Belly Button

Baby belly buttons.  I mean is there anything cuter!  But, in the beginning, the belly button and umbilical cord stump are not as cute.  Once baby is born, the umbilical cord is cut, and baby is left with a stump of it attached to their belly button.  This is because it takes a few days or weeks for the belly button to take note that nothing is attached to it anymore and close off the vascular connection that it once had via the umbilical cord.  When caring for the stump, it is best to “set it and forget it.”  We don’t really need to do much.  Back in the day (and what grandparents may insist on) was putting rubbing alcohol drops on it to help dry it out, but we don’t do that anymore.  It doesn’t speed up the process and it doesn’t prevent infection.  So, best to just leave it alone and keep it dry, meaning no submersion baths until that thing falls off.  Over the next few days to weeks the cord will dry up and start to peel away from the belly button.  As it does this, there may be some bloody spots or snotty looking mucous discharge around the belly button or on the baby’s onesies when you are changing diapers; this is very normal.  Sometimes the belly button does not get the message that the stump is gone and will still ooze some clear discharge for a while.  Your pediatrician will investigate and see if there is granulation tissue present.  Granulation tissue occurs in this area when the skin is having trouble deciding to mature and be free of the umbilical stump.  If it is still oozing with granulation tissue after a few weeks, your pediatrician can apply silver nitrate to help from a “fake” scab over the granulation tissue which tells the granulation tissue, “Hey no more stump, let’s move on dude!”  Sometimes it needs to be treated a couple times to be effective.  There are some rarer causes of continued discharge from the belly button, such as issues surrounding the bladder and its placement during prenatal development.  These things will usually be investigated if the discharge smells like urine, or if after a few granulation treatments with silver nitrate, we continue to see discharge from the belly button. 

Another concern that can arise around the belly button is something called an umbilical hernia.   If your child has more of an “outie” than you would expect, they probably have an umbilical hernia.  A lot of kiddos have this at some point in the first 6 months of life.  Kids are not born with awesome 6 pack abs, or any semblance of abs really, which is why their tummies are so soft and squishy.  Because of this, there is a weakness in the center of the ab muscles around the belly button, which can cause a protrusion.  Most are small, but some can be pretty big.  The good news is these almost always (95-98%) close up on their own by the time the kiddo is 6 years old.  If, for some reason, your pediatrician thinks it is too big or may not close, they will send you to a pediatric surgeon for their opinion regarding whether it should be surgically closed when the kiddo is older or if it is ok to wait and see if it closes up on its own.