Umbilical cord is the lifeline of the fetus and after birth when it is no longer needed it is snipped near the umbilicus (belly button) and a short stump is left behind that eventually becomes dry and shriveled and falls off within 5 to 15 days.
Sometimes this short stump can harbor infection or can heal improperly giving rise to a soft fleshy pink or red tissue known as umbilical granuloma.
What is an umbilical granuloma?
Umbilical granuloma is a soft fleshy pink or red swelling that is noticed at the centre of the umbilicus following the separation of umbilical cord in the newborn. It can vary in size from 2 to 10 mm. It usually has a clear or yellow discharge that oozes out in small quantities.
It is usually NOT associated with any redness, swelling, yellowish foul smelling discharge unless associated with infection.
How common is umbilical granuloma?
Umbilical granuloma is very common in newborns. In fact it is the most common lesion arising from umbilicus in newborns. The incidence is believed to be 1 in 500 newborns.
What causes umbilical granuloma?
Although the definitive cause of the umbilical granuloma is not discerned, there are few fairly reliable theories. Mild infection and delayed separation of the umbilical cord are two important factors that might result in the formation of umbilical granuloma.
A mild and subclinical umbilical tissue infection can stimulate excessive growth of the scar tissue. This mild infection itself may be one the causes of delayed separation of the umbilical cord. These tissues can in turn secrete clear or blood stained fluid.
What does umbilical granuloma look like? What symptoms or signs will an umbilical granuloma cause?
You might notice a small fleshy pinkish or red tissue in the umbilicus which discharges clear or pinkish fluid. The fluid is usually odourless and clear unless infected. It should not contain any fecal matter or urine.
The surrounding area remains normal. There is no pain in touch. The baby remains active and feeds well unless there is an infection.
Rarely the granuloma can be buried deep inside the umbilicus and you might only notice discharge without seeing any swollen tissue.
So it is important to consult a doctor whenever you see any discharge from the umbilicus.
How is umbilical granuloma treated?
There are various treatment options for umbilical granuloma. Your pediatrician may recommend any of the following like application of silver nitrate, common salt, topical antibiotics, topical steroids, excision, cryotherapy, electrocautery1.
The initial treatment is usually silver nitrate. But not all cases might respond to silver nitrate and might require other modes of management.
Can I prevent umbilical granuloma?
Good hygiene helps prevent any subclinical infection and in turn umbilical granuloma.
Read our article on umbilical cord care : the ultimate guide to know more.
Do I need to see a doctor if my baby has umbilical granuloma?
Yes, a visit to a pediatrician or a healthcare professional is strongly recommended. There are a number of lesions which can look like umbilical granuloma. An experienced doctor will examine and evaluate to confirm the diagnosis. Rarely, the doctor might suggest certain investigations to confirm if in doubt.
Are umbilical granulomas painful to the baby?
No, umbilical granulomas are not painful. As umbilical granulomas do not contain any nerve tissue they are not painful to the baby.
Are there any home remedies for umbilical granuloma? Can I use common salt to treat umbilical granuloma?
Common salt is a scientifically proven and completely safe home remedy for umbilical granuloma. The salt is believed to draw water out of the cell and shrinks the granuloma.
How to use common salt to treat umbilical granuloma?
After confirming from your doctor that it is in fact umbilical granuloma, you can follow the below instructions and apply common salt.
- Wash the umbilical area using warm water and dry with a clean cloth
- Apply petroleum jelly to the healthy surrounding skin
- Apply a small pinch of common salt to the umbilical granuloma
- Cover the area with cotton gauze or clean cotton cloth
- Use an adhesive bandage to cover the area and keep the gauze in place
- Make sure the surrounding area is clean and devoid of any salt crystals
- After 30 minutes, clean the area with warm water, making sure all of the salt is removed. Then dry the area.
Repeat this 2 to 3 times a day for 5 days.
Consult a health professional if the granuloma does not shrink or dry up.
How to apply silver nitrate for umbilical granuloma?
Silver nitrate is the most commonly used treatment for umbilical granuloma because of its antiseptic functions. It is extremely important to exercise caution while using silver nitrate as it caustic and can cause chemical burns on healthy skin.
After washing your hands, thoroughly clean the area with warm water.
Make sure to protect the healthy skin around the umbilicus with petroleum jelly. Using a q-tip carefully apply a small quantity only on the granuloma.
This is usually done once in 3 to 5 days. It is best done by a healthcare professional.
How long does it take for umbilical granuloma to heal?
It can take anywhere between 5 to 15 days for umbilical granuloma to heal completely. While on treatment if you do not see any response in the form of drying or reduction in size within 5 days it is time to review with your pediatrician.
Are there any complications of umbilical granuloma?
They can frequently get infected which in turn can cause fever, refusal to feed, irritability, excessive crying, swelling around the umbilicus, rash or redness around the umbilicus, yellowish foul smelling discharge.
1. Karagüzel G. Umbilical Granuloma: Modern Understanding of Etiopathogenesis, Diagnosis, and Management. JPNC [Internet]. 2016 Mar 1;4(3). Available from: https://medcraveonline.com/JPNC/umbilical-granuloma-modern-understanding-of-etiopathogenesis-diagnosis-and-management.html
2. NHS guidelines https://www.ruh.nhs.uk/patients/services/clinical_depts/paediatrics/documents/patient_info/PAE020_Umbilical_Granuloma.pdf
3. Pinch of salt: A modified technique to treat umbilical granuloma. https://onlinelibrary.wiley.com/doi/abs/10.1111/pde.13851.