In plain words
Chlorhexidine is an antiseptic that kills germs on skin and on the cut end of the umbilical cord. It appears in some hospital cord care and in guidelines written for places where newborn infection is common. In many high-income settings, clinicians use dry cord care, which means keeping the stump clean and exposed to air. Mothers may see a tinted antiseptic liquid on the cord or be asked about it at discharge. The guideline answer depends on the baseline risk of infection where the baby is born. Your provider can explain what is used in your hospital and why.
The deeper version
Chlorhexidine gluconate is a cationic bis-biguanide antiseptic with broad activity against gram-positive and gram-negative bacteria and a residual effect on skin. The World Health Organization recommends chlorhexidine 4 percent cord cleansing at home births in settings with high neonatal mortality, based on cluster trials in Nepal (Mullany and colleagues, Lancet 2006), Bangladesh (Arifeen and colleagues, Lancet 2012), and Pakistan (Soofi and colleagues, Lancet 2012), which reported reduced and lower neonatal mortality. A 2013 Cochrane review (Imdad and colleagues) found lower risk of omphalitis and death with chlorhexidine in community trials in high-mortality settings. Dry cord care is recommended in settings with low infection burden, and the AAP has endorsed dry care in those settings. The main controversy concerns extrapolating high-mortality trial results to low-risk hospital births.
Where it comes up
What mothers here say about chlorhexidine
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Sources
- World Health Organization — Recommendations on postnatal care of the mother and newborn, 2013
- Soofi S et al. — Effect of provision of chlorhexidine for umbilical cord care on neonatal mortality in rural Pakistan. Lancet 2012