Omphalitis or Navel Infection in Newborns

Omphalitis or navel infection in newborns is a potentially life-threatening condition. Here we'll tell you everything you need to know.

Reviewed and approved by the dermatologist Maria del Carmen Hernandez.

Written by Maria del Carmen Hernandez

Last update: 10 November, 2022

Omphalitis or a navel infection in newborn babies is one of the most common concerns of parents during the first days of life. In addition, prompt diagnosis and treatment are important to avoid serious complications.

In this article, we’ll tell you about the preventive measures to implement, the clinical manifestations, and therapeutic management.

What is omphalitis in newborns?

Omphalitis is a navel infection or an infection of the surrounding tissues in newborns. After birth, the umbilicus of the newborn is colonized with various types of bacteria present in the birth canal and on the hands that handle it.

The devitalized tissues of the umbilical stump stimulate rapid bacterial growth and, in addition, the thrombosed blood vessels allow entry into the bloodstream, which can lead to systemic infection.

Therefore, omphalitis is a polymicrobial infection. In turn, a publication by the American Academy of Pediatrics considers the following risk factors for the development of the infection:

• Low birth weight
• Home delivery (non-sterile delivery)
• Prolonged rupture of membranes
• Maternal infection
• Inadequate cord care
• Prolonged labor

Proper home care after delivery can decrease the risk of a navel infection. Therefore, your physician’s instructions should be followed carefully when caring for your baby.

Clinical manifestations of omphalitis in newborns

Symptoms usually begin within 3 days, as it’s a disease of newborns and is characterized by redness, pain upon palpation, and induration of the umbilicus and surrounding tissues.

In the beginning, only superficial cellulitis is usually observed, but if adequate treatment isn’t started, it can evolve unfavorably and affect the entire abdominal wall.

There may even be bleeding or purulent drainage from the umbilical cord stump. Sepsis, along with a poor prognosis, should be suspected with the following systemic symptoms:

• Fever
• Poor feeding
• Lethargy
• Irritability

Sepsis is one of the most common complications of omphalitis in newborns and can progress to a much more harmful and severe condition, so early detection and treatment are essential.

In addition, navel infection is much more common in third-world countries due to a lack of resources and means for proper hygiene.

Therapeutic options for navel infection

To determine the most appropriate treatment for navel infection, a physician will take a swab sample from the infected area. This sample is then examined in the laboratory to identify the exact microorganism that caused the infection.

However, in most cases, treatment requires intravenous antibiotics that are broad-spectrum (active against both gram-negative and gram-positive organisms).

The duration of antibiotic treatment depends on the newborn’s response and any complications that may occur. In addition, milder cases can be treated with topical medications, and more severe cases should be managed more aggressively with parenteral antibiotics.

Prevention of omphalitis in the newborn

Prevention of omphalitis requires adequate umbilical cord hygiene measures. Dry cord care is recommended, which involves keeping the cord free of moisture and exposing it to air to help prevent infection.

In fact, according to research published in the journal Medicine, dry cord care (regarding the use of an antiseptic product) is a safe, effective, and easy way to help prevent omphalitis in healthy newborns.

Some tips for dry cord care include:

• Washing your hands properly before touching the baby’s cord area.
• Avoiding getting the navel stump wet. Therefore, avoid wiping the area around the stump and only offer sponge baths until the cord falls off.
• Keeping the diaper folded down in the umbilical area until the cord falls off instead of placing the elastic of the diaper over the stump. This way, air circulates and helps dry the area.
• Gently wiping away any urine or fecal matter with a sponge or gauze soaked in water.

Breastfeeding also allows antibodies to be passed on to the newborn, which can help their immune system develop and strengthen.

Prevention is always best

In conclusion, the bottom line is that it’s essential to implement the necessary measures to prevent umbilical cord infection.

However, if the characteristic signs or symptoms of omphalitis are still present, you should go as soon as possible to the emergency room so that your baby can be in the hands of specialists who can indicate the right treatment to follow.

Under no circumstances should creams, medications, or home remedies be used to try to cure the infection.