Comparison of topical breast milk versus dry cord care on umbilical cord separation, complications and cord colonization

Abstract

Introduction: Neonatal death due to infections is still a great concern worldwide. Umbilical cord related infections play significant role in the neonatal mortality specially in very low birth weight infants, mother chorioamnionitis and premature rupture of membranes. It is associated with umbilical colonization, delayed separation and poor hygiene. In the current study, effect of topical breast milk usage with dry cord care on separation time, complications and colonization were compared. Methods This is a randomized clinical-trial on 150 very low birth weight neonates in 2016-18. Patients' were divided in two groups; Group-M (N = 73) (3–4 drops of maternal breast milk were dropped on the umbilical cord stump within eight hours of birth and went on every eight hours until 48-hours after cord separation) and Group-D (N = 77) (the umbilical cord was drought gradually in open air). Umbilical cord culturing was performed from cord stump within 2–4 hours after delivery, three days after birth and at the day of separation. Cords were assessed considering omphalitis, bad smell, exudates formation and granulation tissue. Results Neonates of two groups were not statistically different regarding separation time (P = 0.09), incidence of omphalitis (P = 0.16), bad odor (P > 0.99), exudative secretions (P = 0.97), granulation tissue (P = 0.96) and sepsis (P = 0.13). In addition, hospitalization duration (P = 0.71), time to reach full enteral feeding (P = 0.31) and death (P > 0.99) were not statistically different. Three times cultures derived from two groups presented no significant difference (P > 0.05). Conclusion Based on findings of the current study, neither topical breast milk nor dry cord care was superior considering separation, associated complications and colonization. As neonatal death is still a serious concern worldwide and lacking of unanimous approach for prevention of cord related complications, further studies are strongly recommended.

Effectiveness of the Topical Application of 4% Chlorhexidine on Umbilical Cord Bacterial Colonization – A Non-Randomized Control Study

“…17,18 These organisms were presented by other authors as well. 19 Ozdemir et al, who evaluated the effect of different antiseptics on cord separation time, also showed that chlorhexidine application was the most effective agent in decreasing colonization, as it significantly increased cord separation time. 20 In a study by Azza A et al, 21 2 swab samples were taken, baseline swab was taken soon after birth within 3 hours of life and 2nd swab on third day of life.…”

Umbilical Stump Colonization and Antibiotic Susceptibility Patterns of Bacteria from Umbilical Stumps of Neonates Admitted at Holy Innocents Children’s Hospital, Mbarara, South Western Uganda

“…Mortality in children less than one month is still crucial in neonatal care systems, contributing deaths of about 1.6 million per year in still developing countries (Armanian, Barekatain et al 2020). This health concern is more serious in developing countries the fact that the mortality burden seen in the rst ten days of life is estimated at about 42 percent (Armanian, Barekatain et al 2020). An umbilical stump that has just separated is known to be the best route for bacterial entrance leading to development of serious infections (Armanian, Barekatain et al 2020).…”

“…This health concern is more serious in developing countries the fact that the mortality burden seen in the rst ten days of life is estimated at about 42 percent (Armanian, Barekatain et al 2020). An umbilical stump that has just separated is known to be the best route for bacterial entrance leading to development of serious infections (Armanian, Barekatain et al 2020).…”

“…Deliveries from home, use of non-sterile delivery methods, rupturing of membranes prematurely, passage of catheters through the umbilical stump and being underweight are amongst the most common risk factors associated with umbilical stump infection (Armanian, Barekatain et al 2020).…”