An outward-protruding belly button, or “outie,” on a newborn often prompts questions from parents navigating their child’s first few weeks of life. The navel is the scar left behind after the umbilical cord detaches, and its final appearance is a natural variation of this scarring process. Understanding the normal healing timeline and the difference between a typical variation and a medical condition can help alleviate common concerns.
The Newborn Navel: Stump Healing and Scar Formation
During pregnancy, the umbilical cord serves as the lifeline connecting the baby to the placenta, supplying oxygen and nutrients. Immediately following birth, the cord is clamped and cut, leaving a small remnant known as the umbilical stump. This stump is typically dark, moist, and about two to three centimeters long.
The stump is composed of tissue with no nerve endings, so its detachment process is painless for the baby. Over the next one to three weeks, the tissue dries out, shrinks, and changes color, often turning black or dark brown. The belly button forms when the stump naturally falls off, usually occurring between five and 15 days after birth. The navel that remains is a scar, and its final shape—whether an “innie” or an “outie”—is determined by individual healing and the amount of skin and tissue surrounding the site.
Understanding the “Outie” Appearance
The outward appearance that parents call an “outie” is most often a natural cosmetic result of how the skin closed around the umbilical scar. This shape is not determined by how the cord was cut or clamped, but by the body’s natural healing pattern. The final look is a variation of the resulting scar tissue, with about 10% of people having an “outie” navel.
In some cases, a protruding navel appearance is caused by an umbilical granuloma, an overgrowth of tissue that forms after the stump falls off. This condition is not dangerous and looks like a soft, moist, pink or red lump that may leak clear or yellow fluid. Granulomas are common and are typically treated easily by a doctor if they do not dry out and disappear within a week or two. These benign conditions are temporary and distinct from the structural issue of a hernia.
When the “Outie” is an Umbilical Hernia
A true, persistent “outie” may be the result of an umbilical hernia. This occurs when a small portion of the intestine, fat, or other abdominal tissue bulges through a weak spot in the abdominal muscle wall near the navel. The opening, known as the umbilical ring, failed to close completely. The distinguishing feature is that the bulge often changes size, becoming more noticeable when the baby cries, coughs, or strains due to increased abdominal pressure.
Conversely, the bulge may flatten or disappear when the infant is quiet or relaxed. Umbilical hernias are common, affecting an estimated 10% to 20% of newborns, and they are usually painless. The prognosis for an umbilical hernia in infants is positive, with over 90% closing spontaneously without medical intervention. Closure happens as the baby’s abdominal muscles strengthen and grow, typically resolving by the time the child reaches two to five years of age. Surgery is reserved for hernias that are very large, cause symptoms, or fail to close by age four or five.
Care and Concerns for the Newborn Navel
Proper hygiene is important for encouraging the navel area to heal naturally and preventing infection. Until the umbilical stump detaches, parents should keep the area clean and dry, using sponge baths instead of submerging the baby in a bathtub. The top of the diaper should be folded down to keep the stump exposed to air, which promotes drying and keeps it from becoming soiled.
Parents should monitor the navel area for signs that may indicate an infection, which requires prompt medical attention. Warning signs include redness or swelling of the surrounding skin, a foul odor, or a cloudy, yellow, or pus-like discharge. Other concerning symptoms are a fever, poor feeding, excessive tiredness, or the baby crying when the navel area is touched, suggesting tenderness or pain. Immediate medical care is needed if the bulge becomes hard, tender, discolored, or if the baby experiences vomiting.