The umbilical cord is a tough, flexible cord that carries nutrients and blood from birth mom to baby during pregnancy. After birth, the cord, which has no nerve endings, is clamped (to stop bleeding) and cut close to the navel, leaving a stub. The stub generally falls off in one to three weeks after birth.

During birth and the clamping and cutting process, germs can invade the cord and cause infection. Infection of the umbilical cord stump is called omphalitis.

Omphalitis is rare in the United States, United Kingdom, and other countries where people have easy access to hospitals.

Read on to learn how to identify and treat an umbilical cord infection.

It’s normal for the clamped cord to develop a scab at its end. It may even bleed a little bit, especially around the base of the stump when it’s ready to fall off. But the bleeding should be light and quickly stop when you apply gentle pressure.

While slight bleeding is normal and usually nothing to be concerned about, signs of infection may include:

  • red, swollen, warm, or tender skin around the cord
  • pus (a yellow-greenish liquid) oozing from the skin around the cord
  • a bad smell coming from the cord
  • fever
  • a fussy, uncomfortable, or very sleepy baby

The umbilical cord has direct access to the bloodstream, so even a mild infection can become serious quickly. When an infection enters the bloodstream and spreads (called sepsis), it can cause life-threatening damage to the body’s organs and tissues.

Contact your child’s pediatrician immediately if you notice any of the above signs of an umbilical cord infection. Umbilical cord infection is fatal in up to about 15 percent of babies with an umbilical cord infection, so it’s considered a medical emergency.

Premature babies are at increased risk for severe complications from this type of infection because they already have a weakened immune system.

To determine the most appropriate treatment for your child’s infection, a medical professional will usually take a swab of the infected area. This swab can then be examined in the lab so that the exact germ that’s causing the infection can be identified. When doctors know which germ is responsible, they can better pinpoint the right antibiotic to fight it.

Once the cause of the symptoms is identified, treatment largely depends on the extent of the infection.

For minor infections, your child’s doctor may recommend applying an antibiotic ointment a few times a day on the skin surrounding the cord. An example of a minor infection is if there’s a small amount of pus, but your child otherwise seems fine.

Minor infections can become more serious when left untreated, however, so it’s important to see a doctor whenever an umbilical cord infection is suspected.

For more serious infections, your baby will likely need to be hospitalized and given intravenous antibiotics to fight the infection. Intravenous antibiotics are delivered through a needle inserted into a vein. Your child may be in the hospital for several days while they are receiving the antibiotics.

Babies given intravenous antibiotics typically receive them for about 10 days. They may then be given additional antibiotics via their mouths.

In some cases, the infection may need to be surgically drained.

If the infection has caused tissue to die, your child may also need an operation to remove those dead cells.

When the serious infection is caught early, most babies recover fully within a couple of weeks. But they usually need to stay in the hospital while they receive intravenous antibiotics.

If your baby had surgery to drain the infection, the opening may have been “packed” with gauze. The gauze will keep the cut open and allow the pus to drain. Once the draining stops, the gauze is removed and the wound will heal from the bottom up.

Just a few years ago, hospitals routinely covered a baby’s cord stump with an antiseptic (a chemical that kills germs) after it was clamped and cut. Nowadays, though, most hospitals and pediatricians advise “dry care” for cords.

Dry care involves keeping the cord dry and exposing it to air to help keep it free from infection. According to research published in the journal Medicine, dry cord care (compared to using an antiseptic) is a safe, easy, and effective way to help prevent cord infection in healthy babies born in hospitals in developed areas.

Dry cord care tips:

  • Clean your hands before you touch the baby’s cord area.
  • Avoid getting the stump wet as much as possible. Use sponge baths to cleanse your baby until the stump falls off, and avoid sponging the area around the stump. If the stump does get wet, gently pat it dry with a clean, soft towel.
  • Keep your baby’s diaper folded under the stump until it falls off instead of laying the diaper band across the stump. This will allow air to circulate and help dry the stump.
  • Gently sponge away any pee or poop that collects around the stump with some water-moistened gauze. Let the area air dry.

While not care tips per se, other strategies may also help reduce risk for umbilical cord infection, such as having skin-to-skin contact or breastfeeding your baby.

By placing your bare-chested baby against your own bare chest, known as skin-to-skin contact, you can expose your baby to normal skin bacteria. According to a 2006 study of Nepalese newborns published in American Journal of Epidemiology, babies who got skin-to-skin contact were 36 percent less likely to develop an umbilical cord infection than babies who didn’t have this kind of skin exposure.

Breastfeeding allows you to pass antibodies (substances that can help fight disease) to your baby, which can help their immune systems develop and strengthen.

In the United States, United Kingdom, and many other countries, umbilical cord infections are rare in healthy, full-term babies born in hospitals. But cord infections can happen, and when they do, they can become life-threatening if not caught and treated early.

Contact your doctor immediately if you notice red, tender skin around the cord or pus draining from the stump. You should also contact a doctor if your baby develops a fever or other signs of infection. Your baby has the best shot at a full recovery if treatment is started promptly.