Intervention Review

Topical umbilical cord care at birth

  1. Jelka Zupan1,
  2. Paul Garner2,
  3. Aika AA Omari3

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 19 JUL 2004

Assessed as up-to-date: 6 MAY 2004

DOI: 10.1002/14651858.CD001057.pub2

How to Cite

Zupan J, Garner P, Omari AAA. Topical umbilical cord care at birth. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001057. DOI: 10.1002/14651858.CD001057.pub2.

Author Information

  1. 1

    World Health Organization, Department of Reproductive Health, 1211 Geneva 27, Switzerland

  2. 2

    Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK

  3. 3

    Alder Hey Children's Hospital, Liverpool, UK

*Frances J Kellie, Cochrane Pregnancy and Childbirth Group, Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, L8 7SS, UK.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2004




  1. Top of page
  2. Abstract
  3. Plain language summary


Umbilical cord infection caused many neonatal deaths before aseptic techniques were used.


To assess the effects of topical cord care in preventing cord infection, illness and death.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group trials register (September 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003). We also contacted experts in the field.

Selection criteria

Randomized and quasi-randomized trials of topical cord care compared with no topical care, and comparisons between different forms of care.

Data collection and analysis

Two reviewers assessed trial quality and extracted data.

Main results

Twenty-one studies (8959 participants) were included, the majority of which were from high-income countries. No systemic infections or deaths were observed in any of the studies reviewed. No difference was demonstrated between cords treated with antiseptics compared with dry cord care or placebo. There was a trend to reduced colonization with antibiotics compared to topical antiseptics and no treatment. Antiseptics prolonged the time to cord separation. Use of antiseptics was associated with a reduction in maternal concern about the cord.

Authors' conclusions

Good trials in low-income settings are warranted. In high-income settings, there is limited research which has not shown an advantage of antibiotics or antiseptics over simply keeping the cord clean. Quality of evidence is low.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Topical umbilical cord care at birth

No evidence that applying sprays, creams or powders are any better than keeping the baby's cord clean and dry at birth.

The umbilical cord connects the baby to its food and oxygen supply in the womb, and is clamped and cut at birth. The cord stump dries, shrivels and becomes black before falling off the baby's belly button, five to 15 days after birth. Without proper care, the baby may become infected through the stump. Usually the cord is kept clean and dry by loosely covering it with clean clothes. Hand washing is critical. The review found that not enough trials had been done to show if antiseptics or antibiotics were any better at keeping infection away. More research is needed.