Neonatal umbilical granuloma

　　After the umbilical cord is detached, the wound at the base of the umbilical cord may form small granulation tissue due to irritants (such as talcum powder, blood crusts) or infection, etc. The diameter is 0.2 to 0.5 centimeters, with a moist surface, a small amount of mucus or bloody secretions, and it does not heal for a long time. It is necessary for a doctor to cauterize or scrape the local area with silver nitrate or electrocautery, which can generally be cured; if it is ineffective, then surgical excision should be considered.

　　The main complication is neonatal umbilical cellulitis. After the pathogen invades the umbilical area, the infection is initially confined to the local area. If the inflammation is not controlled, the range of inflammation will expand, leading to perinephric cellulitis. The infection can spread along the lymphatics, causing widespread infection in the upper and lower abdominal walls, even the lower chest. After the infection is localized, an umbilical abscess may form. If it invades deeply, it can cause peritonitis. Neonatal infection can also enter the blood through the unclosed umbilical artery and vein, causing portal vein inflammation, portal vein thrombosis, or sepsis. If the thrombus extends to the portal vein, it can cause portal hypertension of the extrahepatic type.

　　Umbilical granuloma is a tissue hyperplasia that occurs after the umbilical cord falls off, and it may also be caused by the mucosa bulging due to the intestinal tract connecting with the umbilicus. Umbilical granuloma is very prone to infection and inflammation.

　　After the umbilical cord falls off, pink granulation tissue appears in the middle of the baby's navel, and the size of umbilical granuloma in different children is different.

　　Umbilical granuloma can also cause symptoms such as purulent discharge and bleeding.

　　When touched with the finger, the baby often cries out in pain.

　　In the process of umbilical cord care, parents should pay special attention to keeping the umbilical area dry and not wetting it with diapers or other items. If the baby's umbilical cord bandage is wet, it should be changed immediately, and it is not recommended to touch or wipe the navel with dirty hands or cloths.

　　Within 24 hours after umbilical cord ligation, parents should closely observe for any bleeding. Some newborns may have slight leakage or bleeding due to the loosening of the ligature. If the gauze covering the umbilical cord is contaminated with blood or becomes wet, it should be immediately replaced and re-draped by a doctor.

　　Clinical physical examination: After the umbilical cord falls off, the baby's navel may appear pink granulation tissue, and the size of umbilical granuloma in different children is different. There may be moist secretions on the surface. If there is umbilical malformation or ectropion, there may be purulent smelly secretions. It is often accompanied by infection, causing infectious umbilical cellulitis, and even causing sepsis if the infection spreads into the blood.

　　Umbilical granuloma is the result of long-term unhealed umbilical inflammation, or the use of talcum powder, umbilical cord powder, talcum powder, and other foreign bodies to stimulate the umbilical area. It is recommended to go to the hospital for cauterization with 10% silver nitrate or surgical removal. After the umbilical cord falls off, there may be a chronic infected wound left at the umbilical area, or a polypoid granuloma may form inside the umbilicus due to foreign body stimulation (such as talcum powder, etc.). This disease is most common in infants 2 weeks after birth. The clinical manifestations include slight swelling of the umbilical area, with a 0.2-0.5cm granulation tissue hyperplasia in the center, presenting as a bright red spherical shape without mucosal covering, with frequent pus and bloody discharge, soiling clothing, and not healing for a long time. It can also stimulate the surrounding skin, causing eczema-like changes, and even leading to ulceration. Excessive granulation tissue can be removed using 10% silver nitrate corrosion or scissors, electrocautery, and it is important to keep the umbilical area clean and dry, which can usually lead to healing.

　　1. Diet Principles

　　After a child has a fever, the secretion of saliva decreases and the gastrointestinal activity is weakened, resulting in a loss of appetite. It is forbidden to force the child to eat during this period, as eating more may cause indigestion. During this period, the diet should follow the principle of light, easy to digest, small and frequent meals.

　　2. Diet Plan

　　1. Parents should adjust the child's diet in a timely and appropriate manner according to the development of the illness process:

　　2. During the acute stage of the illness, children have poor appetite and high fever, at this time, liquid foods should be the main choice, such as rice gruel, milk, juice, mung bean soup, etc.;

　　3. During the convalescence period or after the fever subsides, semi-liquid foods can be prepared, such as: nutritious rice noodles, minced meat porridge, noodle soup, egg custard, etc.;

　　4. After the fever subsides, you can eat some easily digestible dishes such as congee, noodles, and fresh vegetables.

　　3. Diet taboos

　　Some parents, seeing their children not wanting to eat due to fever, are afraid that it will affect the supply of nutrition and development, and therefore force their children to eat high-protein foods such as meat and eggs. However, they do not realize that this often does more harm than good.

　　Fever is a systemic response characterized by enhanced sympathetic nervous system activity. In this state, the digestion and absorption of food are greatly affected, especially for difficult-to-digest meaty foods. If these things stay in the gastrointestinal tract for a long time, they will ferment, rot, and even cause poisoning. Therefore, it is advisable to eat less or no greasy food.

　　1. The disinfection method must be thorough and complete, the dried parts should be flipped up to expose the moist bottom, and the 75% alcohol cotton swab should be used to disinfect twice first, followed by 95% alcohol cotton swab to dry twice, and it should be done three to four times a day.

　　2. Apply iodophor solution twice or thrice a day (first disinfect with 75% alcohol, then apply iodophor), which can be alternated with the second item.

　　3. Take oral antibiotics for five to seven days (dosage as instructed by the doctor).

　　4. Burn the silver nitrate rod with nitric acid to make it completely eroded at the pediatric clinic.