Umbilical Granuloma: A simpler way to treat using Table Salt

Rathi G; Maheshwari Rajesh

doi:https://10.7199/ped.oncall.2023.47

Rathi G¹, Maheshwari Rajesh².

¹Pediatric Department, Devanshi Hospital, Kota, Rajasthan, India,
²Neonatology Department, Westmead Hospital, Sydney, Australia.

ADDRESS FOR CORRESPONDENCE
Dr. Ghanshyam Rathi, Devanshi Hospital, C 13 Nursery, Talwandi, Kota, Kota, 324005, India.
Email: drrathi@hotmail.com.

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Keywords

Umbilical Granuloma, Table Salt, Silver Nitrate.

Umbilical Granuloma (UG) is not an uncommon problem in neonates. It often presents with umbilical sepsis, umbilical discharge, cellulitis of surrounding skin and sometimes bleeding. Contrary to standard ‘dry cord care’ recommendation, the traditional oil application on cord is still prevalent in our country which delays shrivelling and falling off of cord and perhaps contributes to a higher incidence of UG.
A simpler way to treat UG is to instruct the mother or the primary caretaker to clean the cord granuloma with a cotton swab soaked in boiled warm water and then to sprinkle a small amount of common salt (Sodium Chloride) enough to cover the granuloma, every day. After three such applications in 3 days, most babies are cured of UG. Due to the osmotic effect of Sodium Chloride, the cells of granuloma undergo necrosis and epithelialization ensues. As the granuloma is devoid of nerves, the procedure is painless. No side effects have been noticed in reported studies.^1,2,3
This simpler method does not require any toxic chemical such as silver nitrate or copper sulphate or frequent office visits for the procedure. Most standard texts still recommend application of 75% silver nitrate which is difficult to procure and maintain. It also requires frequent office visits and is fraught with side effects such as burns of the surrounding skin which have been well reported.^4,5
In view of this, a discussion on evidence based therapy for UG had suggested conservative therapy with salt in preference to topical silver nitrate.⁶ In recent years, alternative therapies have been suggested such as topical application of clobetasol propionate⁷ and excision followed by application of absorbable hemostatic materials.⁸ However, concerns have also been raised about absorption of topical clobetasol.
Although this simpler method of using common salt is known for quite some time², still many pediatricians do not know about it because it is not mentioned in our standard textbooks. Such simple and cost-effective health intervention deserves a place in standard textbooks.

Compliance with Ethical Standards

Funding None

Conflict of Interest None

References

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