Everything You Need to Know About Umbilical Granulomas

umbilical cord

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When you leave the hospital with your newborn baby, you’re usually armed with tips for helping the stump of your baby’s umbilical cord heal. What starts as a pale, wet-looking lump inside your baby’s belly button eventually begins to dry up and harden, turning into a dark and shriveled knot before falling off completely.

Once your baby’s stump finally falls off, it reveals a super cute little belly button—and, often, a small raw spot where the last bit of cord was attached (kind of like when a scab falls off). This is totally normal and should heal up pretty quickly.

In some cases, though, not only does this spot seem to never heal, it actually grows into a small lump of tissue inside your baby’s belly button. If this happens, your baby probably has an umbilical granuloma. While it’s completely harmless and painless for your baby, it usually has to be treated by a doctor to avoid infection.

Umbilical Cord Care 101

For the most part, you don’t have to do much to aid in the umbilical cord healing process other than keep the area around the stump clean and dry. Your pediatrician will examine your baby’s umbilical cord at each newborn well visits, checking for infection.  

In the meantime, you will probably be advised not to give your baby a full bath or submerge their belly button in water. Stick to sponge baths until your baby’s cord has fallen off completely:

  • In a small tub or in your sink, gently cleanse your baby’s skin with warm, soapy water and a washcloth.
  • Carefully wipe the area around your baby’s belly button with the washcloth, avoiding getting the umbilical cord stump overly wet.
  • Pat your baby dry, including their belly button. If the top of your baby’s diaper rubs up against the belly button, fold the top part of the diaper down to leave the area exposed and free of friction.

The umbilical cord should fall off on its own between one and three weeks after birth; if the cord is still attached after three weeks, you should let your pediatrician know. Sometimes, it falls off sooner—as long as it wasn’t removed on purpose, that’s totally fine. 

When Does a Granuloma Form?

According to the American Pediatric Surgical Association (APSA), about 1 in every 500 newborns will end up with an umbilical granuloma.

A granuloma is a clump of tissue somewhere in or on the body that forms as a result of inflammation or infection. They can be associated with certain medical conditions, but when they form in the belly button after a newborn’s umbilical cord has fallen off, it’s due to the development of scar tissue during the healing process. (Some adults develop granulomas in the belly button after navel piercings.)

After your baby’s cord falls off, it’s normal for there to be a small red spot or even a red lump of tissue left behind...at first. But if, after two weeks, your baby’s belly button isn’t fully healed or you notice new growth of tissue, you should contact your doctor for next steps.

What Does It Look Like?

The granuloma itself will look like a small, moist, pink or red ball. It may be covered with a thin yellow or white film, drain light-colored fluid, or look pink or inflamed around its perimeter. 

Can It Hurt My Baby?

An umbilical granuloma is not painful or dangerous, and it’s not a cancerous growth. The only reason doctors treat umbilical granulomas is to prevent further growth that could become restrictive or lead to future problems, and to prevent any kind of umbilical infection.

How Is It Treated?

In most cases, your child’s pediatrician will treat your baby’s granuloma with a chemical called silver nitrate. When a tiny amount is applied to the granuloma, it burns or cauterizes the tissue, forcing it to stop growing and, eventually, shrink; this doesn’t hurt your baby, because there are no nerve endings in the granuloma tissue.

If this doesn’t work, there are other treatment options:

  1. Your pediatrician can remove the granuloma by applying a small amount of liquid nitrogen to the growth to freeze it off.
  2. Your pediatrician can tie suture thread around the base of the granuloma to deprive the tissue of blood flow. This will force it to dry up. 

Neither one of these procedures are painful for your baby. In some rare cases, surgery may be required to remove the granuloma, but the vast majority of these growths are treated with simple procedures at your pediatrician’s office.

Can I Do Anything to Prevent It?

No. No one knows why some newborns develop granulomas and others don’t. There are no genetic or environmental causes, and we don’t have any evidence proving that granulomas are more likely to form when proper umbilical cord care isn’t performed after birth. It may be more common in babies when the cord takes longer than average to fall off, but again, we don’t know for sure.

Other Umbilical Cord Problems

You should always be on the lookout for signs of infection in your newborn’s belly button. According to the American Academy of Pediatrics (AAP), an umbilical infection may:

  • produce a foul-smelling discharge
  • ooze yellow fluid or pus
  • cause fever and/or irritability
  • make the surrounding area look bright red, inflamed, or streaked with red
  • cause your newborn distress when you touch it

Another common umbilical cord problem is an umbilical hernia. Per the APSA, about 20% of babies have an umbilical hernia, a condition where the muscles around the belly button aren’t fully connected. This leaves a little bit of room for internal tissue to bulge out through the belly button and is often most noticeable when a baby is crying. Like a granuloma, hernias are not painful for your baby.

Although umbilical hernias sound scary, the AAP says most heal on their own without intervention by the time a child is 18 months old. If not, an outpatient surgery may be required when the child is older to close the gap. (This usually isn't done until a child is closer to 5 years old.)

When to Call Your Doctor

While most umbilical cord issues aren’t harmful or painful for your baby, you should let your doctor know if your baby’s umbilical cord isn’t healing the way it's supposed to. This might include not falling off in the first month of life, leaving behind a growth of tissue for more than two weeks, or appearing infected at any time. 

A Word From Verywell

While it may be nerve-wracking to think about your child having an umbilical granuloma, you can find ease knowing that it isn't painful or harmful to your baby, and most can be easily removed by a doctor. In no time, your child's belly button will be ready for warm baths and plenty of tickles.

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Article Sources
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  1. American Pediatric Surgical Association. Umbilical conditions. Updated November 2016.

  2. American Academy of Pediatrics. Umbilical cord care. Updated March 3, 2020.