April 10, 2013
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Communicating about chlorhexidine cord cleansing key to compliance

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It is important to communicate with parents the benefits of cleansing umbilical cords with chlorhexidine, according to study results published online.

Luke C. Mullany, PhD, MHS, of the department of international health, Johns Hopkins Bloomberg School of Public Health, and colleagues reviewed literature published between June 2007 and September 2009. They reviewed data on about 30,000 newborns in Bangladesh who received one of three cord regimens: 1) either single cleansing; 2) dry and clean cord care as a comparison group; 3) cleansing with chlorhexidine.

Mullany and colleagues noted that mothers in the cord cleansing group reported longer separation times “and dissatisfaction with the separation time (11.1% and 17.6%, respectively) vs. the comparison group (2.5%).”

Despite the mothers noticing the length of time involved with the cord cleansing, the researchers said discussions with the mothers about the benefits of cleaning the cords yielded good compliance.

The researchers encouraged physicians to emphasize to parents that chlorhexidine cord cleansing can improve survival and reduce infection risk. They should begin as soon as possible after birth because it will help achieve clean and hygienic cord care, and although it may increase the time to normal healing and separation of the cord by a few days, the increase is not harmful to the infant.

“This low-cost intervention is easily implemented and can save hundreds of thousands of babies each year, in places where infections are common, including facility and home births,” Mullany told Infectious Diseases in Children. “As we scale up programs globally, we need to give moms and dads simple and clear messages about how cleaning the cord with chlorhexidine might make the time to separate a couple of days longer, but that this is a sign of the cord being cleaner, thus protecting the baby from dangerous infections.”

Luke C. Mullany, PhD, MHS, can be reached at the Department of International Health, 615 N. Wolfe St., Suite W5009C, Baltimore, MD 21228; email: lmullany@jhsph.edu.

Disclosure: Mullany reports no relevant financial disclosures.