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New parent issues with infants. Cord care and tummy buttons in a newborn baby

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By Anthony J. Mancini & Ricky Richardson MD & BSc, MBBS, FRCP, FRCPCH

"Every day offers a new surprise, and my job is never dull or boring," says pediatric dermatologist Anthony Mancini. "How could it be with all those kids?"

Anthony J. Mancini, MD, is Assistant Professor of Pediatrics andDermatology at Northwestern University Medical School in Chicago, Illinois, and an attending physician at the city's Children's Memorial Hospital. In addition to his active clinical practice, Dr Mancini continues to be involved in clinical research and has written for a number of prestigious medical journals and textbooks. Dr. Mancini has special interests in the treatment of skin disorders in infants and children, fetal skin development and skin problems of premature babies, and infectious skin diseases in children.

Dr Mancini trained in pediatrics, pediatric dermatology, and dermatology at Stanford University Medical Center in Palo Alto, California, where he was the chief resident in dermatology. He is a fellow of the American Academy of Pediatrics and the American Academy of Dermatology, and an active member of the Society for Pediatric Dermatology and the Chicago Dermatological Society.

Dr Mancini and his wife, a neonatal intensive care nurse, have two children.

He spent five years in Brunei to devise and implement a comprehensive integrated paediatric service at the request of the Government of Brunei. He also spent two years in Muscat in the Sultanate of Oman as Senior Paediatric Consultant and advisor to the Ministry of Health.

In addition to his academic role, he was appointed Honorary Consultant Physician at The Great Ormond Street Hospital for Children, a position which he still holds. He is also a Consultant Physician at the Portland Hospital for Women an

"Every day offers a new surprise, and my job is never dull or boring," says pediatric dermatologist Anthony Mancini. "How could it be with all those kids?"

Anthony J. Mancini, MD, is Assistant Professor of Pediatrics andDermatology at Northwestern University Medical School in Chicago, Illinois, and an attending physician at the city's Children's Memorial Hospital. In addition to his active clinical practice, Dr Mancini continues to be involved in clinical research and has written for a number of prestigious medical journals and textbooks. Dr. Mancini has special interests in the treatment of skin disorders in infants and children, fetal skin development and skin problems of premature babies, and infectious skin diseases in children.

Dr Mancini trained in pediatrics, pediatric dermatology, and dermatology at Stanford University Medical Center in Palo Alto, California, where he was the chief resident in dermatology. He is a fellow of the American Academy of Pediatrics and the American Academy of Dermatology, and an active member of the Society for Pediatric Dermatology and the Chicago Dermatological Society.

Dr Mancini and his wife, a neonatal intensive care nurse, have two children.

He spent five years in Brunei to devise and implement a comprehensive integrated paediatric service at the request of the Government of Brunei. He also spent two years in Muscat in the Sultanate of Oman as Senior Paediatric Consultant and advisor to the Ministry of Health.

In addition to his academic role, he was appointed Honorary Consultant Physician at The Great Ormond Street Hospital for Children, a position which he still holds. He is also a Consultant Physician at the Portland Hospital for Women and Children. His clinical interest is in children with specific learning and behavioural difficulties. In 1990, he co-founded Whizz-Kidz, a children’s charity which has become the largest supplier of mobility aids and specialist services to disabled children outside the NHS.

Dr Richardson is an acknowledged authority on the emerging field of e-Health and Telemedicine. He lectures frequently on the subject and is Chairman of the UK Telemedicine Association. He is also involved in an European working group mandated to facilitate e-Health and telemedicine activities across the European Community.

Dr Richardson is a Fellow of the Royal College of Physicians (FRCP), a Fellow of the Royal College of Paediatrics and Child Health (FRCPCH), a Fellow of the Royal Society of Medicine and a Fellow of the Royal Society of Tropical Medicine.

Dr Richardson is married and has two sons.

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How do you care for your newborn's umbilical cord stump? Read on for nappy-changing tips, bathing recommendations, and warning signs to watch out for, like redness or discharge.

Cord care and tummy buttons

If you're the new parent of a newborn baby, you'll want to know about cord care. The umbilical cord that kept your baby nourished in the womb is now a little stump. As it dries, it will turn brown, shrivel, and harden. Within two or three weeks, it will fall off.

Here, you'll find instructions for a new parent on caring for the stump - how to help it heal, dry up and fall off safely. You'll also learn to identify the signs of infection and find out when to call your GP.


Cord Curriculum

Bathing Techniques

Warning Signs to Watch For


Cord Curriculum


Follow these guidelines to protect your newborn baby's cord stump.

 Whenever you change your baby's nappy, pay special attention to the area at the base of the cord, nearest to the tummy button. Wipe it gently but thoroughly to clean out any moist dirt that may have collected. Don't worry about hurting your baby - there are no nerve endings in the cord stumps of infants.

 Make sure you allow air to reach the cord stump. This will help it heal and dry faster.

 Try to prevent nappies from rubbing against the stump. You can fold the nappy down under the cord stump.

 Let the cord stump fall off on its own. In the past, we often suggested cleaning off the stump with rubbing alcohol. New data suggests that natural drying will allow the cord to fall off faster. And remember, infants are born with "innies" or "outies". Don't try to cover the umbilical area with coins, bandages or wraps to change what your baby was born with - it won't work and will only cause problems.



Bathing Techniques


While your newborn baby still has his umbilical cord, it's best to give him quick sponge baths rather than submerging the cord stump. Once the cord has fallen off, feel free to bathe him in a baby tub or washbasin. For more information for a new parent, see Bathing Basics.



Warning Signs to Watch For


1. If the cord oozes yellow pus, if it develops a bad odour, or if the area around the base is red and swollen, it may be infected. You should notify your baby's doctor.

2. Redness can also be caused by the dry cord stump irritating the nearby skin. To determine what is causing the irritation, gently push the stump away from the red area and mark the margin of redness with a pen. Wait 30 minutes and check it again. If the redness is still there, and especially if it has spread beyond your mark, call your GP immediately. If the redness is just irritation from the stump, it will take care of itself in a little while.

3. Occasionally, you may see small amounts of bleeding from the navel - this is normal in infants as the blood vessels separate. If you notice bleeding, first try applying a little pressure. If the bleeding doesn't stop after five to seven minutes of constant pressure, call your GP.

4. After the cord falls off, your baby's tummy button may swell a bit and continue to ooze slightly. This is called an umbilical granuloma. Your GP may treat it with a drying medication called silver nitrate.


 
 
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