Umbilical Cord Separation Time in Healthy Nigerian Newborns

Abstract

Background: An umbilical cord that remains attached beyond a week is usually a matter of concern to mothers in developing countries. Furthermore, delayed cord separation may increase the risk of bacterial infection. Objectives: To determine the average time of umbilical cord separation and evaluate the relationship between this time and gender, birth weight, gestational age, parity of the mother, mode of feeding and common cord care practices among Nigerian neonates. Methods: Questionnaires were administered to mothers of healthy newborns seen at the Infants' Welfare Clinic of the Institute of Child Health, College of Medicine, University College Hospital (UCH), Ibadan, and the Adeoyo Hospital and Maternity, Yemetu, Ibadan. Mother's parity, place of antenatal care and birth, gestational age, time and nature of amniotic fluid, duration of labour, birth weight, time of umbilical cord separation after birth, mode of feeding and mode of cord care were recorded. Results: Complete data were available in respect of 536 newborns. The mean cord separation time was 8.7 days (SD 3.7; range 2-21 days). Cord separation time was significantly shorter among male babies, infants fed with only breast milk, those whose mothers did not book for antenatal care and those delivered per vaginam (p<0.005). Alcohol (methylated spirit) was the most common single agent used for umbilical cord treatment. Other forms of cord care consisted of alcohol and hot fomentation, alcohol and menthol containing substances, alcohol and traditional mixture. The time taken for the umbilical cord to separate varied significantly (p<0.05) with different types of cord treatments. Conclusions: We suggest an intensification of the promotion of exclusive breast feeding and clean cord care practices and recommend that the use of menthol containing substances, traditional herbal mixtures and hot fomentation be discouraged.