Very young infants can develop an umbilical infection or omphalitis . If left untreated, the infection can become life-threatening, so antibiotic therapy and observation in the hospital are almost always necessary. In countries with adequate hygiene standards and good medical care, umbilical infections hardly contribute to infant mortality anymore.
What is umbilical infection?
Umbilical infection, or omphalitis, in newborn infants is bacterial inflammation of the umbilical stump remaining after the umbilical cord has been cut and the surrounding tissues of the abdominal wall. See psyknowhow for Hyperoxaluria Explained.
Mixed infections with different types of bacteria that belong to the normal bacterial flora of humans are often responsible for the complication of navel healing. The species Staphylococcus aureus and Streptococcus found on the skin and the intestinal bacteria Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis are frequently involved in umbilical infections.
Causes
Since the stump of the umbilicus is still an open wound for a few weeks after delivery, it is relatively easy for germs to penetrate and possibly trigger an infection of the umbilicus. The germs usually come from the mother and reach the navel during childbirth or in the following days.
The infant’s immature immune system is often unable to cope with the normally harmless bacteria. When it comes to bacteria, a newborn is pretty much a blank slate – in the largely germ-free environment of the uterus, his body has had little experience with bacteria. Risk factors for umbilical infection are low birth weight, other infectious diseases such as pneumonia or existing sepsis, immunodeficiency and poor general condition.
In normal-weight, healthy infants, risk factors include unusually long labor and previous complications such as placental infection. An umbilical catheter inserted during neonatal treatment also increases the risk of developing an umbilical infection.
Symptoms, Ailments & Signs
Umbilical infection usually occurs immediately after birth. The disease can be recognized by the slimy-purulent, usually reddened navel, which is very sensitive to touch. The infection can also cause general symptoms such as fever, exhaustion and malaise. Affected children also drink little and usually refuse to eat.
Bleeding and swelling may occur in the navel area. As the infection progresses, the navel bulges forward and acquires a reddish-white color. If pus has formed, a cyst will also develop. This can break open and spread the pathogens into the blood, which can result in complications such as superinfections and sepsis.
Possible consequences of a navel infection are also peritonitis, abscesses in the gastrointestinal tract and bacterial thrombosis. In severe cases, liver abscesses or inflammation of the inner lining of the heart form. Omphalitis is a life-threatening condition and, if left untreated, can lead to the death of the infant.
Symptoms develop in the first hours to days after birth and rapidly increase in intensity. If treatment is given before an abscess has formed, the signs of the disease usually subside quickly.
Diagnosis & History
Even if slight redness and minor bleeding can be normal side effects of the navel healing: signs of a navel infection should always be examined by the pediatrician. Diagnosis of umbilical infection is made by examining the navel.
Reddening of the skin, bloody or purulent discharge, swelling, warmth and bulging of the navel are common symptoms of an incipient navel infection. In the advanced stage of navel inflammation, an extreme bulging of the navel can often be observed. Fever, accelerated heartbeat, low blood pressure and apathy appear.
If left untreated, the infection can quickly spread to the blood and lead to sepsis and life-threatening bacterial infections of the organs. Peritonitis, liver abscesses, bacterial thrombosis (clogged blood vessels) and endocarditis (inflammation of the inner lining of the heart) can be extremely dangerous consequences of an umbilical infection.
Complications
Umbilical infection is a life-threatening disease. For this reason, treatment must be carried out in any case, since self-healing usually does not occur. In the worst case, the infant can die from the navel infection. However, if the standards of hygiene are observed, death can be avoided.
Those affected usually experience severe redness or swelling at the belly button. A secretion can also escape from the navel. The infection continues to spread throughout the body, usually leading to fever and an increased heart rate. Low blood pressure and breathing difficulties can also occur as a result of the navel infection. Furthermore, if left untreated, damage to the liver and peritonitis can occur.
Those affected can also develop heart inflammation and die from it. In most cases, the relatives and parents also suffer from psychological stress or depression. The treatment of the navel infection is usually carried out with the help of antibiotics and leads to success relatively quickly. There are no complications.
When should you go to the doctor?
Infants belong to the risk group of umbilical infection. Parents or guardians in particular should therefore initiate a doctor’s visit with the offspring if symptoms or irregularities occur. If the newborn behaves strangely and abnormally, it is recommended that you seek clarification from a doctor. Teariness, apathy, or apathy are signs of an ongoing disagreement. If food is refused, the body temperature rises or there is restlessness, the infant needs medical help.
In the event of sleep disorders, visual changes in the area of the navel, bleeding or swelling, consultation with a doctor is necessary. Reddening of the skin on the navel or open wounds require medical attention. If the symptoms increase in scope or intensity, you need to see a doctor as soon as possible. In severe cases there is a risk of sepsis and thus a life-threatening condition for the child.
Poor hygienic conditions can lead to the premature death of the infant without medical treatment. Persistent fatigue and discomfort in the infant should be reported to a doctor. If the child hardly reacts to social interactions or other sensory stimuli in the environment, these are signs of an existing irregularity. The observations should be discussed with a doctor so that the cause can be clarified and a treatment plan to alleviate the symptoms can be drawn up.
Treatment & Therapy
If the navel infection presents itself in a very early stage, local disinfecting measures can bring the inflammation to a standstill. A navel infection typically requires a hospital stay of around two weeks. A combination of antibiotics that target the different types of bacteria involved are given intravenously.
Penicillin is often supplemented by aminoglycosides and agents that are effective against anaerobic germs. The course of the infection can be closely observed through the constant monitoring of vital signs that is possible in the hospital. Any complications are recognized early and treated in good time.
In addition to antibiotic therapy, measures to stabilize blood pressure, ventilation and other steps to stabilize the general condition are often required. The possible complications of a navel infection also include abscesses (encapsulated foci of pus) or the death of skin and muscle tissue (necrosis) in the area around the navel. In these cases, surgical intervention to remove foci of pus and necrotic tissue is urgently needed.
Outlook & Forecast
The prognosis for umbilical infection is very favorable. However, complications of inflammation, if left untreated, lead to mortality rates of 7% to 15%. The dreaded sepsis often occurs in around 4% of newborns who develop a localized form of omphalitison. The death rate in such cases is still very high, despite today’s advances in modern medicine. In the case of sepsis, the mortality rate is 30% to 40% in normally born children, while the mortality rate in preterm babies is around 50% and more. This prognosis indicates the very high need for timely diagnosis of the disease. Omphalitis is a pathology that can be seen well despite the rapid prevalence of inflammation. Therefore, it should also be possible for the mothers of the affected children to diagnose it based on the visual assessment of the navel.
The unforeseen diagnosis of the disease and the resulting delay in treatment of omphalitis often lead to disability or even death in affected children. Therefore, timely diagnosis and effective treatment are of the utmost importance. Consequences and complications arise when the bacteria migrate to the umbilical cord, which is a direct access point to the blood flow. This leads to complications that increase the risk of death significantly.
Prevention
Navel hygiene measures can be effective in preventing navel infection. However, today the navel is generally dealt with in a much more relaxed manner than in previous generations. For example, it is generally no longer recommended to cover or bandage the navel, and bathing is no longer advised against.
Silver powder or disinfectants are no longer part of normal navel care. It is important to keep the navel dry, airy, clean and free of urine and stool. The umbilical stump should only be touched with washed hands. If it is necessary to clean the navel directly, sterile compresses moistened with water or alcohol are recommended.
Aftercare
As long as the navel infection has not yet completely healed, the diaper should be closed slightly below the navel in infants. Otherwise there is a risk that the navel will become infected again through excretions. Adults affected should also wear their clothing as loosely as possible.
Because covering it would significantly delay the drying out and healing of the navel. If the navel is weeping, those affected should use some navel powder to keep the inflamed navel as dry as possible. A special antibiotic navel powder can also be used. Breathable navel compresses are also available to keep the navel dry.
The most important thing during aftercare is that the navel stays dry and, above all, is protected from chafing. Under no circumstances should creams or perfumed oils be used for aftercare of the navel, as they would only irritate and soften the sensitive skin. If those affected use a special powder to dry it out more quickly, all powder residue should be carefully removed from the inflamed navel once a day.
This works best with the help of a sterile compress that has previously been soaked in diluted calendula essence. Any crusts should not be removed, otherwise there is a chance of injuring the sensitive navel. If, despite careful aftercare, redness, moisture or even suppuration persists for a longer period of time, it is advisable to consult a doctor.
You can do that yourself
If a navel infection has been detected, parents should first of all ensure strict personal hygiene in the child in order to prevent further spread of the inflammation. The doctor can prescribe a suitable ointment, which the parents can apply to the affected areas.
In addition, close medical supervision is important. Parents should consult the doctor closely and inform them of any complications. If the inflammation gets worse or there are other symptoms, such as fever or increasing discomfort, it is best to go to the doctor’s office immediately. The other self-help measures focus on using the antibiotic and antiseptic ointments according to the doctor’s instructions. You should also make sure that the child is drinking enough fluids. If this is taken into account, a speedy recovery can be expected.
Nevertheless, serious complications such as necrosis can develop in individual cases. Then the child has to be treated surgically. Rest and warmth in bed are important after such an operation. In addition, the child should be checked for allergies so that there are no unforeseen complications when using painkillers and anti-inflammatory drugs.
