Antiseptics are often used on the umbilical cord to prevent omphalitis. Yet the incidence of omphalitis has become quite rare and the cost of antiseptic care and the cost is therefore high relative to its benefits. To determine if dry cord care is as good as antiseptic care, Steurer et al. (10.1542/peds.2016-1165) performed a non-inferiority cluster randomized cross-over study in France involving six university maternity units that enrolled babies over 36 weeks gestation.
Units were randomly assigned to dry care or antiseptic cord care for a four month period and then the methods were switched in each unit for the next four months. The outcome measure was actual omphalitis occurring. Among more than 8600 babies enrolled, there were three cases of omphalitis out of 4293 babies that got dry care and none in the antiseptic group—but this difference was non-significant nor was there any difference in late infections, or parental complaint that one form of cord care was more difficult, nor was there a difference in the time it took for the cord to fall off.
Are you recommending dry care for umbilical cord separation in your practice? If not, does this study convince you of the non-inferiority of dry care to antiseptic care? We welcome your thoughts about what you use by responding to this blog, sending a comment to our journal website or posting your thoughts on our Facebook or by Twitter.