Umbilical Cord Stump Care and the Use of Chlorhexidine: A Narrative Review
Y. O. Oyedeji, O. E. Oyedeji, A. O. Olajide, M. O. Fijabiyi, M. I. OlatubiAbstract
Background:
Neonatal mortality remains a major global health concern, with approximately 2.3 million deaths annually, predominantly in low- and middle-income countries. Infections such as neonatal sepsis and omphalitis are key contributors, with the umbilical cord stump serving as a major entry point for pathogens.
Materials and Methods:
This narrative review synthesised evidence from studies published between 2000 and 2025. A comprehensive search was conducted across PubMed, Scopus, CINAHL, Web of Science and the Cochrane Library. Eligible sources included randomised controlled trials, observational studies, systematic reviews and programme reports. Findings were analysed thematically.
Results:
Harmful traditional cord care practices, including the application of ash, dung and oils, remain widespread and increase infection risk. Evidence shows that 7.1% chlorhexidine digluconate significantly reduces omphalitis, neonatal sepsis and mortality, particularly in high-risk, community-based settings in South Asia, with more modest effects observed in Africa. Chlorhexidine is safe, cost-effective and widely accepted, although challenges such as supply constraints, limited training and cultural barriers affect implementation.
Conclusion:
Chlorhexidine is an effective, scalable intervention for improving neonatal outcomes in high-mortality settings. The World Health Organization recommends its use in such contexts, alongside dry cord care in low-risk environments. Strengthening health systems and community engagement is essential for maximising impact.