NeoNotes Journal Club
Andrew B. Kairalla MD, Editor

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Objective: The purpose of the present study was to compare alcohol versus natural drying for umbilical cord care in preterm infants and to examine its effects on bacterial colonization and cord detachment.
Study Design and Methods: Eligible infants <34 weeks gestation admitted to the NICU were randomized to receive either umbilical cleansing with 70% isopropyl alcohol at each diaper change or natural drying. Umbilical stump cultures were performed at 12 to 24 hours, 72 hours, 7 days, and 14 days of age.  
Results:  A total of 109 infants were enrolled; 102 completed the study. Analyses revealed that the median cord detachment time was significantly shorter in the natural drying group compared to the alcohol group (13.0 versus 16.0 days; p=0.003). There were no cases of local umbilical infection in either group.         
 Conclusion: Based on the present study, it appears that natural drying is a safe and effective means of umbilical cord care in preterm infants.

Comments:  These findings are virtually the same as those reported in term babies.  In a recent Cochrane Meta-analysis of 10 randomized, controlled trials of cord care in term neonates it was found that simply keeping the cord clean is as effective as using antiseptics.  Furthermore, the use of alcohol or triple dye on the cords delayed cord separation.  For a further discussion of umbilical cord care, see 4-001.  ABK

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