When we “contemplate our navels,” is that such a bad thing? Although these days, due to its popularity as a site for tattooing and piercing, the navel, or belly button, seems to be more of a fashion statement than anything else, it’s worth looking at its role in a developing fetus.
While the baby is growing inside her mother, her belly button, or umbilicus, is a lifeline. To it is attached the umbilical cord—the connection of the fetus to the placenta. Seen on an ultrasound as early as eight weeks’ gestational age, the umbilical cord serves to transfer oxygen and nutrients from mother to baby. It also functions to carry away waste products.
At birth, the cord is clamped, and the baby receives what he needs through his own heart, lungs, and feeding. While this is usually a straightforward practice, sometimes problems with the cord arise around the time of labor or delivery. The team assisting with delivery of the baby will generally take steps to anticipate and deal with any issues related to the cord.
The Belly Button’s First Few Days
OK, so you’ve delivered your baby and she’s made the transition to the outside world. The umbilical cord has been cut and a clamp has been placed on the stump—a remnant of the cord attached to the baby’s belly button. What are some of the things your newborn’s doctor might look for during those first few days?
First off, your provider will examine the stump for the presence of blood vessels—arteries and veins. These are the actual tubes that carried essentials from the placenta to and from the fetus. Normally, each umbilical cord has two arteries and one vein. However, in about 1 percent of newborns (the percentage is a little higher for twin newborns) a cord will have just one umbilical artery. It’s been found that infants with just one artery in their cord have a higher rate of abnormalities in their vital organs, particularly their kidneys. Your baby’s provider will closely observe your little one for other abnormalities; sometimes providers will order additional tests to make sure all is well.
Less commonly, a newborn will have a communication through the umbilicus between the belly, or abdomen, and the outside. This might show up as unusual drainage from the belly button, and might mean an abnormal connection to the bladder or intestine. If your provider is suspicious that this might be happening, she will look for other abnormalities and refer the baby to a specialist for treatment. Often, surgery is involved.
The Belly Button at Home
New parents may wonder how to care for the umbilical stump area at home. It’s mainly a matter of keeping the area dry. Although hospitals formerly would use special products on the stump area to keep away bacteria and/or recommend that parents apply alcohol at home, these practices are now recommended less often.
The umbilical stump usually falls off around two weeks of age. Occasionally, there is a little bit of bleeding; this is normal. If the stump is still on after a month of age, it may indicate a problem with the baby’s ability to fight infection, and her provider may choose to run some tests.
Some Common (and Not-So-Common) Problems
Despite the best of care, the belly button area occasionally becomes infected. Signs of infection include redness, tenderness, or pus draining. The newborn may be fussy or have a fever. Infection in a newborn is a medical emergency; if you think your baby might have an infected umbilicus, a prompt call to her doctor is in order.
What else can happen to the belly button? A less serious but common finding is an umbilical granuloma, a small growth in the cord area. Sometimes a small amount of fluid drains from the area, but the surrounding tissue is not reddened like it is in a serious infection. This often gets better on its own, or your provider can usually do a simple procedure in the office to take care of this.
Another very common condition that develops in the belly button area is known as an umbilical hernia. It shows up as a small bulge surrounding the umbilicus. The bulge may increase in size with crying, is usually easily pushed back with gentle pressure and doesn’t seem to hurt the baby.
Why do umbilical hernias occur? In order to allow blood vessels to run from the cord to the baby when he’s still inside Mom, the muscles of the abdomen near the umbilicus are separated during early infancy. Since that cord connection is no longer needed after birth, those surrounding muscles generally grow together as the baby grows. This more or less “seals off” the connection, and a hernia, if present, will disappear.
Some babies, however, will develop a more prominent bulge up to about nine months of age. This may take several years to go away, and a small number of children will need surgery to fix the problem. Rarely, a baby will need surgery earlier if a piece of bowel gets trapped in the hernia. This may show up as a red or tender area, or inability to push the bulge back.
There are other rarer conditions affecting the navel—some serious, some not. Certainly, your little one’s provider is available to monitor the belly button’s status and look for additional problems. However, in the majority of cases, the umbilicus turns out just fine—ready for whatever fashion may dictate in the future!
