While there is a general agreement about the clean technique for cutting the cord using a sterile cutting instrument (blade or scissors) and regards to clean hands to avoid infection, there is less accord on what is the best care of the cord stump [1]. On the basis of a Cochrane review [1] and other several studies [2-6], WHO [7] recommends daily chlorhexidine (7.1% chlorhexidine digluconate aqueous solution or gel, delivering 4% chlorhexidine) application to the umbilical cord (UC) stump during the first week of life for newborns who are born at home in settings with high neonatal mortality (30 or more neonatal deaths per 1000 live births), while dry cord care for newborns born in health facilities and at home in low neonatal mortality settings. Dry cord care consists in keeping the cord clean without application of anything (a dye, an antiseptic, or an antibiotic) and leaving it exposed to air or loosely covered by a clean cloth, in case it becomes soiled it is only cleaned with water [7]. Despite WHO recommendations, healthcare working in neonatal unit and caregivers use different procedures to care the UC according their experiences and their preferences.
1. Zupan J, Garner P, Omari AA. Topical umbilical cord care at birth. Cochrane Database Syst Rev. 2004:CD001057.
2. Arifeen SE, Mullany LC, Shah R, et al. The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial. Lancet 2012;379:1022 – 1028.
3. Soofi S, Cousens S, Imdad A, Bhutto N, Ali N, Bhutta ZA. Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, cluster-randomised trial. Lancet 2012;379:1029 – 1036.
4. Mullany LC, Darmstadt GL, Khatry SK, LeClerq SC, Katz J, Tielsch JM. Impact of umbilical cord cleansing with 4.0% chlorhexidine on time to cord separation among newborns in southern Nepal: a cluster-randomized, community-based trial. Pediatrics 2006;118:1864 – 1871.
5. Kapellen TM, Gebauer CM, Brosteanu O, Labitzke B, Vogtmann C, Kiess W. Higher rate of cord-related adverse events in neonates with dry umbilical cord care compared to chlorhexidine powder. Neonatology 2009;96:13 – 8.
6. Verber IG, Pagan FS. What cord care – if any. Arch Dis Child. 1993;68:594 – 596.
7. World Health Organization. Postnatal care of the mother and newborn. Geneva, Switzerland: 2013.