The efficacy of different umbilical cord care regimens: an in vitro study on their drying and antimicrobial effect

Topical regimens have been used for umbilical cord care for different purposes, but their drying efficacy has rarely been statistically analyzed. We designed an in vitro study with six regimens to determine which one can achieve the best drying and antimicrobial effects in umbilical cord care.

Twenty-seven umbilical cords were resected when babies were born. Each cord was cut into seven segments in appropriate length and randomly labeled to seven groups. Six regimens including 75% alcohol, 90% alcohol, tincture povidone-iodine, aqua povidone-iodine, Chinese herbs, and one powder agent (M) were used topically on six groups of umbilical cords once daily. The control group received no treatment. Daily weight of the cords was recorded for 7 days, and bacterial culture was performed on the sixth day.

All study groups presented similar algebraic functional relationship between weight change and time. The drying effect occurred mostly within the first 3 days (weight loss 88.6%), especially on the first day (62.1%). Mean ratio of the final weight/initial weight was 10.2%. Significant day-by-day weight loss was noted from day 1 to day 5 (p < 0.001). Both aqua and tincture povidone-iodine groups showed not only satisfied drying effect but also significantly better antimicrobial effect than other groups.

Povidone-iodine has both good drying and antimicrobial effects in umbilical cord care. As the topical use of povidone-iodine has been reported to relate to transient neonatal hypothyroidism, we suggest it to be used only as a good substitute if there are signs of umbilical cord infection.