An umbilical granuloma is a common, benign overgrowth of tissue that appears in a newborn’s belly button after the umbilical cord stump has fallen off. This small, soft, reddish-pink lump is essentially scar tissue that remains moist and may produce a slight discharge. When a granuloma does not resolve on its own, a healthcare provider often treats it with silver nitrate, a chemical cauterization method. This treatment chemically destroys the excess tissue, allowing the area to dry out and the navel to heal completely.
Immediate Appearance of the Treated Area
The most noticeable change immediately following silver nitrate application is a dramatic color change at the treatment site. Silver nitrate reacts with the tissue and salts, causing the granuloma and any nearby affected skin to turn a dark gray, black, or dark brown color. This staining is temporary and a normal result of the chemical reaction, not a sign of a burn or complication. Care is taken during application to protect the healthy skin, as the chemical may also stain surrounding skin or clothing.
The treated granuloma tissue, now darkened, has been chemically cauterized. This tissue will often dry out, shrivel, and form a crust or scab over the next few days. The appearance of this dark crusting is a sign that the treatment has worked, as the goal is to dry out the moist tissue. Mild redness on the skin immediately bordering the treated site may occur, but this is typically a transient, minor irritation.
Post-Treatment Care Instructions
Keeping the area clean and dry is the primary focus of post-treatment care. Parents should gently clean the belly button area at least once a day, or as needed, using a cotton swab dipped in warm water and mild soap. After cleaning, it is important to softly pat the area completely dry to prevent moisture from hindering the healing process.
Ensuring the treated area is exposed to air helps it dry out quickly. This can be achieved by folding the top of the baby’s diaper down below the navel, or by using diapers with a cutout area. Parents should use sponge baths instead of submerging the baby in a tub bath until the area has fully healed. Avoid applying lotions, powders, or ointments to the navel unless instructed otherwise, as these substances can trap moisture and delay healing.
Distinguishing Normal Healing from Complications
The healing process following silver nitrate application involves a few expected physical changes as the granuloma shrinks and resolves. Normal healing often includes minimal discharge that is clear or slightly yellowish, and a mild, non-spreading redness immediately around the perimeter of the treated area. The dark, cauterized tissue of the granuloma should begin to shrink and may fall off completely over a period of several days to a week.
It is common for the granuloma to require more than one silver nitrate treatment, typically spaced a week or two apart, if the tissue does not fully resolve after the initial application. This indicates the initial treatment only partially destroyed the excess tissue. The healthcare provider will assess the progress during follow-up appointments and determine if another application is necessary.
Parents should watch for signs of infection or complications that require prompt medical attention. A fever above 100.4°F, a rash that spreads away from the belly button, or increasing warmth and swelling around the navel are signs of a potential problem. Persistent or increasing tenderness, where the baby cries when the area is lightly touched, also warrants a call to the pediatrician.
Discharge that is foul-smelling, thick, or contains pus can indicate an infection called omphalitis. While some minimal bleeding may occur if the scab is accidentally rubbed off, persistent or significant bleeding is a cause for concern. If the granuloma appears to be growing larger after treatment, or if the darkening of the tissue is accompanied by increasing pain, contact the provider to rule out other issues, such as an umbilical remnant that may not respond to silver nitrate.