What factors affect the separation of the umbilical cord?

The umbilical cord connects the developing fetus or embryo to the mother's placenta. After birth, the cord is cut, leaving a small portion attached to the baby's navel. Between seven days and 12 weeks after birth, this portion of the umbilical cord usually falls off on its own. Some factors that can lead to delayed umbilical cord separation include the use of antiseptics, immunodeficiencies, cesarean section, prematurity, and neonatal sepsis.

When a baby is born, the umbilical cord will be clamped and cut no more than about 1.2 inches (3 cm) from the baby's stomach. Keeping the cord clean and dry is important because of its potential source of infection for the baby. This can be accomplished by using unscented soap and clean water. Overuse of antibiotics will restrict the normal colonization of the umbilicus by helpful bacteria, leading to a delay in cord separation.

Leukocyte adhesion deficiency is an immunodeficiency disorder that affects phagocytic blood cells. One of the effects of this disorder is that it causes a delay in the separation of the umbilical cord in babies. Severe cases of this disorder can be treated with an allogeneic bone marrow transplant.

Urachal anomalies can also cause delayed separation. The urachus connects the dome of the embryo's urinary bladder with the umbilical ring. If the umbilical cord does not close properly, it could cause a urachal cyst to form and delay separation.

An infection of the cord stump or surrounding tissues is known as omphalitis. This condition is most likely to affect newborns after five to nine days, or even earlier for premature babies. One of the factors leading to omphalitis is the lack of proper hygiene during childbirth, and one of the effects is a delay in the separation of the umbilical cord.

Premature babies are at higher risk of late umbilical cord separation, compared to full-term babies. One of the reasons for this is a decrease in the normal bacterial colonization of the navel.

Neonatal sepsis is caused by an infection of the blood of babies younger than 90 days. The baby can get the infection from the mother during or before delivery. Symptoms of this infection include swelling of the abdomen, diarrhea, seizures, and delayed separation of the umbilical cord.

It may take longer for the umbilical cord to separate in babies delivered by cesarean section compared to babies delivered vaginally. The reason for this is the sterile nature of the cesarean section. This inhibits normal colonization of the cord by helpful bacteria that aid in separation.

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