Umbilical Cord Care

Umbilical cord care involves two related but distinct decisions. At birth, the team decides when to clamp the cord, balancing placental transfusion against the newborn’s need for immediate stabilization. After clamping, the remaining stump is devitalized tissue that must dry and separate without becoming infected. For a newborn in a Canadian health facility, the routine postnatal approach is clean, dry cord care. The exam pivots are the same ones that guide bedside priority: Is the newborn vigorous enough for deferred clamping? Does the stump look like normal drying tissue or an infected portal of entry? Is a small amount of blood expected at separation, or is bleeding persistent? A dry, darkening stump that separates within the usual time course needs teaching and observation; spreading erythema, purulent or foul drainage, systemic illness, or dangerous bleeding requires immediate escalation.