contacted experts in the field.

Selection criteria: 

Randomized and quasi-randomized trials of topical cord care compared with no topical care, and comparisons between different forms of care.

Data collection and analysis: 

Two reviewers assessed trial quality and extracted data.

Main results: 

Twenty-one studies (8959 participants) were included, the majority of which were from high-income countries. No systemic infections or deaths were observed in any of the studies reviewed. No difference was demonstrated between cords treated with antiseptics compared with dry cord care or placebo. There was a trend to reduced colonization with antibiotics compared to topical 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.