Your baby's umbilical cord goes through some big changes after birth. After it's cut, the remaining stump usually dries out, shrivels, and falls off within about two weeks. Sometimes, though, a small bit of scar tissue called a granuloma may remain behind in the belly button.
This common condition won't hurt your baby and may go away on its own. If not, your pediatrician can easily treat it to prevent a potential infection. Here's what you need to know.
What is an umbilical granuloma?
An umbilical cord granuloma looks like a small, round bump in the middle of the navel after the cord stump has fallen off, according to the American Academy of Pediatrics (AAP). The tissue is often pink or reddish and may look a little moist.
Adults can also develop umbilical granulomas – after a tattoo or navel piercing, for example. For adults, antibiotics would be given, and a surgical removal of the granuloma would likely be done if there's an infection.
Sometimes other conditions – like an umbilical hernia – can look similar to a granuloma. So be sure to check with your pediatrician if you notice something unusual.
“Both my babies had an umbilical granuloma . . . and were fixed with silver nitrate. My first needed it two times before it finally healed,” says What to Expect Community member ellearia.
What causes an umbilical granuloma?
It's not exactly clear why some babies develop granulomas while others don't, but doctors think they may happen when the cord stump doesn't heal completely or when there's a tiny delay in the separation process.
It happens fairly often, though— in about 1 out of 500 newborns, according to the American Pediatric Surgical Association.
Umbilical granulomas may measure up to 10 millimeters and tend to grow if untreated. As a result, this mass could allow bacteria to get inside, potentially causing an umbilical infection.
“An infection can be very dangerous and needs immediate medical care,” notes Lauren Crosby, M.D., F.A.A.P. a pediatrician with La Peer Pediatrics in Beverly Hills, California, a nationally-recognized parenting expert, and member of the What To Expect Medical Review Board.
“An infection in this area would show as any combination of fever, redness, swelling, pus draining from the area, red streaks onto the skin, and irritability,” says Dr. Crosby. “Usually it's not subtle.”
How are umbilical granulomas treated?
If the granuloma doesn't go away on its own, your pediatrician may recommend a simple, quick treatment in the office.
- Silver nitrate: The most common option, this treatment cauterizes the tissue so it shrinks and heals. While usually painless, it's possible that silver nitrate may burn or temporarily stain the skin, so your pediatrician will take extra care with it.
- Liquid nitrogen: Sometimes used instead of silver nitrate, this “freezes” the bump so it falls off.
- Suture (tie-off) treatment: Rarely, if the granuloma doesn't respond to topical treatments, a doctor may perform a double ligature. This procedure removes the umbilical granuloma with a scalpel or ties it with two pieces of thread. Your baby may be given antibiotics during the procedure to prevent post-op infection, says Dr. Crosby.
“The treatment was painless — she didn't make a sound while the doctor was doing it,” says What to Expect Community mom ans1015, whose baby had silver nitrate treatment. “After about a week, it had healed completely, and now she has a normal-looking belly button.”
Caring for your baby at home
After treatment, your pediatrician will share aftercare tips, but in general, you'll follow regular umbilical cord care. Here's what you should keep in mind:
- Keep it clean and dry. Expose the belly button to air as much as you can and avoid ointments or rubbing alcohol.
- Diaper carefully. Fold diapers down so they don't rub against the area, or use newborn diapers with a special cut-out. Change diapers frequently to keep the area dry.
- Dress your baby in loose clothing. Choose clothing that doesn't press on your baby's tummy.
- Stick to sponge baths. Until the area is fully healed, sponge bathe your baby instead of bathing her in the tub.
- Leave it alone. Don't pick at the bump or scabs — let nature (and your pediatrician, if needed) do the work.
How long does a treated umbilical granuloma take to heal?
If your baby's granuloma is treated, it generally takes a week or two to heal. It's not uncommon for a baby to need several silver nitrate treatments before the granuloma has completely resolved, though.
Keep an eye on the area as it heals, and call your pediatrician if you notice:
- Redness, swelling, or warmth around the belly button
- Yellow or foul-smelling discharge
- Bleeding
- Your baby crying when the belly button is touched
These may be signs of infection, which your pediatrician will want to check right away. “Should an infection occur, baby would be admitted to the hospital for blood tests and IV antibiotics, along with possible surgical removal of the granuloma,” says Dr. Crosby.
Most of the time, the umbilical cord stump simply falls off, and you'll never think about it again. But if your baby develops an umbilical granuloma, rest assured that treatment (if necessary) is usually quick, easy, and effective. Before you know it, your little one will have the cutest belly button — ready for all those extra kisses.
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