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O período neonatal é crítico na vida de uma criança, devido à sua maior vulnerabilidade e ao maior risco de morte, sendo os cuidados realizados ao recém- nascido revestidos da maior importância e com reflexos na sua saúde futura. A cultura, os mitos e as crenças revelam-se num conjunto de saberes tradicionais que muitas vezes prevalecem sobre os conhecimentos científicos, dando origem a práticas de cuidados com o corpo não recomendadas pela Organização Mundial de Saúde e com consequências negativas para a saúde, como é exemplo a onfalite. Em Angola, a mortalidade neonatal é elevada, constituindo a septicémia uma das principais causas. Analisou-se saberes e práticas de mães angolanas relativamente aos cuidados corporais com o recém-nascido, em particular com o coto umbilical, através de um estudo descritivo, exploratório, comparativo e transversal, com metodologia de cariz qualitativa, cuja amostra é não probabilística por conveniência. Verificou-se que os saberes e as práticas de mães angolanas relativamente a estes cuidados derivam da componente empírica, transmitida maioritariamente pela família através das gerações, sobretudo pelas avós do recém-nascido, e da componente científica, através dos profissionais de saúde. Observou-se que as mães com experiência migratoria revelam alguns comportamentos distintos das mães naturais de Luanda, nomeadamente ao mencionarem com mais frequência o álcool como conhecimento prévio, sendo no entanto as mães naturais de Luanda as que mais o utilizam de forma isolada como prática nos cuidados ao coto umbilical. The neonatal period is critical in the life of a child, due to its greater vulnerability and the greater risk of death, and the care provided to the newborn is of utmost importance and with reflections on its future health. Culture, myths and beliefs are revealed in a set of traditional knowledge that often prevails over scientific knowledge, giving rise to body care practices not recommended by the World Health Organization and with negative consequences for health, such as an example is omphalitis. In Angola, neonatal mortality is high, with septicemia being one of the main causes. Knowledge and practices of Angolan mothers regarding body care with the newborn, in particular with the umbilical stump, were analyzed through a descriptive, exploratory, comparative and transversal study, with a qualitative methodology, whose sample is non-probabilistic because of convenience. It was found that the knowledge and practices of Angolan mothers regarding this care derive from the empirical component, transmitted mainly by the family through generations, especially the newborn's grandmothers, and from the scientific component, through health professionals. It was observed that mothers with migratory experience reveal some different behaviors from mothers born in Luanda, namely by mentioning alcohol more frequently as prior knowledge, although mothers born in Luanda are the ones who most use it in isolation as a practice in umbilical stump care. info:eu-repo/semantics/publishedVersion

Background: Several mothers do not adhere to the standard medical advice given by health professionals as observed during medical practice and tend to follow potential harmful practices during the postnatal period. Little evidence is available in the state of Goa on the various traditional practices observed by mothers post-delivery.Aim: To identify and explore various traditional beliefs and practices concerning newborn care and postpartum period among postnatal mothers at South Goa District Hospital.Materials and Method: This descriptive, cross-sectional study was conducted over a period of 3 months using convenient sampling among admitted postnatal mothers. Data were entered into an Excel spreadsheet and analysed using SPSS version 22.Results: Majority of the study participants breastfed their newborn babies within 24 hours of childbirth (97.50%). 96.25% of the mothers fed colostrum to their newborn babies. A significant proportion of mothers used new washed clothes for their babies (83.75%) and bathed them five days post-delivery (72.5%). No dressing was applied to baby’s umbilical stump (58.75%). Postpartum home confinement with newborn baby for 40 days was observed by 22.5% of the mothers. Mothers applied kajal to the baby’s face and eyes (50%), used bangles (35%) and anklets (16.25%) to protect baby from evil eye.Conclusion: The study highlighted the need for awareness of health professionals about the popular traditional practices observed among postnatal mothers in order to eliminate possible harmful practices and reinforce beneficial practices for a healthy postpartum period for the mother. How to cite this article: Vernekar PP, Cacodcar JA, Panandikar M, Almeida I. A Study on Traditional Beliefs and Practices during the Postpartum Period among Mothers at a District Hospital in Goa. Int J Preven Curat Comm Med. 2021;7(3):1-11. DOI: https://doi.org/10.24321/2454.325X.202111

Umbilical catheterization is commonly used as a route to provide medications and fluids to the neonates as well as for blood sampling and continuous monitoring. Although the rupture of umbilical catheters is considered as a rare, preventable complication, it has been reported several times in the literature. Healthcare providers need to be cautious with catheter placement, maintenance, and removal to prevent such a complication. Hereby, we review the literature about this complication after presenting two incidents of umbilical venous catheter rupture in two separate patients in our neonatal ICU. One was removed easily through the umbilical stump, whereas the other required surgical exploration.

Lewandowska Anna, Bilska Beata. Educational needs of parents towards a healthy newborn baby. Journal of Education, Health and Sport. 2020;10(1):47-55. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.01.006 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.01.006 https://zenodo.org/record/3611273 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.12.2019. Revised: 25.12.2019. Accepted: 17.01.2020. Educational needs of parents towards a healthy newborn baby Potrzeby edukacyjne rodziców wobec zdrowego noworodka Anna Lewandowska1, Beata Bilska1 1Institute of Healthcare, State School of Technology and Economics in Jaroslaw, address: Czarniecki Street 16, 37-500 Jaroslaw 1Instytut Ochrony Zdrowia, Państwowa Wyższa Szkoła Techniczno-Ekonomiczna w Jarosławiu, ul. Czarnieckiego 16, 37-500 Jarosław Contact address: dr n. med. Anna Lewandowska ul. Czarnieckiego 16, 37-500 Jarosław phone: 698757926; e-mail: am.lewandowska@poczta.fm Summary Introduction: The birth of a child is not only one of the most important life events for parents, but also a challenge in dealing with many difficulties associated with the basic stages of development and nursing a newborn baby. Often, insufficient knowledge and lack of skills about the child's development and care, are the cause of considerable difficulties for the parents of the newborn child. Health education is an important element of supporting activities in medicine, especially the education of young parents. It should include knowledge of maintaining hygiene, the use of appropriate care products, protecting umbilical stump, feeding, stimulating the child, as well as the use of vaccines. As many studies show, knowledge of healthy behaviors and parents' skills in newborn care and care determine the child's health in a broad sense. The aim of the study was to analyze the state of knowledge of parents about the newborn period and childcare as well as to analyze educational needs in this area. Material and method: The study involved 80 parents of newborns. The research method used in the work was a diagnostic survey. The survey technique in the form of a questionnaire was used to conduct the research. Results: In assessing the knowledge transferred about neonatal care by medical staff in the maternity ward, male and female responses are mixed. Only 37% of women obtained extensive knowledge, while 63% of women insufficient and in need of supplementation. As many as 70% of the men did not receive any information from the staff, the rest (30%) of the men were given messages, but they were incomplete. The most frequently chosen form of acquiring knowledge by both female and male respondents was to talk to staff (63%) and instruct (43%). For the vast majority of respondents (95%) the concept of newborn is familiar Conclusions: However, the knowledge possessed by parents is incomplete. Men are ignored in parental education. Most of the respondents know the rules of childcare. Most parents need to transfer knowledge and skills from specialists. Key words: newborn baby, parents, education Streszczenie Wstęp: Narodziny dziecka stanowią dla rodziców nie tylko jedno z ważniejszych wydarzeń życiowych, ale również wyzwanie w zakresie radzenia sobie z wieloma trudnościami związanymi z podstawowymi fazami rozwojowymi i pielęgnowaniem noworodka. Niejednokrotnie niedostateczna wiedza i braki umiejętności na temat rozwoju dziecka i jego pielęgnacji, stają się przyczyną znacznych trudności dla rodziców nowo narodzonego dziecka. Edukacja zdrowotna jest ważnym elementem działań wspierających w medycynie, a zwłaszcza edukacja młodych rodziców. Powinna obejmować wiedzę z zakresu utrzymania higieny, stosowania odpowiednich preparatów pielęgnacyjnych, zabezpieczania kikuta pępowinowego, karmienia, stymulacja dziecka, a także stosowania szczepionek. Jak pokazują liczne badania znajomość zachowań prozdrowotnych oraz umiejętności rodziców w zakresie opieki i pielęgnacji noworodka decydują o szeroko pojętym zdrowiu dziecka. Celem pracy była analiza stanu wiedzy rodziców na temat okresu noworodkowego i pielęgnacji dziecka oraz analiza potrzeb edukacyjnych w tym zakresie. Materiał i metoda: Badaniami objęto 80 rodziców noworodków. Metodą badawczą wykorzystaną w pracy był sondaż diagnostyczny. Do przeprowadzenia badań posłużono się techniką ankietową w formie kwestionariusza. Wyniki: W ocenie wiedzy przekazanej na temat opieki nad noworodkiem przez personel medyczny na oddziale położniczym odpowiedzi mężczyzn i kobiet są zróżnicowane. Jedynie 37% kobiet uzyskało obszerną wiedzę, natomiast 63% kobiet niewystarczającą i wymagającą uzupełnienia. Aż 70% mężczyzn nie otrzymało od personelu jakichkolwiek informacji, pozostałej części (30%) mężczyzn przekazano wiadomości, lecz były one niekompletne. Najchętniej wybieraną formą pozyskiwania wiedzy przez respondentów zarówno kobiet jak i mężczyzn była rozmowa z personelem (63%), oraz instruktaż (43%). Dla zdecydowanej większości ankietowanych (95%) znajome jest pojęcie noworodka Wnioski: Posiadana przez rodziców wiedza jest niekompletna. W edukacji rodziców pomija się mężczyzn. Większość badanych zna zasady pielęgnacji dziecka. Większość rodziców potrzebuje przekazania wiedzy i umiejętności od specjalistów. Słowa kluczowe: noworodek, rodzice, edukacja

In protesting against the routine of midwives tying the umbilical cord of newborns, Dr. Allen cites a number of facts that indicate the infection of children by this path; death from tetanus, erysipelas, diphtheria and septicemia he attributes to contamination of the umbilical cord ligation.

Umbilical stump sepsis in a nonpassively immunized neonate poses a high risk to neonatal tetanus. Management of neonatal tetanus is still a great challenge in resource‐limited settings where some health facilities lack tetanus toxoid containing vaccines, ventilator support, and inaccessibility of tetanus immunoglobulin.

Background The optimal method of umbilical cord care after birth is still a controversial issue, as umbilical stump has remained a focus of infection in newborns. Use of topical antiseptics is one intervention that could reduce the incidence of infection by preventing or reducing the bacterial colonization of the umbilical cord in neonates. Aim To compare the incidence of umbilical cord infection between neonates receiving 7.1% chlorhexidine gel (CHG) and Methylated-spirit (MTS) in Ibadan. Method and subjects This study was a prospective-comparative study. The study settings were selected by a multistage sampling technique from the 11 local governments in Ibadan. A total of 179 newborns (93 in the Chlorhexidine group and 86 in the Methylated spirit group) were enrolled into the study from three primary health centers (PHC) in Ibadan and analyzed for the incidence of umbilical cord infection. Results There was no statistical significant difference in the incidence of umbilical cord infection between the two groups [p = 0.447). There was a higher non compliance rate in the CHG group (21.1%) than in the MTS group (9.6%) [p = 0.001] Conclusion: There is no difference in incidence of umbilical cord infection with the use of Chlorhexidine or methylathed spirit in newborns.

BackgroundThe present study was aimed to evaluate the effect of umbilical cord milking technique on severity of Hypoxic Ischemic Encephalopathy (HIE) in asphyxiated neonates and assessed by Modified Sarnats staging as primary outcome, APGAR score at 5 minutes and Respiratory support requirement as secondary outcome. MethodsThis was a randomized, controlled pilot study conducted in neonatology department at a tertiary care centre, Thrissur, Kerala for one year starting from March 2020. The neonates were divided into two groups non milking group, control (n=38) and umbilical cord milking, case [UCM] (n=32) and their outcomes were compared. In the intervention group, the cord was cut at 30 cm from umbilical stump within 30 seconds of birth and euthermia was maintained. The umbilical cord was raised and milked from the cut end towards the infant 3 times with speed at 10 cm/sec and then clamped 2-3 cm from the umbilical stump. In the control group, the umbilical cord was clamped without doing cord milking. ResultsIn this study moderate to severe HIE were less in case group 46.9 % than control group 55.1% and less neonates 44.7 % had Mild HIE in control group compared to case group 53.1% even though result was statistically not significant as primary outcome (p value - not significant). Eight neonates (21.6%) in control group had Apgar at 5 min score 0-3, whereas only 4 (12.5%) neonates in cord milking group. ConclusionsThe insufficient knowledge of placental transfusion limits and benefits leads to a wide variation in the management of cord clamping. It would be useful to standardise the UCM procedure in order to offer protocols applicable to clinical practice, and to spread knowledge among professionals through educational programs.

La onfalitis corresponde a una de las principales causas de mortalidad neonatal en países en vías de desarrollo. Se define como el proceso infeccioso asociado al muñón umbilical, tejido circundante y estructuras adyacentes. Actualmente el manejo adecuado del cordón umbilical permanece controversial, sin embargo, la Organización Mundial de la Salud sugiere el manejo en seco del cordón umbilical en situaciones de bajo riesgo social y el empleo de antisépticos en poblaciones con alta mortalidad neonatal y prevalencia de partos caseros. Tras el diagnóstico, el manejo oportuno consiste en la pronta instauración de antibioticoterapia parenteral con el fin de mitigar posibles eventos adversos.

Objetivou-se avaliar o tempo de cicatrização e de queda do coto umbilical de caprinos recém-nascidos, a partir da utilização de fitoterápicos de uso tópico à base de aroeira (Schinus terebinthifolius Raddi) ou babosa (Aloe barbadensis Miller) em substituição ao iodo comercial. Analisou-se também o emprego de diferentes metodologias de aplicação dos fitoterápicos e a viabilidade econômica da utilização desses produtos. No experimento I foram utilizados 28 cabritos neonatos da raça Saanen, sendo sete animais em cada tratamento, com peso médio ao nascimento de 2,69 kg. No experimento II foram utilizados 15 cabritos neonatos da raça Saanen, com peso médio ao nascimento de 2,66 kg. Os animais foram distribuídos em um delineamento inteiramente casualizado, com três tratamentos e cinco repetições. Os tratamentos experimentais consistiram em: a) grupo controle - tratamento do coto umbilical em solução de iodo a 10%; b) grupo 1 - tratamento do coto umbilical com tintura de aroeira; e c) grupo 2 - tratamento do coto umbilical com tintura de babosa. Verificou-se que o tempo médio para cicatrização e queda do coto umbilical não diferiu entre os animais submetidos aos tratamentos aroeira e babosa (20,8 e 18,6 dias), com uma aplicação diária por três dias consecutivos, comparado ao grupo controle (20,4 dias). As tinturas fitoterápicas à base de aroeira ou babosa podem substituir a tintura de iodo a 10% e demonstram maior viabilidade econômica para utilização no processo de cicatrização e queda do coto umbilical de cabritos.

1. Catarina S. Oliveira, MD, MMed* 2. Ines Pessanha, MD, MMed† 3. Liliana Santos, MD, MMed† 4. Marta Machado, MD, MMed* 5. Raquel Zenha, MD* 1. *Department of Pediatrics, Baixo Vouga Medical Center, Aveiro, Portugal 2. †Department of Pediatric Surgery, Coimbra Hospital and Universitary Centre, Coimbra, Portugal A 21-day-old boy presents to the emergency department for the third time in 24 hours due to a 2-day history of an umbilical mass noted to be draining fluid. The mass is growing in size and increasing its drainage. The patient has an unremarkable medical history, and his umbilical stump fell off when he was 15 days old. During the patient’s first 2 trips to the emergency department, it was assumed that he had a bleeding granuloma. He was first treated with silver nitrate and then with a porcine gelatin absorbable sponge. The physical examination during this third visit reveals a comfortable boy with an umbilical mass that is draining a blood-tinged greenish-yellow liquid. Abdominal palpation seems to cause airflow from a small stoma in the umbilical mass (Fig 1). A catheter is inserted into the stoma, and airflow through the catheter is noted. Additional imaging confirms the diagnosis. Figure 1. Photograph of the umbilical mass where a small stoma is seen (white arrow). The physical examination suggests a patent omphalomesenteric duct (POMD). Ultrasonography is performed, revealing a hypoechogenic area between the umbilical mass and the small bowel. No other abdominal anomalies are observed. To better characterize the hypoechogenic mass, fistulography is performed and shows a patent duct between the stoma of the umbilical mass …

A newborn presents with a wide umbilical cord and thick umbilical stump (Figs 1 and 2). Figure 1. Infant with a wide edematous umbilical cord just after delivery. Figure 2. Thick umbilical stump with 3-vessel cord and serous discharge. ### Prenatal and Birth Histories

Background: Umbilical cord care is the handling of the umbilical stump of new-born after delivery. Hygienic umbilical cord care is important for the well-being of the newborn infant. The study was to assess the knowledge, practice and techniques of umbilical cord care among mothers in Primary Health Care centre in Nwezenyi, Ebonyi State, Nigeria . Methodology: The study was cross-sectional descriptive in design. Systematic sampling method was used to select 222 participants. Data were collected with semi-structured interviewer administered questionnaire and analyzed using Statistical Package for Social Sciences version 22. Results: The study showed high (83.3%) awareness of umbilical cord care and low (11.7%) knowledge of proper material (chlorhexidine) for umbilical cord care, poor (8.1%) practice of the use of correct material. Factors influencing the choice of material used are cost (16.7%), availability (17.1%), convenience (10.4%), “works faster” (20.7%) and “type respondent is aware of” (35.1%). Conclusion: High awareness of umbilical cord care management in this study did not commensurately translate to use of correct materials for its care. Thus, there was high risk of neonatal infection including neonatal tetanus. Focused health education to mothers will help improve their knowledge, practice and the use of correct material in umbilical cord care to reduce neonatal morbidity and mortality.

Objective: To identify strategies for the prevention of skin lesions in hospitalized newborns (NBs), published in scientific journals from 2013 to 2018. Method: Integrative literature review performed in two moments of database search, selecting 37 studies published between 2013 and 2018. Results: Thermoregulation, use of antiseptic, use of emollients and cleaning of the umbilical stump were the most commonly found recommendations. Among the evidence-based practices, we highlight those that prevent the risk of hypothermia, such as the use of a polyethylene bag and skin-to-skin contact, which support the assistance and ensure safety in the care of the neonatal patient. Conclusion: The prevention of skin lesions is a relevant topic. However, there is a scarcity of robust evidence to safely sustain NB care practices. It is also observed that the evidence is insufficient to encompass the universe of the theme, demonstrating that skin care is a theme that requires investment and more research.

Objective: To understand how the primiparous mother exercises maternal care of the child under six months of age at home. Method: Descriptive research with a qualitative approach. A research was carried out at the Primary Health Care Unit in Fortaleza/CE, between the months of May and June 2017, with 20 primiparous mothers. It was used thematic content analysis to analyze the data. Results: Through the organization of the speeches, we obtained the category Maternal Experience in Care. It was noticed that fear, insecurity and doubts were present in the daily life of the interviewees, interfering with care such as bathing and holding the baby; the cleaning of the umbilical scar was ceased after the stump fell; babies slept on their stomachs; pain and stress contributed to the failure of lactation; cleaning of the umbilical stump was ceased after its fall; babies slept in the ventral position; previous experience in caring for younger siblings influenced maternal care. Conclusion and implications for practice: It was understood that the orientations made by the nurses are fundamental for the qualification of the primiparous mothers in the care of the child. Resumen Objetivo: Comprender como la madre primípara ejerce el cuidado materno al hijo menor de seis meses en el domicilio. Método: Investigación descriptiva con abordaje cualitativo. Se realizó una investigación en Unidad de Atención Primaria a la Salud, en Fortaleza/CE, en los meses de mayo y junio de 2017 con 20 madres primíparas. Se utilizó análisis temático de contenido para análisis de los datos. Resultados: Através de la organización de los discursos se obtuvo categoría Experiencia Materna en el Cuidado. Se percibió que miedo, inseguridad y dudas estaban presentes en el cotidiano de las entrevistadas, interfiriendo en los cuidados como bañarse y sostener al bebé; la limpieza de la cicatriz umbilical era cesada después de la caída del coto; los bebés dormían de bruces; dolor y estrés contribuyeron al fracaso de la lactación; la limpieza del coto umbilical era cesada después de su caída; los bebés dormían en la posición ventral; experiencia previa en el cuidado a los hermanos más jóvenes influía en el cuidado materno. Conclusión e implicaciones para la práctica: Se comprendió que las orientaciones realizadas por los enfermeros son fundamentales para la calificación de las madres primíparas en la asistencia al hijo. Resumo Objetivo: Compreender como a mãe primípara exerce o cuidado materno ao filho menor de seis meses no domicílio. Método: Pesquisa descritiva com abordagem qualitativa, realizada em uma Unidade de Atenção Primária à Saúde, em Fortaleza/CE, nos meses de maio e junho de 2017. Participaram 20 mães primíparas. Utilizou-se análise temática de conteúdo para análise dos dados. Resultados: Da organização dos discursos, obteve-se a categoria Experiência Materna no Cuidado. Percebeu-se que sentimentos de medo e insegurança estavam presentes no cotidiano das entrevistadas, interferindo nos cuidados como banhar e segurar o bebê; a limpeza da cicatriz umbilical era cessada após a queda do coto; bebês dormiam de bruços; dor e estresse contribuíram para insucesso da lactação; experiência prévia no cuidado aos irmãos mais novos influenciava o cuidado materno. Conclusão e implicações para a prática: Compreendeu-se que as orientações realizadas pelos enfermeiros são fundamentais para qualificação das mães primíparas na assistência ao filho.

The care of the umbilical cord until its detachment still remains controversial. The latest updated recommendations by the World Health Organisation advocate dry cord care in those countries with adequate obstetric care and low neonatal mortality rate. In recent years, new studies and reviews attribute some benefit to applying chlorhexidine on the umbilical stump. An analysis is presented here of the available evidence and results in the advisability of still recommending the dry cord care in the newborns in our setting. Resumen: El cuidado del cordón umbilical hasta su desprendimiento continúa siendo motivo de controversia en la actualidad. La Organización Mundial de la Salud recomienda en su última revisión realizar la cura en seco en países con cuidados obstétricos adecuados y una tasa baja de mortalidad neonatal. Por otro lado, en los últimos años han surgido nuevos estudios y revisiones que atribuyen un beneficio a aplicar clorhexidina tópica en el muñón. El presente documento analiza la evidencia disponible y concluye en la conveniencia de continuar recomendando la cura en seco en los nacimientos de nuestro entorno.

The present work evaluated the effects of LED light therapy at 640 nm on healing the navels of newborns by using animal model. Fifty-seven neonatal calves were divided into two study groups. The members of the control group had the umbilical stump immersed in a solution of 10% tincture of iodine for 60 s, which was repeated every 24 h for three consecutive days. The members of the treated group received light doses of 7.2 J that were applied to four points evenly distributed around the insertion site of umbilical stump every 24 h for three consecutive days before the umbilical stumps were immersed in the iodine solution. The time, in days from birth, at which the umbilical stump fell off for each calf was noted. After the umbilical stump fell off, the remnant wound area was measured at different times after birth. Digital photographs with a dimensional reference were used for area measurements. The results showed that phototherapy hastened the fall-off of the umbilical stump, accelerated navel healing and reduced the mortality rate in newborn calves. We can anticipate that light treatment, as an afterbirth care, could also bring benefits to human neonates.

Introduction Central line-associated bloodstream infections (CLABSIs) in neonates with umbilical catheters occur at a rate that is 5 times higher than CLABSIs in adults with central catheters. No device currently exists tailored to the unique constraints umbilical catheters pose. The current study examined the natural progression of bacterial colonisation in goat umbilical cords and the relationship between embodiments of a novel neonatal umbilical catheter protection device and bacterial colonisation rates. The authors hypothesise that device venting is required to minimise bacterial colonisation in the unique umbilical stump environment. Methods The natural progression of bacterial colonisation in goat umbilical cord segments was studied by examining bacterial colonisation rates each day over 7 days. To understand the relationship between protection and bacterial colonisation, umbilical catheters were placed in goat umbilical cord segments and secured with 1 of 3 embodiments of a novel umbilical catheter protection device, which offered varying degrees of venting. After a 7-day period of incubation, colony counts were compared. Results Bacterial load was largest when umbilical cord segments were fresh and subsequently decreased over time. Further, bacterial colonisation rates showed a statistically significant difference between device embodiments (F(2,9)=4.26, p Conclusions A device to better stabilise and protect umbilical catheters in order to reduce bloodstream infections in neonates is greatly needed. The current experiments confirm the hypothesis that completely enclosed, or non-vented, protection device will have increased bacterial growth.

The umbilical cord, a vital conduit between the placenta and the fetus, loses much of its significance after birth. However, newborns can often present with various abnormalities of the umbilicus, such as benign granulomas or more serious lesions due to persistent remnants, many of which can change the normal course of cord separation and may be associated with significant morbidities if left unrecognized and uncorrected. Although not uncommon, sanguineous drainage from the umbilical stump can be quite alarming to new parents. Parental counseling regarding normal umbilical cord changes, as well as abnormal findings, such as discharge and skin changes, are important for the recognition and timely treatment of potentially significant umbilical cord disorders.

The umbilicus embryologically represents the neck of the bottle, which contains the umbilical vessels and structures related to the digestive and urinary systems. After the fall of the umbilical stump a few days after birth, its scarred tissue remains as the belly button, which is considered a mirror of the abdomen and should be carefully checked, particularly for newborns. A basic understanding of its anatomy and embryology is essential to identify and manage its disorders. Investigating the abnormal conditions at the umbilicus is crucial, because corrective surgical interventions may be required and conducted as soon as possible.

The umbilicus embryologically represents the neck of the bottle, which contains the umbilical vessels and structures related to the digestive and urinary systems. After the fall of the umbilical stump, a few days after birth, its scarred tissue remains as the belly button, which is considered a mirror of the abdomen and should be carefully checked, particularly for newborns. A basic understanding of its anatomy and embryology is essential to identify and manage its disorders. Investigating the abnormal conditions at the umbilicus is crucial, because corrective surgical interventions may be required and conducted as soon as possible.

The umbilicus embryologically represents the neck of the bottle, which contains the umbilical vessels and structures related to the digestive and urinary systems. After the fall of the umbilical stump a few days after birth, its scarred tissue remains as the belly button, which is considered a mirror of the abdomen and should be carefully checked, particularly for newborns. A basic understanding of its anatomy and embryology is essential to identify and manage its disorders. Investigating the abnormal conditions at the umbilicus is crucial, because corrective surgical interventions may be required and conducted as soon as possible.

The main concerns about neonates’ umbilical stump are delay in its falling, umbilical cord infections and bleeding. Optimal umbilical cord care is therefore an important issue for both nurseries’ staff and neonates’ caregivers. Many investigators have explored the optimal cord care treatment. Among current umbilical cord care options, topical application of chlorhexidine decreases omphalitis and neonatal mortality, both in primary and community care settings in developing countries; whereas dry cord care has proved to be adequate in hospital settings, in developed countries. We here report our experience on arnica/echinacea powder, a safe method of treating the umbilical cord in developed countries. Clinical Practice Article Scurati-Manzoni et al.; JSRR, 5(6): 435-440, 2015; Article no.JSRR.2015.110 436

The objective of this article is to review the literature on a very rare association such as patent urachus and a patent omphalo–mesenteric duct in children. Partial or total failure of the obliteration of urachus gives rise to various anomalies, which can be diagnosed both in childhood and in adulthood. The omphalo–mesenteric duct remnants are the most common anomalies of the gastro-intestinal tract, often asymptomatic. The association of patent urachus and a patent omphalo–mesenteric duct in children is very rare. A computer-assisted (PubMed and Google Scholar) search of the pediatric literature to identify all cases of patent urachus and a patent omphalo–mesenteric duct association was performed. We found only eleven cases of the association of patent urachus and a patent omphalo– mesenteric duct in the pediatric literature. All cases except one were males. When reported, all children affected were full term. The clinical sign reported was umbilical spillage. In all cases was reported a lack of healing of the umbilical stump with different clinical pictures, except two cases. Treatments reported were application of silver nitrate, antibiotic cream, povidone iodine, and application of salves and plasters. Various diagnostic examinations were performed. In none of these patients was the possible association with PU and POMD suspected, but it was evidenced only during the surgical excision. The surgical approach was laparotomy in all cases. The association of patent urachus and a patent omphalo–mesenteric duct in children is very rare approached in all cases by laparotomy. This review underlines the importance of evaluating any persisting umbilical lesions without delay when conventional pharmacological therapy fails. Keywords: omphalo–mesenteric duct, patent omphalo–mesenteric duct, patent urachus, remnants, urachus

Anesthetic alterations of umbilical scar in vertical abdominoplasties are common factors for unsatisfactory results. On this chapter, we present technical aspects of the opposite triangular flaps omphaloplasty in vertical dermolipectomy. The technique developed initially for a treatment of umbilical stenosis on a patient with previous vertical dermolipectomy which we used two interpolated lateral flaps to umbilical stump. The aesthetic result obtained encouraged us to indicate it as a primary technique of omphaloplasty on these cases, preventing stenosis and umbilical scar enlargement.

Purpose. To understand the health care practices related to children from birth to five years old in an Indigenous population of the state of Sao Paulo, Brazil. Design. The theoretical and ethnographic methodological framework and the Observation-Participation-Reflection model (OPR) were used for data collection. In total, 20 families with 24 children were observed. Results. The belief in the healing power of teas generally overlapped the use of drugs. Herbs in the form of extracts or oils were used in the umbilical stump dressing and baths. The Indigenous people were assisted by professionals in their own communities and nearby urban areas. Conclusion. The care in daily life of Indigenous families was still informal and provided by women, with beliefs and customs that should be considered by health care professionals in transcultural care.

The urachus is an intra-abdominal fibrous remnant of the allantois. The non-involution of the allantois can result in urachal anomalies. The abnormal appearance of the umbilicus may be a sign of such anomalies. We have observed 3 cases of term neonates with atypical appearance of the umbilical stump, all of which manifested urachal anomalies, as documented by ultrasound scan. These appearances are rarely described in the literature, and seem to regress at around 2 months. Therefore, it is important that healthcare professionals should be aware of the possible implications of atypical umbilical stumps, evaluate each case accordingly and, if an urachal anomaly is diagnosed, refer the patient to a paediatric surgery centre, as such malformations carry an underlying risk of infection or malignancy.

The vertical abdominoplasty technique always had its biggest statement in correcting large hernias or unsightly scars on the midline of the abdomen. With the global spread of gastroplasty for treatment of morbid obesity, we noticed an increase in demand for the correction of intense sagging in the abdomen of emaciated patients. A traditional abdominoplasty is not well indicated in these cases as there is the need for skin resection also vertically to better wear the new body. There was then a huge advance in vertical techniques. In this chapter we present our surgical routine with special emphasis on refining the umbilical region. We propose routine amputation of the original umbilical stump and making a new navel from side flaps as described by Correa and Iturraspe in 1951. We introduced the dermoepidermal security strip, designed to place with pinpoint accuracy the flaps in the original navel position. The technical details as well as the postoperative care and possible complications are described in detail.

BACKGROUND: Umbilicoplasty techniques vary greatly, in both the manner in which the incision the umbilical scar is incised, as well as the manner in which the skin of the abdominal flap is opened and repaired at the aponeurosis and/or the umbilical stump. As the postoperative appearance of the umbilical scar is aesthetically unsatisfying, the authors sought to develop a new technique aimed at providing patients with a greater degree of aesthetic and postoperative satisfaction. METHODS: The abdominoplasties included in this study were performed in 194 patients at Clínica Valle Pereira (Florianópolis, SC) between February 2009 and January 2011. All patients underwent conventional abdominoplasties and triangular umbilicoplasties with skin flaps. RESULTS: Only 8 (4.13%) patients had mild complications. There were no severe complications. Positive satisfaction was reported by patients in 188 (96.91%) cases and by surgeons in 186 (95.88%) cases. CONCLUSIONS: The technique described in this study demonstrates versatility, simplicity in application, and reproducibility, bringing greater harmony in body contouring and improved appearance of the umbilical scar, a major stigma of abdominoplasty INTRODUÇÃO: A técnica de umbilicoplastia varia muito, tanto na forma como é incisada a cicatriz umbilical, quanto na abertura cutânea no retalho abdominal e sua fixação na aponeurose e/ou coto umbilical. Descontentes com o aspecto pós-operatório da cicatriz umbilical, os autores viram a necessidade de desenvolver uma nova técnica, com o objetivo de proporcionar aos pacientes maior grau de naturalidade e satisfação pós-operatória. MÉTODO: Foram incluídas neste estudo as abdominoplastias realizadas na Clínica Valle Pereira (Florianópolis, SC), no período compreendido entre fevereiro de 2009 e janeiro de 2011, totalizando 194 pacientes. Todos os pacientes foram submetidos a abdominoplastia convencional e umbilicoplastia triangular com retalho dérmico. RESULTADOS: Apenas 8 (4,13%) pacientes apresentaram complicações leves. Não houve complicações graves. A satisfação dos pacientes foi positiva em 188 (96,91%) casos; entre os cirurgiões, a satisfação foi positiva em 186 (95,88%) casos. CONCLUSÕES: A técnica demonstra versatilidade, facilidade de execução e reprodutibilidade, proporcionando harmonia no contorno corporal e naturalidade ao principal estigma da abdominoplastia, a cicatriz umbilical

The onset of an infectious complication in an infant leads to an increase in costs for the health of the newborn, psychological costs for the family, and economic costs for the hospital. Several studies have demonstrated that hospital infections are preventable in part: the adoption of "safe" care practices in fact involves the reduction of 35%. Essential principals for the prevention of nosocomial infections are: a particular attention to the care of the skin, of the umbilical stump and of the newborn's eyes, as well as of the tools for every-day use; the implementation of correct behaviors during washing of the hands; prevention of the spread of respiratory viruses; the environmental control; training courses for healthcare personnel and for infant's families.

With their experience and knowledge, patronage nurses in the first days after leaving the maternity ward, provide necessary care and necessary information about the new family member. Complete implementation of the principles of asepsis and antisepsis, both by public health nurses and parents, resulting in faster drying and falling of umbilical stump and closing wounds without signs of infection. The aim of the work Polyvalent Patronage Service (PPS) is to provide health education activities for young parents and present them danger of the formation of the umbilical wound infection to their newborn. With planned education of parents about the importance and application of aseptic working conditions there is an increasing awareness of that conditions, which results in a decreased percentage of occurrence of infection at home.

Background Recent trials of chlorhexidine cord cleansing have employed aqueous solution applied with cotton swabs. Care-takers may prefer gel, resulting in better compliance when implemented at large scale. We examined whether a guar-gum-thickened formulation was at least as efficacious as aqueous in reducing periumbilical flora. Methods Newborns (n = 694) from normal deliveries at a hospital in Kathmandu were randomly allocated to cord cleansing with either gel or aqueous chlorhexidine, applied by finger. Immediately before and 24 hours after cleansing, periumbilical swabs were collected and cultured. The primary outcome was periumbilical colonization at 24 hours. Household-level acceptability and ease of use in a rural setting where most deliveries are not attended by health workers were assessed by providing 61 women with either gel or aqueous formulations and following up on their experience using the products. Results Babies allocated to gel and aqueous chlorhexidine were comparable on a range of variables measured at baseline. At 24 hours postapplication, 4.6% (15 of 327) of cultures were positive in the gel group and 10.7% (35 of 326) in the aqueous group. The absolute difference in rates (gel minus aqueous) was -6.1% (95% CI: -10.2%, -2.1%). The acceptability study found that satisfaction and compliance were high for both; use of either largely displaced the traditional use of oil-based mixtures. Overall, there was a preference for gel. Conclusions The gel formulation was not inferior to aqueous and gel reduced bacterial colonization to a greater degree. A gel formulation might be considered in future research or program settings where chlorhexidine cleansing of the cord is being evaluated or promoted.

Omphalitis contributes significantly to morbidity and mortality in neonatal calves. Diagnosis of omphalitis is based on the local signs of inflammation-pain, swelling, local heat and purulent discharge. An abattoir trial identified an optimal, sign-based, scoring system for diagnosis of omphalitis. A sample of 187 calves aged between 7 and 15 days old were clinically examined for signs of umbilical inflammation and compared with postmortem examination of navels. On postmortem findings, 64 calves (34.2 per cent) had omphalitis. In the examined omphalitis cases, the most commonly affected umbilical structure was the urachus (78.1 per cent). Multivariable logistic regression revealed that thickening of the umbilical stump over 1.3 cm (P0.001), discharge (P0.001), raised local temperature (P=0.003) and the presence of umbilical hernia (P=0.024) were correlated and positive predictors of omphalitis. Discharge from the umbilical stump was associated with intra-abdominal inflammation (P=0.004). Assigning weights based on the multivariable logistic regression coefficients, a clinical scoring algorithm was developed. The cumulative score ranged from 0 to 9. Using this scoring system, calves were categorised as positive if their total score was ≥2. This scoring method had a sensitivity of 85.9 per cent, specificity of 74.8 per cent and correctly classified 78.6 per cent of all calves.

Introduction. The umbilical cord is a life line for the fetus during pregnancy, because through the umbilical cord is all the need for a fulfilled life. After the baby is born the umbilical cord is not needed, so it must be cut and clamped with the umbilical cord clamping. The rest of the umbilical cord is still attached to the umbilical stump or the baby’s stomach requires good care to avoid infection. The purpose of this study was to obtain the description about effectiveness umbilical cord care booklet provision on knowledge and attitude of postpartum mothers on caring for the umbilical cord in Ajibarang Hospital, Banyumas regency, Central Java Province. Methods. This study used a quasi-experimental with treatment of delivery ISBN 978-979-448-992-5 books about umbilical cord care directly to the subject of the study (samples). Results. The results of this study indicated that knowledge of postpartum mothers before and after delivery of booklet umbilical cord care showed no significant differences on how to care for the umbilical cord (p>0.05). While the attitude of post partum mothers before and after delivery of booklet umbilical cord care showed significant differences, respectively before the delivery of booklet p = 0.029 and after the delivery of booklet p = 0.025. The effect of umbilical cord care booklet to the maternal attitudes about umbilical cord care is having the effect of moderate (r = 0.29). Discussion. The booklet umbilical cord care influential moderate (moderate effect) on postpartum maternal attitudes about how to care for the umbilical cord. Keywords: Postpartum Mothers, Knowledge, Attitude, Umbilical Cord Care Booklet.

OBJETIVO: Identificar e descrever os cuidados populares adotados por mães adolescentes na assitência aos filhos nos seis primeiros meses de vida. MÉTODOS: Pesquisa com abordagem qualitativa desenvolvida com seis mães adolescentes residentes em Cambé - PR. Os dados foram coletados no período de fevereiro a abril de 2007, por meio de entrevistas semi-estruturadas, realizadas no domicílio em quatro momentos distintos:uma semana, um, quatro e seis meses após o nascimento. RESULTADOS: As mães adolescentes revelaram reproduzir em seu cotidiano de cuidar várias práticas populares que fazem parte da cultura local e familiar, tais como amamentação cruzada, utilização de benzimentos, xaropes, chás e orações para tratar intercorrências, além de algumas crendices relacionadas com o coto umbilical, soluços e alteração no sono do bebê. CONCLUSÃO: Os profissionais de saúde precisam conhecer as crenças e práticas das mães adolescentes para então planejar, da melhor forma possível, a assistência a ser prestada ao binômio mãe-filho. OBJECTIVE: To identify and describe popular practices of teenage mothers caring for their children during the first six month after birth. METHODS: A qualitative approach was used with six teenage mothers from the city of Cambé, PR. Data were collected through semi-structured interviews from February to April 2007. Interviews were conducted in the participants' home in four different times (one week, one month, four months, and six months after the birth). RESULTS: Findings suggested that teenage mothers use popular practices that were part of their family and community culture when caring for their children. These popular practices included cross breast-feeding, teas, syrups, and blessing's plays to treat adverse events, and popular beliefs regarding the umbilical stump, hiccups, and sleeping pattern. CONCLUSION: Health professionals must be aware of practices and beliefs of teenage mothers in order to plan quality care to the mother-child binomial. OBJETIVO: Identificar y describir los cuidados populares adoptados por madres adolescentes en la asistencia a los hijos en los seis primeros meses de vida. MÉTODOS: Investigación con abordaje cualitativo desarrollado con seis madres adolescentes residentes en Cambé - PR. Los datos fueron recolectados en el período de febrero a abril del 2007, por medio de entrevistas semi-estructuradas, realizadas en el domicilio en cuatro momentos distintos: una semana, uno, cuatro y seis meses después del nacimiento. RESULTADOS: Las madres adolescentes revelaron reproducir en su cotidiano de cuidar varias prácticas populares que hacen parte de la cultura local y familiar, tales como amamantamiento cruzado, utilización de bendiciones, jarabes, infusiones y oraciones para tratar ocurrencias, además de algunas creencias relacionadas con el muñón umbilical, hipos y alteraciones en el sueño del bebé. CONCLUSIÓN: Los profesionales de salud precisan conocer las creencias y prácticas de las madres adolescentes para entonces planificar, de la mejor forma posible, la asistencia a ser prestada al binomio madre-hijo.

Deficiency of factor XIII was detected in an 18-year-old man. During a study of 64 members of his kindred, 2 additional cases were documented. In these 3 cases the onset of symptoms and the clinical course varied considerably. The proband had no abnormal bleeding till the age of 8 years. His 11-year-old sister bled from the umbilical stump on the fifth day, but has had no abnormal bleeding since then. The parents of these siblings are second cousins. The third patient, 10 months of age, also bled from the umbilical stump on the fifth day and she has continued to have significant haemorrhagic problems. Her parents are first cousins. In each of the two affected families, one other daughter had died following haemorrhage from the umbilical stump. The pattern of inheritance is consistent with an autosomal recessive mode of transmission.

Objective: To study the variation of separation of umbilical stump in newborns who received intravenous antibiotics and compare it with healthy newborns. Method: Two groups of newborns were taken, each comprising of 100 newborns. One group had received intravenous antibiotics for sepsis and the other group comprised of healthy newborns. On follow ups, the day of separation of umbilical stump was asked to the mothers and was noted and analyzed. Results: Newborns who received antibiotics had a delay in separation of umbilical stump (mean=18.26 days), whereas the healthy newborns had early cord separation (mean of 8.68 days). Conclusion: Delay in umbilical stump separation in antibiotics received newborns is due to decreased infiltration by bacteria and thus leucocytes and delayed digestion by bacteria. The family members can be counselled accordingly to allay their anxiety.

The case of an ectopic pancreatic mass at the umbilicus in an 8-day-old male neonate is reported, the youngest patient with this condition ever reported in an English-language journal. The patient was healthy except for a protruding mass with intermittent mucous discharge at the base of the umbilical stump. Surgical intervention was performed under the impression of the umbilical mass. Pathology diagnosed an ectopic pancreas with acute hemorrhage. To the best of our knowledge, only one case of ectopic pancreas presenting as an umbilical mass with intermittent mucous discharge has previously been reported.

El estudio tiene como objetivo describir los cuidados de enfermería al recién nacido y analizar las modificaciones en la atención de enfermería al recién nacido durante el período de 1937 hasta 1979. Se trata de un estudio histórico. Las fuentes primarias son 14 artículos publicados en la Revista Brasileña de Enfermería en el período en cuestión, y las fuentes secundarias son los libros y periódicos nacionales e internacionales con relación a la historia de la pediatría y de la neonatología. Es evidente, en este período, la descripción detallada de los cuidados directos (básicos y específicos) y los cuidados indirectos oferecidos por el equipo de enfermería al recién nacido. Entre los cuidados directos básicos, se destacan: higiene corporal y cuidados con el cordón umbilical. Los cuidados directos específicos son: infecciones y afecciones respiratórias. Los cuidados indirectos se relacionan con el material y el equipamiento. Se concluye que el discurso oficial de las enfermeras estuvo volcado para a la sistematización de los cuidados de enfermería al recién nacido, como pionera de los cuidados intensivos neonatales.

Tetanus occurs in all ages, it can be associated with puncture wounds, war injuries, burns, ear infections, umbilical stump and post partum infections, and heroin abuse.5 Recently, we treated a patient who developed tetanus following frostbite of both feet. The patient had been previously immunized against tetanus, and was receiving antibiotics when the disease became manifest.

Purpose of review Neonates in intensive care are more susceptible to sepsis. Infection is commonly acquired via the transcutaneous portal. It is necessary to identify the most effective yet safest topical antiseptics for use in neonates to reduce nosocomial sepsis. Recent findings Recent national surveys indicate that a wide range of topical antiseptic preparations are used in the neonatal nursery. There are very few comparative studies in neonates and no robust evidence in favour of any particular antiseptic. There are significant safety and potential toxicity issues for neonates with all the commonly used antiseptics, particularly in very small immature babies. There are no convincing roles for routine application of emollient creams on the skin, topical antiseptics on the umbilical stump, or maternal vaginal washes with chlorhexidine for the prevention of neonatal infection. Summary Large multicentre trials are needed to determine the optimal antiseptic to use for neonates undergoing intensive care, especially for extremely preterm infants.

Neonatal tetanus occurs in developing countries, particularly those with the least developed health infrastructure. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a nonsterile instrument. World Health Organization defines it as an illness in a child who has the normal ability to suck in the first 2 days of life, but who loses the ability between 3 and 28 days of life and becomes rigid and has spasms. The overall incidence of tetanus is reducing globally and is rare in developed nations. We describe four cases of neonatal tetanus with regard to demography, clinical profile, and outcome. From them, 3 newborns were delivered at home by untrained birth attendants. All the mothers were from lower socio-economic class, illiterate and were below 25 years of age. Common symptoms were unable to feed, difficulty in respiration, episodes of spasms, and convulsions. Mortality was 50%.