What's a Umbilical Granuloma and How Do You Treat It?

Your baby’s umbilical cord travels a little journey as it morphs from a pale, misshapen lump into a shriveled, darkened piece of skin that falls off about two weeks after he's born. But occasionally during this process, instead of drying up and dropping away, the area may form what’s known as a granuloma, a bit of scar tissue that stays behind on the belly button.

While this somewhat common condition won’t hurt your baby, if it doesn’t clear up on its own, your infant’s pediatrician may need to treat it to prevent a potential infection. Read on to learn more about umbilical granulomas, including how to spot one and the way they're treated.

What is an umbilical granuloma?

An umbilical cord granuloma in babies will look like a small, round mass that appears in the middle of the navel after the cord stump has fallen off. The reddish piece of scar tissue is often covered in clear mucus rather than looking dry like the rest of your baby’s skin.

Umbilical granulomas can also occasionally appear in adults, sometimes developing after a tattoo or navel piercing. 

An umbilical hernia is another condition that can look like a granuloma (i.e., swelling or a bulge near the belly button), but it’s when the intestine pushes through the wall of stomach muscles and appears in the middle of the navel. Although they’re most common in babies under 6 months (20 percent will develop one), umbilical hernias can sometimes affect older kids and adults too.

What causes an umbilical granuloma?

It’s not exactly clear what causes a slowdown in the healing process of certain babies’ umbilical cords, but umbilical granulomas occur in about 1 out of 500 newborns. This excess tissue may form because of a low-grade infection or a delay or irregular separation of the cord stump.

Umbilical granulomas may measure up to 10 millimeters in size and tend to grow if untreated. As a result, this mass could allow bacteria to get inside, potentially causing an umbilical infection.

How do you treat an umbilical granuloma?

Treatments for an umbilical granuloma are the same in both babies and adults. Typically, silver nitrate is the go-to remedy as this chemical can cauterize the wound, which stops any bleeding and wards off infection.

While painless, it’s possible that silver nitrate may burn, so your pediatrician will take extra care with it. Liquid nitrogen is another possibility and it’s used in a similar way to silver nitrate. A very small amount is applied to the granuloma, which in turn causes it to “freeze” and drop off.

Though rarely required, umbilical granuloma surgery may be a better option if your baby’s case requires multiple treatments with silver nitrate. This procedure — called a double ligature — removes the umbilical granuloma with a scalpel or ties it with two pieces of thread.

Tips for home care

Post-treatment, your pediatrician will share aftercare tips, including how to bathe your baby with an umbilical granuloma. In general, you'll follow the rules of regular umbilical cord care. Here’s what you should keep in mind:

• Keep it clean and dry. Expose the umbilical stump to the air as much as you can and avoid using rubbing alcohol and ointments as treatments. 
• Diaper with care. Keep your baby’s stump area uncovered by his diaper by either folding over the top portion or buying infant diapers with a special cut-out at the waist. And change diapers frequently so wetness and waste don't come in contact with the belly button.
• Dress him loosely. Just as with diapers, outfit your baby in loose, airy clothing, not snug onesies that might press too hard against his belly. 
• Give him sponge baths. One question on your mind may be whether you can bathe a baby with an umbilical granuloma. Alas, long, sudsy baths in the tub aren’t conducive to drying out a fresh wound, so it’s best to sponge bathe your infant and keep the navel from getting wet.
• Leave it alone. Let nature otherwise take its course. Don’t fiddle with the stump wound or try to remove any scab that forms.

How long does it take for an umbilical granuloma to heal?

After treatment with silver nitrate, an umbilical granuloma should shrink and go away in about a week. The time frame is similar if your baby has double ligature surgery — the tissue dies and drops away within seven to 14 days.

Keep an eye on your baby’s healing umbilical granuloma and alert your pediatrician if you notice excess redness or bleeding, foul-smelling yellowish discharge from the cord area or crying from your baby when the skin around it is touched. Any of these could signal an infection.

The umbilical cord is a funny thing but very often it simply dries up and falls off — and you’ll never give it a second thought. But if a minor condition like an umbilical granuloma develops, treatment is often a quick and easy one performed in your pediatrician’s office. Once it’s healed, your sweetie will have the cutest, most kissable innie or outie ever.