Avoiding infant mortality through proper care for umbilical cord

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In Nigeria, the childhood mortality rate stands at 128 per 1000 live births, with large disparities in her different regions. Report from the Nigeria Demographic and Health Survey, 2013 showed that childhood mortality rates range widely across geopolitical zones.

Regarding child mortality as a persistent public health challenge in Nigeria and other developing countries, researchers have made immense efforts to identify factors responsible for this menace.

Tackling the death of children, whether during perinatal, early or late neonatal, childhood or adolescent age is posing a difficult task in Nigeria. Findings from previous studies in Nigeria and several developing countries revealed numerous predictors of mortality.

These findings triggered intervention initiatives which aimed to identify the factors responsible for the high mortality rates and the most appropriate techniques for tackling them. Nigeria is yet to meet the Sustainable Development Goals (SDGs) targets, regardless of national and international implementation projects on the reduction of mortality.

Death from umbilical cord has in no small way contributed to the country embarrasing mortality rate.
The care for the umbilical cord is still an issue in developing countries, where lots of methods and various oitment including toothpaste are used.

This issue has become necessary following the number of death recorded from umbilical cord infections yearly, which is said to constitute a major cause of neonatal morbidity and pose significant risk for mortality.

Most of the cord issues usually happen within the first week of birth. Sometimes, not cleaning the cord for 2-3 days of birth can take the life of a baby if not attended to by medical personnel.

The risk of cord infection is increased by unhygienic cutting off the cord and application of unclean substances such as herbal preparations, saliva, salt and toothpaste amongst others.
Consequently, it is expected that from the day one of delivery, extra care and attention must be applied to the hygienic cleaning of the cord.Though it might look simple, but if not proper handled it could lead to infection and sometimes to early death.

The care of the umbilical cord of a baby is very essential and cannot be overemphasized. It is as little as cleaning with methylated spirit and cotton wool but very important as cleaning it every two hours.

The question of what if the wife’s mother or mother-in-law fails to come and take care of the baby “omugwuo” which includes bathing of the baby and taking care of the baby’s cord, it is expected that every potential father and mother should be ready before the tasks actually begins.

Methods of caring for the umbilical cord vary greatly between communities depending on their cultural and religious beliefs, level of education and resources.

Our correspondent in an interview with Zainab Lawal, a Midwife with Fontana Medical Centre and Children’s Hospital said the care of the umbilical cord is very paramount.

Lawal described the umbilical cord as the cord that connects the baby and the mother through the placenta. “When the baby is born, the umbilical cord is cut, because the baby is out of the uterus/womb and the baby is now inhaling oxygen and giving out carbon dioxide. The umbilical cord transfers food from the placenta to the baby.”
Describing the process of how the umbilical cord functions, Lawal said at birth immediately the child is delivered the cord is severed and a plastic clamp is used or tie on the stump that’s left behind. The clamp is taken off when the umbilical stump has dried and sealed.
During the first few days after birth, the stump will get darker and shrivel, and will eventually fall off. Sometimes it takes a week or two. If the stump hasn’t fallen off after two weeks, you can check with your child and family health nurse.
While the stump is drying up and just after it falls off, you might notice some oozing around the baby belly button. This might be clear, sticky or brownish, and it might leave a mark on your baby’s clothes or nappy. It might also smell a little. This is a normal part of the healing process.

Lawal explained that “when the baby is born irrespective of the fact that the cord is closed, the cord can still be infected and by extension the baby. One of the infections of the umbilical cord to the baby is high temperature.”

According to Lawal, as a result of the high body temperature, the baby starts feeling unnecessarily hot, uncomfortable and the baby just cry unnecessarily even after feeding him or her. “You put the baby to sleep, after 5 minutes, the baby is up and crying. At that point, it is very necessary for the parents to discern that something is wrong with the baby.

“When the temperature of the baby is high, there is need for the parents to be alert and raise alarm. A friend of mine almost lost her a day and few hours old baby as a result of the negligence in the care of umbilical cord despite the fact that this is her second child.”

Findings by the American Pregnancy Association revealed that there are others signs of infection which may include if the cord; base appears red or swollen, continues to bleed, oozes yellowish or white pus, produces a foul-smelling discharge and seems painful to the baby.

According to the Association, the signs of infection of the umbilical cord stump can result in omphalities (a life threatening infection of the umbilical cord).

In taking care of the umbilical cord, an Australian parenting website (raising children net.) adviced that whoever is taking care of the baby should wash his or her hands before handling the cord stump, and avoid touching it whenever possible. Use water to keep the baby’s belly button area clean. You don’t usually need to use soap, creams, antiseptics or alcohol to clean it, and you don’t need to bandage the belly button.

Make sure the stump dries properly after bathing. The stump will dry and heal much faster if you expose it to air as much as possible. Try not to cover it with plastic pants and nappies. Fold nappies down and away from the stump if you can.

If the stump gets wee or poo on it, wash it off using clean water and a pH-neutral cleanser. Look for ‘pH-neutral’ on product labels, or ask your pharmacist or child and family health nurse to recommend a product. It can be hard to clean poo off with just water because baby poo has a lot of fat in it.

Never try to pull the stump off yourself, even if it looks like it’s ready to fall off.

Therefore, improving the standard of umbilical cord care among mother’s can largely be achieved through health education and follow up visits by nurses after discharge from the health facility.

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