Diseases of the umbilical wound in newborns. Inflammation of the navel in a newborn prevention and treatment

umbilical wound- one of the vulnerabilities in a newborn baby, as it can become " entrance gate» for infection. Inflammation of the skin and underlying tissues in the navel is called omphalitis.

It is customary to distinguish several clinical forms omphalitis: catarrhal omphalitis, purulent, phlegmanous, necrotic, fungus. In cases where the infection spreads to the umbilical vessels, they speak of phlebitis (damage to the veins) and arteritis (damage to the arteries).

The causative agents of omaflit can be both gram-positive (staphylococci, streptococci) and gram-negative microorganisms ( coli, proteus, Pseudomonas aeruginosa).

Predisposing factors: care and processing defects umbilical wound, various manipulations in the umbilical wound (installation of an umbilical catheter, probing, and others).

A little about the umbilical wound

Usually, the umbilical cord falls off on the 3-4th day of the baby's life, after which the umbilical wound becomes covered with a bloody crust, which gradually dries up. The umbilical wound heals by the 10-14th day of life, that is, its complete epithelization occurs (covering thin layer epithelium that lines the entire surface of the body).

Normally, the umbilical wound heals up to the 14th day of life, the discharge is either absent, or there is a small discharge during the first week. By 10-14 days of life, the navel should be dry.

In some babies, the healing process of the umbilical wound may be somewhat delayed (up to 20-25 days) and one of the reasons may be omphalitis.

How does omphalitis develop?

The infectious agent enters the tissues adjacent to the navel. The pathogen can enter transplacentally (through the placenta, even before the birth of the child), through the stump (residue) of the umbilical cord, or directly through the umbilical wound. Further, the infectious process leads to the development of inflammation in the surrounding tissues. If there is a further spread of the infection, then the inflammation passes to the veins and vessels, which leads to phlebitis and / or arteritis of the umbilical vessels.

Catarrhal omphalitis

This form is also known as "weeping navel", simple omphalitis.

Clinical signs catarrhal omphalitis are: the presence of serous (transparent) discharge from the umbilical wound, slowing down its healing. On examination, a slight reddening of the umbilical ring can be replaced. The general condition of the child with this form is not disturbed, the body temperature is normal.

Sometimes the wound may be covered with a dense bloody crust with an accumulation of discharge under it.

In cases where the course of catarrhal omphalitis is delayed (more than 2 weeks), the fungus of the navel may develop. This is a mushroom-like growth of granulations at the bottom of the umbilical wound. Newborns with a large body weight at birth, having a thick umbilical cord and a wide umbilical ring, are prone to the development of the fungus of the navel.

If catarrhal omphalitis is not treated, then after a few days, against the background of a weeping navel, a purulent discharge appears, swelling and redness of the umbilical ring increase (purulent omphalitis).

As the infection spreads, the inflammation progresses to umbilical region and deeper lying tissues, which leads to the development of phlegmonous omphalitis.

Phlegmonous omphalitis

Phlegmonous omafalit is bacterial inflammation bottom of the umbilical wound, umbilical ring, subcutaneous fat around the umbilical ring. The disease begins with symptoms of catarrhal omphalitis, after a few days a purulent discharge appears. umbilical ring become edematous, reddening of the skin of the umbilical region is expressed. Subcutaneous fat becomes dense (infiltrated) and begins to swell above the surface of the anterior abdominal wall.

The skin around the navel is hot, dilated vessels of the anterior abdominal wall, red stripes are visible, which are caused by the addition of lymphangitis.

Very often, with phlegmonous omphalitis, it is noted infection umbilical vessels.

With this form, the child's condition is disturbed, he is lethargic, sucks poorly at the breast, burps, gains weight poorly, body temperature rises.

IN general analysis blood there is leukocytosis (an increase in the number of leukocytes), a shift in the formula to the left, an increase in ESR (which indicates the bacterial nature of inflammation).

The danger of phlegmonous omphalitis is that against its background, the development of metastatic foci of infection is possible (i.e., the infection spreads with blood flow to other organs) and the generalization of the process, up to the development of sepsis (especially in premature and debilitated children), an umbilical ulcer can also develop.

Necrotic omphalitis

Necrotic omphalitis is one of the complications of the phlegmonous form, most often develops in premature, debilitated children and against the background of immunodeficiency states. With this form inflammatory process spreads deep into the tissues. The skin begins to acquire a purple-cyanotic color, its necrosis (necrosis) and detachment from the underlying tissues occur. Formed extensive wound, in severe cases, intestinal eventration (intestinal exit through the hole formed) can be observed with the development of peritonitis.

The general condition of the newborn is sharply disturbed, symptoms of intoxication are expressed.

In most cases, necrotic omphalitis ends in sepsis.

Damage to the umbilical vessels with omphalitis

Thrombophlebitis umbilical vein- palpable elastic cord above the umbilicus.

Thromboarteritis of the umbilical arteries - cords are palpated radially below the umbilical ring.

The skin over the affected vessels may be edematous, hyperemic.

Symptoms of intoxication may be mild.

Treatment of omphalitis

At catarrhal omphalitis treatment at home is possible, but under the direct supervision of the local pediatrician, for all other forms, hospitalization is indicated.

The main goal of treatment is to prevent accumulation and suppuration of the discharge under the crust. Therefore, timely and thorough treatment of the umbilical wound is necessary.

With a simple form(weeping navel) treatment of the umbilical wound is carried out in the following way: first, it is washed with a solution of hydrogen peroxide, after which it is treated with one of the solutions of alcohol or water antiseptics (furacilin, dioxidine, chlorophyllipt). Processing should be carried out 3-4 times a day.

The procedure for treating the wound is 3-4 drops of hydrogen peroxide (3%) instilled into the umbilical wound (it is better to use a sterile pipette for this, boil it for 30 minutes). After that, dry the surface of the navel (with a cotton swab or cotton swab) and lubricate the wound with a cotton swab antiseptic solution.

Also, with a simple form, baths with weak solution potassium permanganate, decoctions of herbs (string, chamomile, celandine).

Treatment of the phlegmonous form

This form shows the purpose antibacterial drugs(taking into account sensitivity), both locally (smears with antibacterial substances) and systemically (injections, tablets).

With a pronounced syndrome of intoxication, infusion and detoxification therapy may be required.

With necrotic omphalitis you can not do without a surgeon, dead tissue is excised to the border with healthy skin. Prescribe antibiotics, detoxification therapy. Wound healing agents are also used.

On the background antibiotic therapy it is necessary to prescribe eubiotics to prevent dysbacteriosis.

Widely used in the treatment of omphalitis physiotherapy- UHF on the umbilical wound, UVI of the umbilical wound, UHF therapy and others.

In some cases, a course of immunotherapy may be required.

In case of damage to the umbilical vessels, in the absence of intoxication phenomena, local treatment- lubrication of the skin area over the affected vein with heparin and antibacterial ointment(mupiprocin, baktroban), alternating them every 2 hours. Regular treatment of the umbilical wound is also carried out, physiotherapy (microwave, ultraviolet radiation, electrophoresis) is indicated.

Forecast

With timely treatment, the prognosis for recovery is favorable. But, children who have had omphalitis are further prone to the development of portal hypertension.

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Prevention of diseases of the navel in newborns.
The child is discharged from the maternity hospital on the 3rd-5th day of life after the umbilical cord falls off. In healthy newborns, the umbilical wound heals after 5-7 days. If the baby was born debilitated (premature, underweight, with intrauterine infection etc.), then the healing of the umbilical wound may be delayed. On wound surface pathogens can enter purulent infection: staphylococcus aureus, streptococcus, E. coli, etc. More often, infection occurs from a mother who has foci chronic infection in any organ (throat, liver, kidneys, genitals). But other people who closely communicate with him and suffer can also infect a baby. pustular diseases. Inflammation of the umbilical region can be superficial and deep. The umbilical wound is covered with a crust, from under which a mucous or purulent discharge oozes. The skin around the wound turns red and becomes pasty. Sometimes the process passes to the vessels and improper care can lead to the spread of infection throughout the body.

Prevention of infection through the umbilical wound should be carried out immediately after birth. The child should be bathed daily boiled water with the addition of potassium permanganate solution. Treat the wound daily with a 3% hydrogen peroxide solution, followed by drying with a 1% brilliant green alcohol solution or a 3% potassium permanganate solution. Treatment of the umbilical wound continues until it is completely healed. In the presence of purulent discharge from the wound, the appearance of pustules on the skin, you should call a doctor.

Is the belly button inflamed in a newborn? He probably has omphalitis, a disease in which the skin and subcutaneous tissue in the navel area become inflamed. Often, the inflammatory process also affects the umbilical vessels, which in turn causes arteritis (inflammation of the arteries) or phlebitis (inflammation of the veins) of the umbilical vessels. The most common pathogens of omphalitis are staphylococcus aureus and Escherichia coli. These microbes penetrate into the tissues near the navel through the umbilical cord residue, and can also penetrate through the umbilical wound, which remains after the umbilical cord falls off.
I must say that in newborns, purulent-inflammatory diseases are often found, including omphalitis. This is due to the fact that the baby's skin is very sensitive, and children's body still can not fight the infection in full force. Therefore, all parents during this period must be especially careful.
Why does omphalitis occur in a baby? What are the causes of omphalitis in a newborn?
most main reason omphalitis is improper wound care, especially when we are talking O primary processing the baby's navel immediately after birth and after - during the first day of the child's life. It should be noted that the skin is very important element protection of any person, and even more so for a baby, because it protects him from an external aggressive environment. When the skin is damaged, various microorganisms easily penetrate into the blood, which is the reason for the appearance different kind trouble. Thus, the umbilical wound is a kind of entrance for microbes, and if it is not properly cared for, then inflammation of the umbilical wound is quite likely. This is omphalitis.
Symptoms of omphalitis in a newborn
Since omphalitis is an inflammatory process of the umbilical wound, external signs this infection are classic, such as redness, swelling in the navel, as well as bad smell secretions.
In most cases (80%), the umbilical wound begins to fester due to the fact that it penetrates Staphylococcus aureus. This microbe quickly penetrates into the wound, for a very a short time it can reach the peritoneum and internal organs.
In general, three forms of omphalitis are distinguished: a simple form, phlegmous and necrotic (gangrenous).
1. A simple form of omphalitis in a newborn is the most frequent form diseases. As a rule, when a newborn is discharged from the hospital (on the 4-6th day), the umbilical wound is covered with a bloody crust, which then disappears, and on the 10-14th day of life, the baby's umbilical wound heals - it is covered with tissue (epithelium) lining the entire body surface. In the presence of inflammation, the healing of the umbilical wound is significantly delayed, a transparent or yellowish (sometimes bloody) discharge is released from the wound. There may also be slight redness of the umbilical ring. Periodically, the umbilical wound of the baby is covered with a crust, under which an insignificant discharge accumulates. If the wound gets wet long time(2 weeks or more), this can lead to the fact that at the bottom of the umbilical wound an excessive growth of the mushroom-shaped form (fungus of the navel) is formed, due to which the healing of the wound is difficult. With all this general state child in most cases is not violated, however, sometimes it can be noted slight increase temperature (about 37.5 degrees).
So, the main signs of a simple form of omphalitis are:
- Sufficiently long healing of the umbilical wound (normally, healing occurs before the 14th day of the child's life).
- The presence of discharge from the umbilical wound - with normal healing, the discharge is either completely absent, or it is very small (during the first, less often - the second week of a child's life). When 14 days have passed after the birth of the child, the navel should be dry.
- Slight redness of the umbilical ring (with normal healing of the umbilical wound, there is no redness).
2. Phlegmonous form of omphalitis in a newborn is the most severe form of the disease. With this form of omphalitis, the inflammatory process moves to the surrounding tissues. The disease, as a rule, begins by the end of the first (or second) week of life, quite often - with a "weeping navel". Further, in addition to the fact that the navel gets wet, it is abundantly excreted purulent fluid, the navel bulges, the umbilical region turns red and swells. The skin in the umbilical region becomes hot. Ulceration of the umbilical wound may also be observed, which is covered with plaque and surrounded by a dense skin roller. If you press on the umbilical region, you can see that pus is released from the umbilical wound. With this form of omphalitis, the general condition of the child worsens significantly, the temperature rises to 38 degrees, the baby sucks poorly, becomes lethargic, often spit up (maybe vomiting), the weight gain of the child decreases.
I must say that in premature babies with omphalitis, in most cases, changes in the skin around the navel are almost not observed, and there are only signs of general intoxication of the body, namely, fever, refusal of the breast, lethargy, etc., in other words, the severity of the disease in any way it is impossible with weight of local manifestations.
3. The necrotic form of omphalitis in a newborn is rare, as a rule, this form develops in sharply weakened children (with low birth weight, reduced immunity, etc.). Inflammation with high speed extends deep into, then passes to the umbilical vessels. At the same time, the skin and subcutaneous tissue acquire a bluish tint and become dead. The necrosis can spread to all layers of the anterior abdominal wall, which often causes peritonitis. The condition of the child with this form of omphalitis is quite severe. At the same time, the body temperature rarely rises, because the child is exhausted from the very beginning, it may even be that the temperature will be lowered (below 36 degrees), the child also becomes lethargic, he has reduced physical activity, inhibition is observed, the reaction to others is inhibited.

How to treat omphalitis in a newborn
Treatment of omphalitis in infants depends on the form of this disease. So, if there is a simple form of omphalitis, then treatment at home (under the supervision of a doctor) is possible, but for all other forms, treatment should be carried out only in a children's hospital - in the neonatal pathology department. At the same time, it is very important to prevent purulent contents and growths from accumulating under the crust, for which the umbilical wound should be treated in a timely manner.
With a simple form of omphalitis, the umbilical wound of the newborn must first be washed with a solution of hydrogen peroxide, and then treated with alcohol or aqueous solutions antiseptics, which include: 70% alcohol, Furacilin, Dioxidin and Chlorophyllipt - 3-4 times a day (that is, more often than with normal navel care). Using a sterile pipette, 2-3 drops of a 3% hydrogen peroxide solution are applied to the wound. After that, the bottom and surface of the navel should be dried with a cotton swab (cotton swab). Then, using a cotton swab, lubricate the wound with an antiseptic solution. And every time you have to take a new one cotton swab.
Treatment of the phlegmonous form of omphalitis in infants is carried out with the participation of a surgeon. In addition to treating the umbilical wound with antiseptics, it is necessary to put an ointment with antibacterial substances into it, for example, Bacitracin, Polymyxin, Vishnevsky Ointment. According to the doctor's indications, antibiotics can be used, for example, anti-staphylococcal immunoglobulin.
At necrotic form omphalitis in a newborn, dead tissues are excised to the border with healthy skin, and antibacterial and detoxification therapy is also carried out. In addition to antiseptics, wound healing agents can be used, for example, sea buckthorn oil or rose hips.
It should be noted that for all forms of omphalitis, physiotherapy can be applied, which includes: ultraviolet irradiation umbilical wound, UHF and microwave therapy, etc.

To prevent omphalitis, you should properly care for the umbilical wound and be sure to observe sterility when processing it.
How to treat the umbilical wound of a newborn? I must say that the treatment of the navel of a newborn is best done on a changing table covered with a diaper. It is necessary to treat the umbilical wound of the baby 1 time per day after washing the child, but if the navel is treated more often, this can injure the wound, which has already begun to heal). Processing is done with 70% alcohol or another (colorless) antiseptic, for example, a 1% alcohol solution of chlorophyllipt. It should be noted that it is undesirable to use potassium permanganate or brilliant green, because they stain the skin, and this can hide it. possible inflammation. But in no case should you tear off the crust from the wound, because of this, bleeding may open. If fluid is released from the navel of the newborn, the navel turns red, becomes compacted, etc., you should immediately contact the doctor, only he will be able to choose the appropriate treatment.
It is not necessary to bandage the umbilical wound. When the wound is completely healed (usually after the 10-14th day of life), it does not need to be treated.
How to properly monitor the navel of a newborn? The most important thing is to keep the skin around the navel dry. It is necessary to ensure that the diaper does not touch the navel when put on, in addition, the baby's clothes should be soft cotton and not irritate the umbilical region.
Thus, prevention is the best treatment! If you properly care for the navel of a newborn, then within two weeks a crust will form in the navel area, which then itself will fall off.

Fungus of the navel of a newborn- a fairly common disease. The disease is common throughout the world in babies of both sexes.

Usually, this pathology the parents themselves identify in the process of bathing the baby and processing the remainder of the umbilical cord.

Already in the first minutes after the birth, the umbilical cord, which connected the mother with the child throughout the pregnancy and contributed to the nutrition of the child, is cut off, and instead of it, a stump remains, which in normal conditions quickly dries up and falls off. However, despite this, in certain situations an infection gets into the navel, and the wound heals for a long time.

Umbilical fungus speaking medical language nothing more than the growth of granulation tissue. Quite often it develops in the form of omphalitis. When bacteria are introduced into the specified tissue, i.e. as a result of infection of granulations, with a certain degree of probability, complications of this disease can be expected.

Causes and signs of navel fungus in newborns

It should be said right away that any reliable established causes fungus of the navel of newborns has not been identified to date.

In itself, the growth of granulations is not an infectious process, but rather refers to the personal adaptive characteristics of a growing organism.

The beginning of the growth of granulation tissue is usually associated with the presence in the baby of such a physiological variant of the norm as a wide umbilical ring. Accordingly, a wide umbilical cord can become the cause of the development of the described condition. After completion of the process of separation of the umbilical cord stump, the resulting free place begins to fill with fungus.

Note that both factors are not classified as a pathological condition. These are bodily features. With all this, the very formation of granulation tissue has never been considered by doctors as the norm. This is still a disease that needs to be disposed of, despite the fact that it is considered quite harmless.

To the risk factors predisposing to the development of the described disease, physicians tend to attribute the large body weight of the born crumbs, as well as the state of prematurity.

As mentioned above, the development of the fungus of the navel in newborns implies the appearance of excess granulation tissue, the growth of which comes from the umbilical cord residue: the process starts after the cord stump falls off, which normally happens very quickly, while a small part of the unhealed cord residue gives rise to granulation tissue, gradually filling the entire umbilical ring.

Outwardly, the process looks like a mushroom-like growth on the tissue remaining after the fall of the umbilical stump. Such growth quickly fills the entire umbilical wound with its mass, and sometimes even goes beyond the umbilical ring.

This fact not only causes cosmetic defect this area, but also represents a serious danger. If in this moment any microbial agent gets into the wound, then the baby will develop inflammation of the umbilical ring, known as omphalitis. In turn, the result of this process may be the penetration of bacteria into the arterial bed with the development of sepsis.

In general, in the absence of fungus infection, the general condition of the crumbs is not disturbed, signs of inflammatory changes are not detected, umbilical vascular bundle not palpable. There are no changes in the blood.

It is enough to look at what the fungus of the navel looks like in newborns in the photo to understand that given state does not cause diagnostic difficulties:

Attentive parents very quickly notice something is wrong in the umbilical wound and turn to a specialist who easily determines the cause of concern and prescribes the necessary therapeutic measures.

Sometimes fungus can be confused with prolapse of the mucosa of an unclosed vitelline duct or with intestinal evagination. However, the differences here are very significant. In particular, the fungus is characterized by a pale pink color (the mucosa is bright red), and its consistency is dense (as opposed to the soft elastic mucosa). The pathology under consideration differs from evagination in the rate of development: granulations appear gradually, slowly, while evaginate occurs quickly, sometimes suddenly.

The essence of the treatment of fungus navel of newborns at home

The described disease is characterized by an independent stop of the process, without affecting the condition of the baby. However, this favorable combination of circumstances does not always occur. Given the possibility of developing unpleasant complications we can conclude that it is not worth delaying the treatment of fungus.

In most cases, with navel fungus in newborns, treatment is carried out at home. Its essence boils down to two main points: it is necessary to carry out a daily thorough toilet of the umbilical wound, and granulations should be cauterized with a solution of silver nitrate of 5% concentration. The latter is also known as Lapis and can be used as a pencil.

You can also use antibiotics in the form of sprays and ointments, or creams or solutions, as prescribed by a specialist doctor. In any case, it is necessary to ensure that diapers and diapers do not damage the granulosa tissue itself.

The umbilical wound should be treated at least once a day. This is usually done after bathing the baby. First, 2-3 drops of a 3% solution of hydrogen peroxide (or, more simply, peroxide) are instilled. After that, the wound is dried with a cotton swab.

The next step is the processing of 1% alcohol (the usual "brilliant green"). As an alternative to the latter, you can use a 5% solution of potassium permanganate (known as "potassium permanganate"), as well as alcohol solution iodine all in the same 5% concentration.

It is worth noting that all of the above means stain the skin, which is why you can not notice the beginning inflammation in time. For these reasons, some experts recommend using 70% ethanol instead, alcohol tincture chlorophyllipt or other colorless antiseptics.

There is also a method of treating fungus of the navel in a newborn with ordinary salt. On the one hand, it is not immediately believed in, because pouring salt on open wound- the procedure is not pleasant. On the other hand, according to many parents, this method of dealing with granulations works well.

This folk method extremely simple. In the umbilical wound, an ordinary salt, from above it is covered with a cotton pad and sealed with a plaster. After 30 minutes, the patch is removed, and the wound is washed with water. Similar procedure should be done twice a day.

If, with a diagnosis of navel fungus in newborns, treatment conservative measures does not give the expected result, then to solve the problem it is worth thinking about surgical intervention.

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After discharge from the maternity hospital, the mother remains alone with the child and is faced with the need to care for him. Some phenomena can frighten a woman, in particular, many young mothers do not know how to properly care for an umbilical wound. Often, babies have a problem in the form of weeping of the navel, how to deal with it?

Table of contents: Symptoms of a weeping navel in newborns Symptoms of purulent omphalitis in newborns Treatment of a weeping navel in newborns What is unnecessary to do with a weeping navel?

Weeping belly button symptoms

In the first minutes after birth, the baby's umbilical cord is clamped with a clamp and cut. The umbilical cord normally falls off within two to four days. In its place, an umbilical wound is formed, which is covered with a crust. Complete healing of the navel occurs within two to three weeks.

Normally, the healing process of an umbilical wound may be accompanied by a slight weeping and the formation of yellowish crusts. But in the case of pronounced weeping and poor healing of the umbilical wound, they speak of the development of catarrhal omphalitis (weeping navel).

Bacteria (staphylo- and streptococci, E. coli) are to blame for the development of omphalitis, which penetrate the tissues through the umbilical cord or umbilical wound. The vital activity of bacteria leads to the development of inflammation.

Symptoms of catarrhal omphalitis (weeping navel) are:

Transparent serous or serous-bloody discharge from the umbilical wound;
Redness of the umbilical ring;
Poor healing of the navel - after the crusts fall off, the erosive surface of the skin is exposed, which does not epithelize, but again becomes covered with crusts.

With a long-term weeping, an overgrowth of mushroom-shaped granulation tissue can form - this is called the fungus of the navel. Catarrhal omphalitis does not affect the general condition of the child. This form of the disease is the most favorable and often occurs among newborns.

Symptoms of purulent omphalitis in newborns

If the discharge from the umbilical wound becomes yellow, thick, this indicates the development of purulent omphalitis. In this case, the skin around the navel swells and turns red. With the spread of inflammation to the umbilical region, phlegmonous omphalitis develops, which is characterized by pronounced edema, redness of the skin around the navel, and protrusion of the umbilical region. The skin around the navel is hot to the touch, and when pressed on this area, pus flows out of the umbilical wound.

A complication of this form of the disease is necrotic omphalitis. This is a very rare condition, often found in debilitated babies. With necrotic omphalitis, the inflammatory process extends deep into the tissues. The skin in the umbilical region becomes purple-bluish and soon exfoliates from the underlying tissues with the formation big wound. This is the most severe form of omphalitis and can lead to sepsis.

Purulent omphalitis is difficult, the children become lethargic, they suck badly at the breast, there is an increase in temperature. Fortunately, purulent forms of omphalitis are quite rare.

Prevention and treatment of a weeping navel in newborns

If parents are faced with such a problem as weeping of the navel, you should contact your pediatrician. The doctor will treat the umbilical wound and teach this manipulation to parents. With catarrhal omphalitis (weeping navel), the doctor can treat the disease at home. However, when purulent forms omphalitis hospitalization of the baby is required.

Treatment and prevention of a weeping navel is carried out as follows:

All newborns need to carry out such a procedure once a day until the umbilical wound is completely healed. For babies with a weeping navel, manipulation can be carried out two to three times a day.

Fungus of the navel is treated by cauterization of granulations with a 5% solution of silver nitrate. In the case of phlegmonous omphalitis, the baby is prescribed antibiotics inside, as well as externally in the form of ointments. In the necrotic form of the disease, in addition to antibacterial treatment perform surgical excision of dead tissue.

What is unnecessary to do with a weeping navel?

Unfortunately, good intentions do not always lead to speedy recovery. So, some manipulations can further aggravate poor healing umbilical wound.

What mistakes do parents often make when caring for their baby's navel?

You should refrain from bathing the child in bathtubs. It is enough to wipe the baby every day with a wet towel.
You can not close the navel with a band-aid, diapers, clothes. Contact of the skin with air contributes to the drying of the wound.
Try to forcefully tear off the crusts.
Treat the wound with an antiseptic more often than the doctor advised.

We recommend reading: Caring for a newborn - the basic rules

Grigorova Valeria, medical commentator

OkeyDoc.ru

Fungus of the navel in newborns: causes, treatment, photos

Newborns are a population group whose health must be carefully protected. To this end, doctors observe newly born children in a specialized medical institution (perinatal centers), and then carry out patronage during the first month of life. At slightest symptoms diseases of newborns are hospitalized in a hospital. This proves that not only the baby's parents are interested in his health, but also it is protected by the state. Most frequent illnesses in the first days and weeks of a child's life are the fungus of the navel and omphalitis. They can be diagnosed even in the hospital. More often they are found during the first month of life.

What is umbilical fungus?

Fungus of the navel in newborns is common. This disease is common throughout the world in both boys and girls. Usually parents notice it when they bathe the baby and process the umbilical residue. High incidence This part of the body in newborns is due to the fact that this place for a long time connected mother and child and contributed to nutrition. In the first minutes of life, the umbilical cord is cut off, leaving a cult in its place. Normally, it quickly dries up and disappears. But in some cases, the wound heals for a long time, as an infection gets into it. The fungus of the navel is an overgrowth of granulation tissue. It develops as often as omphalitis. In some cases, the granulations may become infected. This is due to the penetration of bacteria into the tissue. Then complications of the disease are possible.

Fungus of the navel in newborns: causes of appearance

Growth of granulation tissue is not infectious processes. Rather, it is considered an individual adaptive feature of the organism. There are no definite reasons for the development of fungus. The growth of granulations is most often associated with a wide umbilical ring in a baby. After the stump falls off, the free space begins to fill with fungus. Another reason for its appearance may be a wide umbilical cord. Both of these factors are not pathological conditions, but are features of the organism. However, the growth of granulation tissue itself is not considered the norm. Therefore, the fungus of the navel must be treated. Despite the fact that this disease is considered harmless, its complications are dangerous for the health of the baby.

How does the umbilical fungus develop?

The development of fungus means the appearance of excess granulation tissue, which begins its growth from the umbilical cord. Predisposing factors include a large body weight of the newborn, prematurity. The main reason is the wide umbilical ring. The development of granulation begins after the stump has fallen off. Normally, the umbilical cord falls off quickly. With the development of fungus, a small part of it remains. This unhealed umbilical cord gives rise to granulation tissue that begins to fill the annulus. The process can stop on its own without affecting the condition of the baby. However, this does not always happen. In some cases, granulations completely fill the umbilical ring and begin to go beyond it. This leads not only to a cosmetic defect, but also represents a danger. When the infection is attached, inflammation of the umbilical ring develops - omphalitis. As a result, bacteria can enter arterial blood and induce sepsis.

Symptoms of fungus navel

The clinical picture of the fungus of the navel depends on the degree of growth of granulations. On initial stage disease symptoms are almost absent. Only a slight increase in the umbilical residue inside the ring is noticeable. With further growth of granulation tissue, a tumor-like formation is observed. First, it fills the umbilical ring, and then goes beyond it. As a result, a classic example of fungus is observed - mushroom-like growth of granulations. Education originates in the umbilical ring and can occupy a significant surface of the anterior abdominal wall. In addition to this symptom, clinical picture fungus is weakly expressed. IN rare cases there may be an increase in body temperature and a slight deterioration in the condition. In newborns, these symptoms are expressed in tearfulness when processing the navel, bad dream, rejection of the breast. These manifestations should alert parents, as they are often observed during the development of omphalitis.

Diagnosis of fungus in newborns

Fungus is often confused with other diseases of the umbilical wound. Among them are catarrhal and purulent omphalitis, hernial protrusion, lipoma. When diagnosing, it is important to conduct a thorough survey of the baby's parents. It is necessary to find out how long ago the proliferation of granulation tissue began, whether the fungus is increasing in size, how the child reacts to bathing and processing the umbilical region. It is also important to check for other symptoms. Sharp deterioration the child's condition often speaks of complications that have developed against the background of fungus. If inflammation develops in the umbilical wound, then the following symptoms join:

The appearance of serous or purulent discharge.
Hyperemia and edema.
Soreness with pressure on the fungus area. It is expressed by crying, the sharp mobility of the baby.
Increase in body temperature.
Breast rejection.

These symptoms are dangerous for newborns. When they appear, you must immediately contact for medical care. Performed in the hospital laboratory research. With uncomplicated fungus, no changes are observed in the KLA and OAM. If there are inflammatory phenomena (leukocytosis, acceleration of ESR), then this means that omphalitis has developed. In this case, the discharge from the umbilical wound is taken for analysis in order to identify the causative agent of inflammation and prescribe treatment. In some cases, fungus can be confused with other formations. If the doctor has doubts, an ultrasound of the soft tissues of the abdomen is performed. Most often, the doctor quickly diagnoses the fungus of the navel in newborns. Photos of this pathology are placed in a special medical literature in neonatology. However, parents should not draw conclusions on their own. If granulations appear, you should consult a doctor.

Fungus of the navel in a newborn: how to treat the disease?

The choice of fungus treatment method depends on the size of the formation and the general condition of the baby. For small granulations that do not tend to grow, observation is recommended. If the fungus increases, then you need to get rid of it. In most cases, for this purpose, cauterization of granulations with nitrogen, silver lapis is performed. If there is a fungus of the navel in newborns, treatment (operation) is carried out in the department of pediatric surgery. The child must be hospitalized and examined before the intervention. The operation consists in removing the granulation tissue and washing the umbilical ring with antibiotic solutions.

Prevention of fungus in newborns

The fungus of the navel cannot be foreseen in advance, since its appearance depends on individual characteristics. Nevertheless, it is possible to prevent inflammatory changes that develop against its background. To do this, it is necessary to monitor the condition of the baby, bathe the newborn daily and treat the umbilical wound with a solution of hydrogen peroxide. At inflammatory phenomena you should consult a doctor.

Complications and prognosis of the disease

A complication of fungus is omphalitis. Inflammation of the umbilical wound is very dangerous, as it is one of the main causes of sepsis. In the absence of complications, fungus is not a severe pathology and usually does not affect the baby's condition. However, at rapid growth granulation formation must be removed.

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Diseases of the navel

This is a large group of diseases that are not inflammatory or inflammatory nature. Skin umbilicus. This is an overgrowth of skin over the remainder of the umbilical cord. As a result, a cosmetic defect, a stump, is formed: the navel is enlarged and protrudes above the surface of the abdomen. The stump can then wrinkle and retract, or it can stay forever. Treatment: cosmetic surgery.

Amniotic umbilicus. At the site of the navel, a defect is formed where there is no skin, only gradually covered with skin. special treatment does not require.

Hernia of the umbilical cord. A malformation in which part of the abdominal organs (liver, intestinal loops) are located in the membranes of the umbilical cord. Treatment: surgical.

Omphalitis - bacterial inflammation of the navel, as well as skin, subcutaneous tissue around the navel and its vessels as a result of infection in the umbilical wound.

Forms of omphalitis:

Wet belly button. The umbilical wound becomes wet and does not heal well. It is pus or clear liquid, dries up and turns into crusts. After their falling away, small, sometimes bleeding sores remain. There is no inflammation around the navel. The general condition of the child is satisfactory, the body temperature is normal. Sometimes a fungus is formed at the bottom of the umbilical wound.

Phlegmon of the navel. In addition to weeping and purulent discharge, there is a protrusion of the navel, redness and swelling of the skin around it. On the front abdominal wall red streaks are visible: inflamed lymphatic vessels, arteries and veins. The general condition of the child is disturbed (fever, regurgitation, vomiting, lack of appetite, etc.). The infection can spread through the vessels and further: in the inguinal and axillary region, V abdominal cavity and other remote places.

Navel necrosis. The infection spreads deeper, causing the development of peritonitis. It occurs in severely weakened children.

umbilical sepsis. The most severe form of the disease. The infection "floats in the blood" and spreads throughout the body through the bloodstream. It is characterized by the development of multiple inflammatory foci in various bodies. The child's condition is extremely serious.

Weeping belly button treatment

Weeping of the navel can be treated at home, other forms of omphalitis - only in the hospital.

A weeping navel is treated as follows:

The crusts are removed (there may be inflammation and pus under the crust).
Soak the crust with a pink solution of potassium permanganate, a 3% solution of hydrogen peroxide or a solution of furacilin.
Additionally, the navel is washed with the same solutions.
Lubricate (cauterize) the navel. Use:

a strong solution of potassium permanganate (5%);
fucorcin;
10-15% alcohol solution of propolis;
alcohol 70%;
1% alcohol solution of chlorphilipt;
1-2% alcohol solution of brilliant green.

Fungus of the navel. Consequence of omphalitis. Fungiform growth of granulation tissue (dense, Pink colour) at the bottom of the umbilical wound with prolonged healing.

Treatment: fungus treatment with 3% hydrogen peroxide and cauterization with a lapis pencil.

Umbilical fistula. Surgical pathology. In the fetus, two ducts function in utero: vitelline (connects the navel with the intestines) and urinary (connects the navel with bladder). By the time of birth, they should close. If the infection of these ducts does not occur, then an umbilical fistula develops. Urine is sometimes excreted through the urinary duct, and from the vitelline duct - stool.

The leading symptom of umbilical fistulas is prolonged weeping of the umbilical wound for 1-2 months. The child must be shown to the surgeon. Treatment: surgical.

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Omphalitis in newborns: causes, treatment. Bleeding belly button in newborns

Many babies have inflammation of the navel in the first month of life. This problem occurs in almost every tenth baby. Many parents, faced with this situation, seriously panic. Others, on the contrary, completely underestimate the problem. Meanwhile, this pathology - omphalitis in newborns - needs competent and timely treatment. Neglect or delay can have serious consequences.

Characteristics of the pathology

The umbilical wound is a rather vulnerable place in a newborn. Through it, an infection can easily enter the body of the crumbs. In this case, inflammation of the bottom of the navel develops. Pathology can also cover adjacent tissues. Often, inflammation extends to the umbilical ring with adjacent vessels, subcutaneous adipose tissue. This is how omphalitis develops in newborns.

Most often, the disease manifests itself in the 2nd week of life. As a rule, in most babies, the wound heals by day 7. But in case of penetration of infection, it is not delayed during these periods. The wound starts to ooze. In addition, reddened skin near the navel indicates the development of pathology. To the touch, the tissues are quite dense, the vessels are palpable. And from the wound itself, pus is possible.

Causes

Why does omphalitis develop in newborns? The only cause of the pathology is the penetration of the infection into the body through the open wound of the navel. In most cases, the culprits of infection are streptococci and staphylococci. But sometimes inflammation can develop as a result of penetration Gram-negative bacteria such as diphtheria or E. coli.

The main factors provoking the development of the disease are:

Insufficient or incorrect processing of the navel.
Non-compliance with hygiene rules when caring for a baby. The reason for the development of inflammation may be the treatment of the wound dirty hands or untimely bathing of the crumbs after bowel movements.
The appearance of diaper dermatitis. With a long stay of the baby in diapers contaminated with feces or urine, the skin sweats excessively. If the child rarely takes air and water baths, then the condition is greatly aggravated.
Airborne route of transmission. The infection can enter the baby's body from a sick person caring for the baby.
Infection with an infectious skin disease. Omphalitis can develop against the background of folliculitis or pyoderma.
Infection during childbirth. Sometimes infection of an infant occurs when the umbilical cord is tied.

Most often, umbilical omphalitis is observed in premature babies, as well as in babies who were not born in hospital conditions (during home birth). Often from this disease crumbs suffer, in which abnormal congenital pathologies are observed.

Varieties of the disease

At healthy child the umbilical cord falls off by 3-4 days of life. After that, the wound is tightened with a bloody crust. She gradually dries up. Complete healing occurs on the 10-14th day of life. In the first week, a small amount of discharge from the wound may be observed. But by the time the navel is completely healed, it should be completely dry. If by this time the wound has not healed, there is every reason to assume that omphalitis develops in newborns.

Pathology is characterized by several varieties. Depending on the stage of severity, the disease is classified into:

catarrhal;
purulent;
phlegmonous;
necrotic.

In addition, the disease can be:

primary (if it developed as a result of infection of the navel);
secondary (when an illness occurs against the background of already existing anomalies).

Each type of disease is characterized by its own symptoms. That is why it is necessary to consider all forms separately.

Catarrhal omphalitis

This is a simple type of disease. In the people it is called "weeping navel".

The pathology is characterized by the following symptoms:

Slight discharge from the wound. As a rule, this is how the development of the disease begins. The discharge may be serous. Sometimes the bleeding navel in newborns even contains purulent fragments. Allocations may appear and disappear.
Swelling of the umbilical ring. This symptom is very often observed during the development of pathology, but it is not mandatory. The umbilical ring turns red, swells. Skin shine and stretch.
Fungus may occur (it resembles a mushroom growth). This is a pale pink dense formation. In most cases, it does not cause discomfort to the baby, but it can easily fester if an infection enters. Infection often occurs when the fungus is damaged during swaddling or dressing the crumbs.

With the development of a catarrhal variety of the disease, the baby feels great. He sleeps well, eats with appetite, gains weight well.

But the treatment of the disease must begin immediately. If you do not take the fight against the disease at this stage, then the pathology will begin to progress.

Purulent omphalitis

If the treatment was not undertaken at the stage described above, or the wrong therapy was carried out, then the disease begins to progress. In this case, purulent pathology develops.

This stage is characterized by the following symptoms:

Pus appears. It flows from the umbilical wound. Discharge has an unpleasant odor.
The condition worsens. The child's temperature rises, appetite is significantly reduced. The kid does not sleep well, is capricious, constantly pulls his legs up to his tummy. There may be regurgitation, dyspepsia.
Skin infiltration, swelling. Redness increases significantly in the navel area. The veins are dilated.
The navel of a newborn protrudes above the integument of the skin. In its shape, it resembles a cone. Feels hot to the touch.

In this case, it is necessary to show the baby to the surgeon as soon as possible.

Phlegmonous omphalitis

With further progression of the disease, the inflammatory process covers blood vessels- arteries and veins. In this case, phlegmonous omphalitis is observed.

It is characterized by the following symptoms:

The child's condition is deteriorating significantly. He refuses to breastfeed, loses weight. The baby is extremely restless, he has indigestion. Pathology is accompanied high temperature sometimes reaching 40 degrees.
The inflammation is pronounced. The navel of the newborn is red, swollen. It is hot to the touch, constantly getting wet, and protrudes significantly above the integument.
The focus of inflammation increases. Around convex navel red edematous tissues are observed. In their configuration, they resemble the appearance of an octopus or jellyfish.
IN festering wound the path to the ulcer is determined. With pressure on nearby integuments, the release of pus increases.

With such a pathology, the risk of spreading phlegmon to the abdominal tissues is high.

Necrotic omphalitis

This is the most severe stage of the disease.

It manifests itself with the following symptoms:

Phlegmon acquires a blue-red or purple color.
A hole appears in the navel. The intestines can protrude through it.
Exfoliation of tissues is observed. Under them gaping a huge wound.
The child is apathetic, lethargic. The temperature may drop sharply.

Necrotizing omphalitis in children can lead to dangerous complications one of which is sepsis.

Diagnosis of the disease

The definition of pathology does not cause difficulties. The doctor will make the primary diagnosis as soon as he examines the bleeding navel in newborns.

To exclude the development of complications, additional examinations will be prescribed:

Ultrasound of the peritoneum, soft tissues;
X-ray with survey research.

The baby will definitely be sent for a consultation with a pediatric surgeon.

In addition, bakposev is prescribed. This allows you to identify the causative agent of the infection. This analysis will provide the most accurate choice of antibiotic therapy.

Omphalitis: treatment of catarrhal form

At home, you can only deal with this stage of the disease.

The therapy includes the following activities:

The umbilical wound should be treated 4 times a day.
Initially, a solution of hydrogen peroxide is dripped into it - 2-3 drops. Then, with the help of hygienic sticks, the contents are removed.
After this procedure, antiseptic event. The wound is treated with drugs such as Furacilin, Chlorophyllipt, Dioxidin. It is possible to use greenery.
It is especially important to know how to bathe a baby. It should not be forgotten that the baby really needs water procedures. However, with this pathology, doctors recommend adding a little potassium permanganate to the bath before bathing the baby. The water should be a pale pink color.

Treatment of severe stages

With a progressive disease, they are most often fought in a hospital setting.

For treatment, measures such as:

Appointment of local antiseptic ointments. Recommended "Baneocin", Vishnevsky's liniment. They are used for dressing the wound.
Antibiotic therapy. Sometimes a chipping of the focus of inflammation is prescribed. Antibiotics are selected according to the results of bakposev.
Fungus cauterization. For such an event, silver nitrate is used.
Wound drainage. A special tube inserted into the navel provides a good exit of pus.
If necessary, the baby is prescribed vitamin therapy and drugs that increase immunity.

In some cases, considered surgical intervention to remove necrotic tissue.

Conclusion

Parents should carefully and very responsibly approach the care of a newborn. And if the navel does not heal 10-14 days after birth, it is necessary to show the baby to the doctor. Omphalitis can lead to enough grave consequences. But timely and adequate therapy allows you to quickly cure the pathology, which in the future will not affect either the health or the well-being of the baby.