Alcohol versus natural drying for newborn cord care

Abstract

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.