An umbilical granuloma is a small, moist, pink or reddish lump of tissue that can remain in the belly button after the umbilical cord stump falls off. Silver nitrate is the most common treatment, acting as a chemical cautery to shrink and dry out the excess tissue. The procedure is typically quick and painless for babies because the granuloma tissue does not contain nerve endings. The goal of this treatment is to prevent potential infection and help the navel heal completely.
What the Treated Area Looks Like
The most noticeable result of silver nitrate application is a change in color at the treatment site. Silver nitrate reacts with the treated tissue and surrounding skin, causing it to turn a dark gray, brown, or black color. This is a temporary chemical stain, not a sign of bruising or infection, and is expected after the procedure.
The dark discoloration may extend slightly onto the surrounding skin, but the staining will gradually fade over several days to a week. The granuloma itself, now blackened and cauterized, will appear dried out. A small amount of mild, clear, or yellowish discharge may also be present as the body sheds the treated tissue in the days following the procedure.
Caring for the Umbilical Stump Afterward
The primary focus of care after a silver nitrate application is to keep the area clean and completely dry to promote healing. Avoid applying any ointments, lotions, or rubbing alcohol to the treated area unless specifically instructed by a healthcare provider. Keeping the umbilical area exposed to air as much as possible is beneficial for drying the tissue.
When changing diapers, fold the top edge down to prevent the diaper from covering and irritating the navel. This technique also helps ensure the area is exposed to air and keeps it from becoming moist with urine. Use sponge baths for the baby and avoid fully submersing the belly button in water until the treated area is completely healed and dry.
The blackened tissue should be allowed to fall off naturally without intervention. Do not attempt to pick at or manually remove the dried, discolored tissue, as this could cause unnecessary bleeding or irritation. Gently cleaning around the navel once a day with a cotton swab dipped in mild soap and warm water can help remove any mild drainage, followed by carefully patting the area dry with a soft cloth.
The Healing Timeline
The healing process begins after the silver nitrate has been applied to the granuloma. The blackened, cauterized tissue will begin to dry out and shrivel over the next few days. The dried tissue should then separate and fall off on its own, typically within three to seven days following the treatment.
Full resolution of the umbilical granuloma often occurs within one to two weeks after a successful application. If the initial treatment does not completely resolve the granuloma, a follow-up appointment may be necessary for a second or even third application of silver nitrate. If the granuloma persists or appears wet after about a week, it indicates a need for a repeat treatment or a doctor’s reassessment.
Signs That Require Medical Attention
Although silver nitrate treatment is routine, parents should monitor the area for signs of complication, such as infection or chemical irritation. A spreading area of redness, swelling, or warmth around the belly button requires medical attention. Red streaks leading away from the navel require immediate evaluation.
Contact your doctor if the discharge changes from mild and clear to a thick, pus-like consistency or develops a foul odor. While minimal spotting of blood is not uncommon, persistent bleeding or bleeding that soaks through clothing requires prompt medical care. Additional signs of potential systemic infection, such as a fever over 100.4°F, lethargy, or increased irritability when the navel is touched, should also prompt an immediate call to the healthcare provider.