Umbilical Granuloma

portentosa

Hello. I don't post here often but I want to get the word out to more than my own social circle about the risks of using silver nitrate to treat umbilical granulomas.

I'm not trying to be alarmist here. Silver nitrate is used very commonly in medicine and is generally safe. My concern is that my pediatrician did not inform me of the risks or alternative treatments, if he even knew them. He didn't even tell us how silver nitrate would work. We should have asked, let that be a lesson to us as parents. Silver nitrate chemically burns the granuloma away, since there are no nerves in the umbilical cord it is a pain free procedure.

 

What happened to us:

We went in for our two month appointment at 1:30pm March 4, 2013. John was examined, received his vaccines, and was treated for his umbilical granuloma. The doctor was very matter-of-fact about it... 'Oh, his belly button is still oozing a little and there's a red bump? I'll put some silver nitrate on it.' He didn't tell us anything more about it, just said to continue to clean the area with alcohol.

John cried a little for his shots (he's always been a very happy baby) and we went home with more concern about possible vaccine reactions than anything else. John fell asleep in the car so we stopped at the grocery store to pick up baby Tylenol (doctor recommended if he developed a fever from the vaccines) and did some minor grocery shopping. It was 4pm by the time we got home.

When we got home I changed John's diaper and noticed his belly button was swollen and there was a trail of swellings going onto his stomach from the button. It looked odd but John was still happy so my husband and I took a wait-and-see approach. John took a nap, but about an hour later he woke up absolutely SCREAMING. Like I said earlier he's a happy baby, hardly cries and is easily soothed so this screaming scared us. Nursing, rocking, singing...nothing helped. I went to check his diaper again and the swelling was worse and had turned a light purplely grey color. We gave John a bath to wash off whatever could be on him and to soothe him (he normally loves baths) but he continued to howl in pain. 

I call our pediatrician's office. By this time it is 5:30pm and I get the after hours doctor and explain to her what's going on. She has never heard of what I'm describing before but suggests we go to the ER. That, of course, freaks us out more. At the ER no one had ever seen what happened to John before but they determine that it is a chemical burn. By the time he receives an antibiotic shot (10:30pm) his belly button is starting to peel, turn red, and ooze.

The antibiotic shot prevented the burn from getting infected and it has since been healing up without incident. Doing some research online I found this exact same story happening to parents whose kids end up in the hospital for days on IV antibiotics to treat massive infections because they don't catch it as fast as we did. I found this story happening over and over years back. THAT'S what concerns me most. So many pediatricians making the same mistake!

 

I found that this reaction has been documented by the medical community as far back as 1992 (https://www.ncbi.nlm.nih.gov/pubmed/1603685). I also found that there are alternative treatment options (continuing to wait for it to dry up on its own or double-ligature treatment) and that petroleum jelly should be placed around the belly button before the application of silver nitrate as a safety precaution (https://www.aafp.org/afp/2002/0515/p2067.html). Again none of this was discussed or even known by our pediatrician. I don't know why this information is not more widely known by the doctors themselves, because it's so rare perhaps?

The vast majority of babies with umbilical granulomas are treated with silver nitrate with no ill affects. But I want this story out there because doctors don't even know it. I want parents whose babies develop umbilical granulomas to be informed so they can make sure their doctor uses petroleum jelly before applying silver nitrate...or perhaps use an alternative treatment. I want to save future parents and babies from what my family went through.

John is doing great now. Our pediatrician was very apologetic and took the safety precautions I had found to heart and the ER bill was comped by the hospital. So all and all a happy ending, but I want other people to know.

 I have a series of pictures here.

TMWarren85

I am so sorry your little guy had to go through this, and thank you for posting your story! We have our two week appointment on Monday and DS's belly button is still oozing some and our nurse told us if it is still oozing on Monday they will probably p

bergerbride

 They put silver nitrate on my baby's cord too... And it happened so fast I couldn't even ask questions! Thankfully I didn't see any reactions with her, but it was a huge reminder for me to speak up when it comes to my baby! 

lifeisbetteronthered

DD had a large umbilical granuloma.  We noticed it as soon as her cord stump fell off, DD was 1w4d old.  It extended nearly a centimeter out of her belly button.  I did a bunch of research and right away we started swabbing it with alcoh

portentosa

Silver nitrate is the right decision for the vast majority of babies and I'm not trying to dissuade parents from using that option. I just want to share the possible complication it has...it is such an easy preventative to just apply petroleum jelly.