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.
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