OBJECTIVE: To compare alcohol cleaning and natural drying of newborn umbilical cords. DESIGN: Prospective, randomized controlled trial. SETTING:Tertiary-level university teaching hospital and level II community hospital. PARTICIPANTS: Of 1,876 singleton full-term newborns enrolled, 1,811 completed the study. INTERVENTIONS: Newborns, from birth until separation of the cord, were randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at each diaper change or (b) natural drying of the umbilical site without special treatment. MAIN OUTCOME MEASURES: Umbilical infection, cord separation time, maternal comfort, and cost. RESULTS: No newborn in either group developed a cord infection. Primary care providers obtained cultures for cord concerns in 32 newborns (1.8%), with colonization for normal flora, Staphylococcus aureus, and Group B streptococcus proportionately equal in alcohol and air dry groups. Cord separation time was statistically significantly different (alcohol group, 9.8 days; natural drying group, 8.16 days; t = 8.9, p = < .001). Mothers described similar comfort with cord care and relief with cord separation. Costs of alcohol drying while in the hospital were greater than those of natural drying. CONCLUSIONS: (a) Evidence does not support continued use of alcohol for newborn cord care; (b) health care providers should explain the normal process of cord separation, including appearance and possible odor; and (c) health care providers should continue to develop evidence to support or eliminate historic practices.
RCT Entities:
OBJECTIVE: To compare alcohol cleaning and natural drying of newborn umbilical cords. DESIGN: Prospective, randomized controlled trial. SETTING: Tertiary-level university teaching hospital and level II community hospital. PARTICIPANTS: Of 1,876 singleton full-term newborns enrolled, 1,811 completed the study. INTERVENTIONS: Newborns, from birth until separation of the cord, were randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at each diaper change or (b) natural drying of the umbilical site without special treatment. MAIN OUTCOME MEASURES: Umbilical infection, cord separation time, maternal comfort, and cost. RESULTS: No newborn in either group developed a cord infection. Primary care providers obtained cultures for cord concerns in 32 newborns (1.8%), with colonization for normal flora, Staphylococcus aureus, and Group B streptococcus proportionately equal in alcohol and air dry groups. Cord separation time was statistically significantly different (alcohol group, 9.8 days; natural drying group, 8.16 days; t = 8.9, p = < .001). Mothers described similar comfort with cord care and relief with cord separation. Costs of alcohol drying while in the hospital were greater than those of natural drying. CONCLUSIONS: (a) Evidence does not support continued use of alcohol for newborn cord care; (b) health care providers should explain the normal process of cord separation, including appearance and possible odor; and (c) health care providers should continue to develop evidence to support or eliminate historic practices.
Authors: Rosanna Quattrin; Kim Iacobucci; Anna Lisa De Tina; Letizia Gallina; Carla Pittini; Silvio Brusaferro Journal: Medicine (Baltimore) Date: 2016-04 Impact factor: 1.889
Authors: María Dolores López-Medina; Ana Belén López-Araque; Manuel Linares-Abad; Isabel María López-Medina Journal: PLoS One Date: 2020-01-10 Impact factor: 3.240
Authors: Aamer Imdad; Resti Ma M Bautista; Kathlynne Anne A Senen; Ma Esterlita V Uy; Jacinto Blas Mantaring; Zulfiqar A Bhutta Journal: Cochrane Database Syst Rev Date: 2013-05-31