Umbilical Cord Care - Impact of National Recommendations

Objectives −To analyze the current umbilical cord (UC) care practice in Slovenia and to evaluate the impact of national UC care recommendations by comparing the UC care practice before and after their introduction.Materials and Methods − A questionnaire covering the complete UC care was sent to medical nurses and midwifes involved in UC care in primary-level pediatric centers, health visiting and parent education services (outpatient group) and secondary and tertiary-level pediatric centers (inpatient care group) in Slovenia. Three different clinical conditions of the newborn’s umbilicus, i.e. healthy umbilicus (HU), umbilicus at risk (RU) and unhealthy umbilicus (UU) were used. The inpatient and outpatient groups and UC care in 2013 and 2021 were compared.Results − The sample included 396 respondents from all Slovenian regions. The odds for using UC care protocol in 2021 were 2.6 times higher compared to 2013 (P<0.001). The UC care of HU changed: the dry UC care became less frequent (P<0,001), the use of normal saline solution increased and the use of ethanol solution decreased (P<0.001). The use of ethanol solution for UU decreased (P<0.001) and the use of octenidine increased more than 200 times (P<0.001). Conclusions − The implementation of national recommendations significantly influenced the UC care in Slovenia. The current UC care practice is more unified and consistent with international recommendations. The adjusted UC care, depending on the clinical condition of the newborn’s umbilicus, puts additional value to these recommendations. Further refinements of the UC care protocol should emphasize the use of dry UC care.