Each of us was once connected to our mother by an umbilical cord. After birth, the umbilical cord is cut off and only the umbilical cord remains, which disappears with the formation of the umbilical wound. How to handle the navel of a newborn, tells expert: pediatrician at the Family Clinic Medical Center Anastasia Igorevna Pirozhkova.
Despite the fact that in medicine the rules for the management of the umbilical wound have long been defined, many myths and misconceptions remain around this topic. Therefore, it is worth saying right away: so that the newborn does not have problems with the navel, it is necessary to adhere to one simple and important principle: keep the navel clean and dry. Do not suppose a condition in which the navel in the newborn becomes wet, especially in the first two weeks of his life. And yet - always wash your hands before and after processing your belly button.
While the mother and the baby are in the hospital, a nurse is processing the navel of the newborn. She does this with a cotton swab: first, having wetted one of its ends with peroxide, she gently wipes the umbilical wound, then - with the dry part it removes the remaining moisture. The baby does not experience pain in the umbilical wound area, so do not worry when you process the navel yourself.
How to handle the navel of a newborn and how to process the navel of a newborn at home?
The concepts of cleanliness and sterility vary. It is proved that the colonization of the umbilical cord with normal mother's microflora accelerates the process of separation and healing of the wound. And on the contrary, the destruction of microflora from the skin by treatment with antiseptics lengthens this process and increases the likelihood of infection.
How much does the navel in newborns heal and how much does the navel of a newborn treat?
The process of separation of the umbilical cord is absolutely physiological and occurs by the formation of dry gangrene of the umbilical cord residue followed by its separation: this occurs between the 5th and 15th day of the newborn’s life.
How to handle a newborn's navel after clothespins
How does the navel in a newborn heal? If there are no complications, a flashback with a dried umbilical cord will fall off after 3-15 days (each has its own norm, and any day in this interval is permissible).
Now, to heal the navel in a newborn, the wound must be treated twice a day with a cotton swab dipped in hydrogen peroxide. After peroxide treatment, remove any liquid residue with the dry side of the stick.
After treatment, do not rush to put on a diaper: let the baby's skin breathe and the wound will dry.
After the wound has healed, the baby can be bathed in ordinary (not boiled) water, thoroughly drying the wound after washing with light soaking movements.
It is not worthwhile to treat the navel of the newborn with antiseptics without the recommendation of a doctor. In addition, the doctor or nurse will definitely see the baby after discharge from the hospital. During their visit, they will also evaluate the state of the umbilical wound.
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About the expert: Anastasia Igorevna Pirozhkova
Work experience - 3 years.
Takes in the Family Clinic Medical Center (Moscow, Yaroslavskoye Shosse, 69),
Engaged in children from the first month of life,
Carries out the selection of individual nutrition and vaccination calendar for premature and small babies,
Observes children under 18 years of age.
How is the umbilical wound formed?
The umbilical cord in childbirth is involved in the first place. The 3 vessels passing inside it are wide open gates for ambient air and infection. Therefore, within 10 seconds after the birth of the baby, it is clamped with strong surgical clamps in two places, so that subsequently the umbilical cord crosses between them. The distant clamp is located at a distance of 10 cm from the surface of the skin of the newborn, the nearest - 2-3 cm. After treatment with an antiseptic, the segment of the cord limited by the clamps intersects.
After sealing and crossing the umbilical cord, doctors are already calmly taking care of the child, for which he is transferred to a changing table, covered with a sterile diaper, under a warm lamp. Here, among other things, the formation of a beautiful navel is also completed. A segment of the umbilical cord between the near clamp and the body of the newborn is disinfected with alcohol, drained with a sterile napkin and squeezed blood with fingers in a sterile glove. A bracket of Rogovin (the so-called special plastic clothespin) is placed as close to the umbilical ring as possible, but so that it does not tighten the skin very much.
The excess umbilical cord is cut off at a distance of 1.5-2 cm from the bracket, and the remaining stump is treated with a 5% potassium permanganate solution. Subsequently, due to the lack of blood supply and with proper treatment (or without proper treatment - this will be discussed later), the tissues remaining outside the clothespin will gradually dry (mummify) and disappear. At the same time, the bracket must also disappear. But the timing of its decline already depends on the state of the immune system of the newborn.
My baby is the "navel of the earth"
What a new mother sees in her baby in the navel in the first days after birth, in fact, still little resembles a normal, standard, human navel.
After cutting the umbilical cord, the doctor who took the baby leaves him with a small umbilical cord - literally a few centimeters long. After 4-10 days, this “tail”, having dried, will disappear on its own. And God forbid you to try to get rid of it by any means! Do not injure your own child with your own hands.
Actually, the unhealed umbilical wound itself is the fundamental difference that distinguishes newborn children from the total mass of infants.
After the umbilical cord has fallen off, the wound still needs to be systematically looked after, namely: treat it with disinfectants, do not wet it with water (bathing a newborn baby is fundamentally different from bathing an older baby), do not touch it again with your hands and try not to injure clothes or disposable diapers. As a rule, on average, the umbilical wound of a newborn heals completely in 3-4 weeks.
All About The Umbilical Cord
After the cesarean section, the puerpera and the child are prepared for discharge only after a week, and during their stay in the hospital of the maternity hospital, doctors help to care for the baby. The baby gets home already with an umbilical wound. That is, the mummification of the umbilical cord residue and the falling off of the clothespin are left behind.
But after the physiological birth and in full health of the newborn, it does not make sense to keep mother and child in the ward for a long time (at home it’s better!). They are discharged after 3 days, when the mummification and the brace have not yet fallen. And, if a woman could not remember all the recommended nuances of caring for her child, then a local nurse will come to the rescue, who will enlighten parents how to handle the newborn's navel before and after the clothespin falls off at the first “visiting visit”.
Here is all the information that it can provide.
The return of a young mother and baby from the maternity hospital is a responsible and very important period. Indeed, now all responsibility for the growth of the development and health of a small person rests entirely with his mother and all relatives. Very often, one of the most obscure points is the care of the navel. The need for this can even cause panic among inexperienced parents. However, in reality there is nothing complicated in this. After all, you can master the basics of this business under the guidance of a patronage pediatrician.
Even in the maternity hospital, mothers are interested in the doctor how long the umbilicus heals in a newborn. The answer to the question, how much time heals umbilical woundrather individual. In most cases, this occurs in the third week of a child’s life. But sometimes this process can be a little delayed. Therefore, parents should clearly know how to understand that the navel has healed.
Why is the umbilical cord needed?
In the womb, the fetus receives nutrients through a special education - the placenta with the umbilical cord. Both of these elements are simultaneously conducting systems and barriers to pathogenic microorganisms. A placenta with an umbilical cord is present in almost all mammals.
In a newborn, the umbilical cord is quite long - 50-70 cm, which allows the baby in the womb to arbitrarily change the position of the body. The thickness of the umbilical cord is about 2 cm, it is elastic to the touch and resembles a rubber tube, the surface is smooth and shiny. The umbilical cord is connected at one end to the abdominal wall of the fetus and at the other end to the placenta.
Blood passes through this system, which is enriched with oxygen in the mother’s body and carries it to the baby. Also through it, all toxins received as a result of metabolism in the fetus are transmitted to the mother. The blood flow in the umbilical cord is about 240-250 ml / min. For comparison, the blood flow in the liver is 1200 ml / min, that is, in the umbilical cord it is 5-5.5 times lower, while the body weight and blood volume of the fetus are 20 times lower.
The vessels of the umbilical cord are sensitive to the hormone oxytocin, which is thrown into the bloodstream during childbirth in large quantities. Because of this, the vessels of the umbilical cord after birth are narrowed so much that the blood flow is reduced to zero. For this reason, the heartbeat in the umbilical cord disappears 5-20 minutes after birth. As a result, umbilical cord tissues after birth completely atrophy after 2-3 hours.
The umbilical cord resembles an elastic rubber hose. Its length is more than half a meter and it is able to withstand severe loads. One side of the umbilical cord is adjacent to the stomach of the baby, and the other to the central part of the placenta.
Inside the umbilical cord are two arteries and one vein. Blood saturated with carbon dioxide and metabolic products flows through the arteries towards the placenta, and pure blood, rich in oxygen, nutrients and minerals, enters the baby through the vein.
The umbilical arteries are very sensitive to oxytocin. When its level in the body of a pregnant woman reaches a maximum, and this happens during childbirth, they narrow, mobilize. So there is a natural rejection of the umbilical cord at the cellular level, but physically the umbilical cord is cut by obstetricians who take birth. After the baby is born, he begins to breathe lightly, to eat - through the gastrointestinal tract, so there is no longer any need for the umbilical cord.
When the umbilical cord falls away
In full-term newborns with a strong immune system, this event occurs on 3-5 days, in weakened and / or premature - on 8 days, although cases of later falling away of the residue are quite common. The main thing is that it really dries, and does not get wet. And it is precisely because of this basic condition that doctors arrange disputes.
Some are of the opinion that there is no need to handle the drying segment of the umbilical cord. It just needs to be:
- aerate frequently during air baths,
- Do not wet if necessary
- do not squeeze with clothes
- do not soar under the diaper (unscrew the edge of the standard or temporarily use the diaper with a special cut-out for the navel),
- in case of contamination with urine or feces - rinse with cooled boiled water and dry with a cotton pad.
Others insist on one or two times daily treatment with antiseptics.
What you need to know about the navel
In the womb of the mother through the umbilical cord, the baby receives the necessary nutrients for him, as well as oxygen. In addition, products come out through it. metabolism. When the baby is born, this connection between his and his mother’s body is cut. On the rest of the umbilical cordRogovin bracket.
However, even if the navel is not bandaged after birth, bleeding will not happen. There are two arteries and a vein in the umbilical ring. After cutting, the arteries gap in view of the denser structure of the wall, and the vein collapses. However, this does not mean that bacteria cannot enter the resulting wound. To prevent this, in the maternity hospital, the umbilical remainder is bandaged and carefully processed.
And when the rest of the umbilical cord disappears, which occurs after about 4-5 days, you need to continue to carefully treat the wound. There is no need to panic over the fact that "the balance has fallen off, what should I do?"
If the navel does not disappear, you must wait a few more days. Sometimes this does not happen in the hospital, and this means that it will disappear after 7-10 days already at home. After the navel disappears, you need to process the umbilical wound very carefully, doing this in three stages.
Initially, using a sterile cotton swab, you need to treat the wound from all sides hydrogen peroxide. It is best to take hydrogen peroxide of 3% concentration.
Lubricate the wound to prevent infection. alcohol 96%. The remaining stump must be dried and gently lubricated. potassium permanganate 5%.
In the hospital
During childbirth, obstetricians begin to process the baby before its full appearance. As soon as the head is born, mucus is sucked off with a sterile pear, which fills the baby’s nose and mouth. When a boy or girl is born as a whole, doctors continue to conduct the birth process, because the mother still needs to give birth to the placenta, and the baby has to go through several stages of processing the umbilical cord.
The primary treatment of the umbilical cord of the newborn should pass quickly - literally 10-15 seconds after birth, the crumbs of the umbilical cord are clamped with Kocher clamps. One of the clamps is superimposed on the cord ten centimeters from the navel of the baby, from his umbilical ring. The second clamp is applied a few centimeters from the first towards the placenta.
Between the clamps is the part of the umbilical cord, along which the clipping will be carried out. It is treated with alcohol and cut with sterile surgical scissors. Only after that the "liberated" baby is shown to the newly minted mother, the obstetricians say half the crumbs and carry him to a special changing table with heating and a sterile diaper. This is where the secondary processing stage starts.
The remains of the umbilical cord should be treated with alcohol, then blot dry with a sterile cloth. The algorithm of actions of the medical staff in this matter has been worked out to the smallest detail, everything is done quickly. The processed umbilical cord is squeezed out with fingers and a Rogovin bracket is applied 20-30 mm from the umbilical ring. About 2 centimeters retreat from it and the umbilical cord is cut again, treating the cut with a five percent solution of potassium permanganate.
Previously, the navel was tied with a knot, now the child is practiced with a clothespin (Rogovin's bracket) until it completely falls off. In the children's ward of the maternity hospital, the doctor will examine the condition of the remainder of the umbilical cord and umbilical ring on a daily basis. The baby will be treated with a navel every day. If medical personnel do not violate sanitary requirements and instructions, the risks of infection of the umbilical wound will be minimal.
If the SOP algorithm (standard operating procedures) has not been violated, and the child was born healthy and full-term, there is practically no chance of developing an umbilical hernia, severe infection, or sepsis. Complications begin where the responsible attitude of doctors to their work ends.
Cutting off the umbilical cord of a newborn in the hospital
After birth, the umbilical cord is not cut off immediately, but wait until the blood circulation in it drops so much that a heartbeat is heard.After that, at a distance of 10 cm from the navel, a small portion of the umbilical cord (about 2 cm) is clamped between the two terminals and cut it in this place. Then, at a distance of 0.3-1 cm from the umbilicus, the umbilical cord is clamped with a bracket or pulled by a ligature thread. The remaining area is removed using medical scissors.
As a result, a 1-2 cm section remains from the umbilical cord, fixed with a special clothespin or bandage. It gradually dries and leaves on its own after 3-4 days. At this time, processing of the navel of the newborn with a clothespin is required so that the area does not become infected. In case of complications, the remainder of the umbilical cord is removed by doctors surgically. At the exit from the hospital, the umbilical cord is usually completely separated, leaving the umbilical wound at the point of its attachment.
Means for treating the umbilical wound of a newborn
Even before giving birth, collecting a first-aid kit for a newborn should stock up on funds for future care for the umbilical wound. Mom will need them from the first day the baby is born. The set of drugs is simple, ingenuous and affordable:
- Hydrogen peroxide
- Brilliant green solution (brilliant green)
- Cotton pads
Some modern pediatricians advise using other, analog, antiseptic agents instead of green stuff (which ones - the pediatrician will tell you). The reason is that the green paint stains the skin, and if the navel suddenly begins to fester or bleed, the mother may simply not notice these negative symptoms under a dark green “paint” layer of paint.
Navel care in the ward and at home
The pediatrician carefully processes the remainder of the circumcised cord with an iodine solution. To accelerate the healing of the wound, a specialist can prescribe a mini-operation, involving quick and delicate removal of the remaining umbilical cord.
From the first days, a young mother should be informed about how to care for a navel of a newborn before discharge home, so every mother should know how to care for a newborn.
Standard umbilical care is as follows:
- Using a diamond solution (in other words, green) and a cotton swab, we process the umbilical ring, without filling it with a solution.
Standard care for the umbilical wound after the remainder has fallen off is slightly different:
- The umbilical ring is processed with hydrogen peroxide (2-3 drops are enough).
- The navel is dried using a sterile cloth.
- The wound is lubricated with an antiseptic drug, such as brilliant green, with penetration into all folds.
If the wound heals for a very long time, then it is advisable to bathe the child using boiled water with a weak solution of potassium permanganate. You need to take care of the wound with special care and smear the navel both from above and inside. Thus, it is possible to stop the penetration of microbes into the wound and provoke early healing of the wound.
It is equally important to ensure that the child strains as little as possible when crying. When the baby screams, his stomach tightens, which contributes to an increase in the wound. You can strengthen the abdominal wall by placing the baby on the table surface more often. If this exercise does not help, then you need to seek help from a pediatrician.
Reasons for Long Healing
Some mothers face a rather serious problem when a navel in a newborn does not heal for a long time. This occurs for the following reasons:
- large belly button size
- improper wound care,
- hernia development
- the course of the inflammatory process,
- weak immune system.
If the diameter of the placental umbilical cord exceeds standard sizes, then the wound will heal much longer. There is no cause for concern here.
But more often, slow wound healing occurs due to insufficient wound care. Sometimes a serious inflammatory process develops against this background. You can avoid the development of inflammation if you take care of the wound daily and bathe the baby in the herbs. Also, mom should ensure that the excrement and urine of the crumbs do not fall into the wound. If this happened, then the wound must be urgently treated with an alcohol solution.
The alarm should be sounded when the wound not only heals poorly, but also resolutely sticks out. This symptom indicates the growth of an umbilical hernia, which requires immediate medical attention. If the diagnosis is established in a timely manner, then surgical intervention can be avoided.
A symptom such as navel moisture is indicative of the inflammatory process. If strange discharge of a cloudy tint constantly oozes from the wound, this indicates suppuration. Untimely medical intervention threatens the occurrence of sepsis.
Long healing of the navel is often observed in children with low weight. The immunity of such children is greatly weakened and the body cannot resist the infection. Only a highly qualified pediatrician can help in this case.
Belly button care from the first days
If you touch the umbilical wound with clean hands, then do no harm, the baby may be slightly anxious. Without care, the umbilical wound can become inflamed and cause serious illness, so the place should be carefully treated for 10-15 days.
The wound and the area around it should not be covered with gauze diapers or disposable diapers. If this zone is closed, then conditions will be created for moisturizing the umbilical wound and infection through it. When dressing diapers, they should be bent so that the navel area remains free.
Umbilical wound treatment procedure: instruction
The umbilical wound of a newborn should be treated daily, preferably after an evening bath.
A few words about swimming: Since the baby's navel that has not yet healed is essentially a wound, it is by no means impossible to bathe the baby in ordinary tap water (even if with a succession). However, this does not mean that the baby does not need hygiene. Parents have little choice in this situation: either you use special wet baby wipes (not for long, but exactly until the umbilical wound heals and dries completely), or you bathe your baby in boiled and filtered water. It should be understood that for the umbilical wound, not only the bacteria that can appear in ordinary water, but also the chemistry that is present in it, for example, bleach, are scary.
So, the sequence of actions when processing the umbilical wound of a newborn such is:
- 1 The baby should be undressed or swaddled, removed (or pulled down) the diaper.
- 2 Then - wipe the skin with wet wipes (instead of bathing), but without touching the navel. Or gently bathe the baby in a small bath with boiled water.
- 3 Using a towel, in no case rub the baby's skin with it - just dip it as gently as possible until it dries completely.
- 4 Drop 2-3 drops of hydrogen peroxide directly into the umbilical wound. So far, during the procedure, peroxide “hisses” on the skin - this means that the wound still bleeds from time to time (although you may not notice any traces of blood visually). And accordingly, this means that the next day it is necessary to use peroxide. But when you notice that the peroxide no longer foams during processing, it will serve as a sign for you that the next time you can no longer use it.
- 5 Wait a couple of minutes (while the peroxide is working), then blot the navel with a cotton pad (to dry it a little).
- 6 Take a dropper, draw a little green, and drip 1-2 drops directly into the umbilical wound of the baby. Wait a moment - and you can wear a baby. If you use another antiseptic instead of brilliant green - the doctor will tell you how to apply it to the navel of the child.
After discharge from the hospital, the responsibilities for treating the umbilical wound fall on the shoulders of the young parents. And here a great many questions arise. The local pediatrician can teach the mother to properly handle the umbilical wound, who will visit the child at home on the first day after discharge. But it is advisable for parents to have a memo on hygiene procedures associated with the navel;
In fact, there is nothing complicated in processing. Its conduct must be included in the morning toilet of the baby.
Navel with umbilical cord: when it disappears, how to handle, what to do with the dropped umbilical cord?
Usually, all the procedures for caring for the navel of a newborn are first performed by a pediatric nurse. She will also teach you how to properly handle the newborn's umbilical cord.
In the early days, the umbilical cord remains with a clamp attached to its edge, which is a bit in the way. Read the important article: Newborn Care >>>
Attention! Some mothers try to tear off such a stump or “unscrew” by turning several times in different directions. This can not be done in any case!
Doctors indicate that the drying of the umbilical cord should occur naturally. Usually it disappears after 3 to 5 days after the birth of the child. Sometimes this event also occurs a little later, at 6 - 10 days (this may indicate intrauterine infection and requires closer monitoring of the child). And until then, there is nothing left but to process the navel of a newborn with a clothespin attached.
To do this, you must first lubricate the umbilical ring itself with an antiseptic, and then the entire umbilical cord residue. The clamp can be taken in hand to lift and facilitate access to the cult from all sides.
In former times, mother and newborn were not discharged from the hospital until the umbilical cord falls off. Now this event often happens at home. Whether to store this dropped piece or throw it away is up to you. There are many tips in this regard.
The most interesting of them:
- To make a hole in the door jamb and put an umbilical cord there, cover everything with putty - it is believed that when the newborn outgrows this mark, then all infant diseases will pass,
- Keep until the child is 6-7 years old, and then put his clothes in the pocket when he first goes to school - then the child will study well,
- Some mothers decide to bury such an umbilical cord in the ground.
Possible pathological processes in the umbilical cord
The umbilical cord, after applying a clothespin, remains without power, so it gradually dies. Her baby’s immune cells do not get into her tissue and she is not able to fester. But if the staple was not tightly clamped or it corroded the blood vessels passing through the remainder, then blood will start to stand out from it - from minor blood smearing to noticeable bleeding.
In the future, inflammation with phlebitis and / or arteritis may develop. But, being at home, you have nothing to fear from these complications: they can occur only in the first days, that is, even in the hospital. And with the appearance of bleeding, doctors simply change the brace to a new one.
Processing a navel for a newborn at home
With the normal development of the baby, the healing of the umbilical wound occurs on the 3rd week - during this period it epithelizes. How to treat a navel to a newborn before healing, the woman will be explained to the woman by the local nurse or pediatrician. This procedure must be carried out as it happens in the maternity hospital. Mom, who needs to know exactly how to handle the navel of a newborn correctly, it is important to consider that you need to do this every day after bathing. First, mom needs to wash her hands thoroughly with soap.
It is important to know about how to process the navel of a newborn. Used for these purposes. hydrogen peroxide, alcohol 96%, brilliant green solution2%or chlorophyllipt for processing. And here is the solution potassium permanganate it is not recommended to use for these purposes, since it is not easy to prepare a solution of the correct concentration of their powder, and, moreover, if the crystal accidentally appears on the skin of a child, it can provoke burn.
Initially, you need to soften the crust with a cotton swab soaked in hydrogen peroxide. If the peroxide does not start to foam, this means that the navel has healed.
In the healing process, crusts that need to be removed very carefully will gradually disappear. You can’t peel off the crusts using force.
When processing the navel, special attention should be paid to the base of the umbilical cord. Each time it is very carefully wiped to remove all wet secretions. This is most convenient to do with a cotton swab. So you can speed up the process of drying and healing.
What can go wrong in the process of treating the umbilical wound of a newborn
Normally, the umbilical wound heals within two, at most three, weeks. She can bleed for a maximum of 8 days. If on the 10th day you see blood, it is imperative to inform the pediatrician about this. The same must be done if the wound has not completely healed a month after birth.
The consequences of improper treatment of the umbilical wound:
- There are frequent cases when in children, during the treatment of the umbilical wound, a so-called umbilical hernia occurs. It is clearly visible especially in those minutes when the baby is crying and screaming - the tummy is tensing, and a dense tubercle appears in the navel. This situation is not dangerous and does not require urgent medical intervention - as a rule, umbilical hernias in infants pass by themselves.
There are situations when the umbilical wound of the baby becomes inflamed. This process is accompanied by redness of the skin around the navel and a slight swelling. Pus can stand out from the wound itself. This negative development is called omphalitis. As soon as you notice the above symptoms - the baby should immediately show the pediatrician. He will prescribe a new scenario for treating an inflamed umbilical wound (most often with a solution of furatsilin). In extreme cases, antibiotics are used.
If the clothespin does not fall off
The clothespin with which the baby was discharged may fall off along with the dried cord residue on the 5th day after birth, and maybe only on the 7-9th day. Everything is individual here. If the navel is all right, there are no signs of inflammation, you do not need to process it until the umbilical cord falls off. If a doctor insists on treatment, take this process responsibly.
While the bracket is in place, the navel is carefully treated so as not to disrupt the mummification of the remainder of the umbilical cord by introducing the infection. For processing, you will need tweezers, cotton pads, brilliant green and a pipette. Previously, mother should wash her hands, treat with any antiseptic (preferably Miramistin). Using a pipette, carefully apply 1-2 drops of brilliant green to the place of attachment of the remainder of the umbilical cord to the umbilical ring.
It should be remembered that the remains of the umbilical cord with a clothespin should always be dry. Try not to cover them with a diaper. If the baby's feces or urine gets on the navel, rinse it with running water and dry it well naturally, after drying it with a clean, ironed napkin.
With the remains of the umbilical cord of the child, you can and should bathe, they also spread it on the tummy. Only for hygienic procedures, it is advisable to use boiled water. The clothes of the newborn should be sewn from natural fabrics, in the navel should not be rubber bands and pressure fasteners.
The right diaper choice
The belly button of a baby should always have access to fresh air. Otherwise, the wound will sing and bother the child for a long time. You can relieve it from anxiety by choosing a diaper with a special neckline.Or, if the choice fell on an ordinary diaper, you should bend the front part so that the navel remains higher. So the navel will breathe freely, and the wound will soon become crusty and heal.
How much to process once a day?
This procedure should be carried out once a day.
If the navel does not heal well, regular “airing” will help speed up this process, for which you need to open your tummy more often. When using diapers, you need to bend down the girdle so that the wound remains open. No need to touch the wound, if there is no need.
Warning for too zealous moms
Inadequate treatment of the umbilical wound in a newborn can not only be that you do not finish something (process less than once a day, do not clean the skin before treatment, dig into the wound with cotton swabs, etc.), but also too "persistent" attitude to this process. Remember - not allowed:
- 1 Treat the wound several times a day (one is enough!),
- 2 To use more than two products during processing (peroxide and brilliant green are an ideal company of antiseptics that does not need “colleagues”). Do not forget that the drugs themselves can enter into undesirable chemical reactions with each other.
- 3 Seal the umbilical wound with a band-aid, supposedly then so that dirt or bacteria do not get into it. In fact, a prerequisite for speedy healing is air access to the wound, it should dry out. And under the patch it is impossible in principle.
- 4 Glue the patch to the skin at the bottom of the navel, supposedly then to slightly “turn” the navel out. Like, so it dries faster. Do not scoff at the baby! Firstly, such a strange method does not accelerate the healing of the umbilical wound. Secondly, you can get an infection during the procedure itself. And finally, tearing off even the most tender patch, you still involuntarily inflict pain on the baby and injure the skin.
Umbilical cord care rules
Newly made mothers are concerned with the question: “How long does the navel of a newborn heal?” During pregnancy, the child contacted the mother through the umbilical cord, she became the conductor of food, oxygen and other useful substances, through it the products of the activity of a small organism were excreted. On average, the length of this special organ does not exceed 60 cm, and as a result, cut-off will occur, which will mark the beginning of a new independent life. At this moment, the child should take a first breath and a first cry outside her mother’s cozy tummy.
Obstetricians take care of the baby in the first minutes of independent life, clean the airways if necessary, and most importantly - separate the child from the mother. The baby remains with a small umbilical cord of 2-3 cm, on which a ligature or clothespin is applied. A dressing is applied from above, which is changed daily by medical personnel, treating the healing site with an antiseptic.
Umbilical cord anatomy
What is the term for an umbilical cord to fall off in an infant? Young parents worry about possible complications. This two-centimeter residue requires great attention until complete healing. As soon as the umbilical cord disappears, you can breathe a sigh of relief, some of the problems and worries are left behind.
Normally, the umbilical remainder should disappear after 4-5 days, but this period may not end long, depending on the individual characteristics of the body. But if healing is delayed for more than a week, then it makes sense to contact a local pediatrician. Doctors distinguish several cases when the umbilical cord heals for a long time:
- Anatomical features of the umbilical cord.
- Prematurity of the fetus.
In these cases, do not worry, you need to continue regular treatment of the wound, waiting for complete healing. But there are pathological cases when you immediately need to sound the alarm.
So, the navel is a favorable environment for the development of microbes and harmful microorganisms, which, if improperly maintained, can develop abundantly. Such abscesses are accompanied by complications with the onset of infection. To avoid problems, it is recommended to adhere to the generally accepted rules for the care of the umbilical cord.
Severe consequences of navel infection
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If the umbilical wound heals poorly and for a long time, this may be a harbinger of omphalitis - a formidable complication of infection. A characteristic manifestation of omphalitis is the inflammatory process of the subcutaneous layer. It appears due to improper treatment of the wound and the entry of pathogenic microbes into it. The most likely occurrence of this disease during the first 3 weeks of a baby's life.
At the first stage, infection, inflammation, and pus formation occur; later on, without appropriate care and treatment, this condition will become more complicated. As a result, blood poisoning will begin, which can lead to death without medical intervention. Therefore, the slightest change in the type of wound, fever, tearfulness and the appearance of purulent discharge is a signal of an urgent visit to the pediatrician.
Some mothers frighten crusts out of fear and worries, treat an umbilicus countless times a day, using all kinds of medications. And sometimes it happens that parents generally forget to process such a sensitive area. When a healed wound appears in place of the umbilical remainder, it is recommended that you stop using an antiseptic.
Rules for the treatment of umbilical wounds
To avoid complications, from the moment of birth, you need to properly process the umbilical remainder:
- Before each procedure, wash your hands thoroughly with soap,
- do not use several antiseptics at the same time,
- in no case violate the integrity of the dried crust,
- You cannot touch, pull or tear off the umbilical cord,
- if the umbilical cord has disappeared, the baby should be bathed in boiled water with the addition of a weak solution of potassium permanganate,
- the baby’s underwear needs to be washed and ironed thoroughly, guaranteeing the absence of microbes on it,
- things should be made of soft natural fabrics, without tight elastic bands or belts,
- in order not to injure the umbilical cord, you can use special diapers or bend the belt on the usual ones,
- treat the wound twice a day,
- It is strictly forbidden to use adhesive tape.
Nothing extraordinary or expensive is needed to treat the umbilical wound. Enough to have at hand a bubble of hydrogen peroxide or tincture of sophora. Previously, the use of greenbacks was practiced, but modern doctors refused, because the green color hides the possible appearance of ulcers.
Navel treatment with clothespin chlorophyllipt, potassium permanganate
To process the navel you will need the following materials and tools:
You need to process the navel 2 times a day according to the scheme:
- Moisten a cotton swab with hydrogen peroxide and clean the navel of dried blood and other secretions. Rubbing with a swab is not necessary, just put it on for 2-3 minutes. Hydrogen peroxide does not cause pain, so do not be afraid if the baby is anxious.
- A cotton swab should be removed from the navel yellow crusts, in which microbes often multiply. Hydrogen peroxide greatly softens them, making the process easier. To remove, gently push the edges of the navel with one hand, take a cotton swab into the other with your hand and gently peel off the crusts. Before doing soak the stick in hydrogen peroxide. If the crust is not removed, then leave it, you can not tear them off by force.
- After removing the yellow crusts, swab the wound to dry the surface. Then use brilliant green or chlorophyllipt to treat the navel of the newborn. At the same time, try to prevent the antiseptic from getting on the skin around the umbilical wound.
Bathing the baby with a wound
There is no unanimous conclusion on the question of whether to bathe a child with an unhealed umbilical wound. Some doctors talk about the risk of infection from the water. Others insist that when disinfecting water, this danger can be minimized, in addition, water softens the yellow crusts and helps to quickly cleanse the navel.
Many mothers agree with the latter point of view, because it’s quite simple to purify water from germs using potassium permanganate or boiling. And softening and removing crusts reduces the risk of infection. But here you need to remember that potassium permanganate solutions dry the skin of the child. It is better to boil water for disinfection, and this takes a lot of time.
When you decide to bathe a baby with an unhealed wound, follow a few rules:
- To bathe, draw water not into an adult bath, but into a small bath.
- It is better to disinfect water by boiling, without the use of potassium permanganate and other chemicals. Boil water before the umbilical wound does not heal completely.
- After bathing, be sure to clean the wound using a solution or powder to treat the navel of the newborn, according to the above scheme.
What to do with the baby's umbilical cord in the hospital
The umbilical cord is bandaged in two stages. At the first stage in the birth block, 2 sterile surgical clamps are placed on it: one at a distance of 10 cm from the umbilical ring, the second 2 cm from the first clamp. The umbilical cord between the clamps is treated with a solution of iodine, then cut with sterile scissors. Then, 3 mm – 1 cm from the umbilical ring of the newborn, the umbilical cord is pinched with a special bracket or bandaged with silk thread (ligature). The remainder of the umbilical cord is cut off with sterile scissors.
After that, two main methods of cord care are used in maternity hospitals. In recent years, the method of surgical cutting of the umbilical cord residues on the second day of a newborn’s life has become more and more widespread. An aseptic dressing is applied to the umbilical wound, and on top the edges of the wound are pulled together with an adhesive plaster. This method allows you to reduce the healing period, simplify the care of the navel. Another option is that the remainder of the umbilical cord is not cut off, and together with the bracket placed on it in the birth block, it mummifies (dries out) and disappears spontaneously within the next few days with the formation of the umbilical wound. As a rule, this also happens in the hospital. In both cases, a wound surface is formed that requires care.
Navel without clothespins and umbilical cord: processing technique
From the moment the umbilical cord residue disappears, the most crucial stage begins - the healing of the umbilical wound. The risk of inflammation or infection during this period increases significantly. There are no special differences in how to process the navel of the newborn after the clothespin falls off. This process also consists of the following stages:
- Disinfect the umbilical wound with hydrogen peroxide. In this case, it will be most convenient to drip a few drops with a pipette. The liquid should begin to foam. Such a reaction will be observed every time until the wound heals completely,
- A few seconds after instillation, the crusts that form inside the umbilical ring become wet and will easily separate from the skin. Then they all need to be carefully removed using cotton buds,
It is important to remember that you can not tear off dried crusts by force, otherwise bleeding will open.
- Next, gently pat the wound with a sterile cloth so that it becomes completely dry,
- Processing ends with lubricating the entire umbilical ring with an antiseptic. In this case, it is necessary to push its edges and work well inside the navel. It is important to try not to hurt the healthy skin around.
It is worthwhile to separately draw your attention to what exactly is recommended to process the navel. Previously, for these purposes, used "brilliant green" or a strong solution of potassium permanganate. It has now been proven that such products are not very suitable because of their rich color.
Know! The fact is that this prevents timely notice of the onset of inflammation of the umbilical wound. The redness that appears in this case on the skin simply will not be visible.
Modern pediatricians suggest using chlorophyllipt to treat the navel. This drug is a colorless alcohol solution based on extracts from eucalyptus. It very effectively copes with pathogens of staphylococcus, is an antimicrobial and anti-inflammatory agent. Chlorophyllipt can be replaced with an alcohol solution of calendula.
It will also be interesting to read the article: How to clean the nose of a newborn?
Umbilical wound infection
With unscrupulous care for the umbilical wound, infection can begin, the characteristic signs of infection are:
- the navel "gets wet", that is, it has high humidity and does not heal,
- purulent discharge comes out of the navel,
- unpleasant or unnatural odor from the navel,
- the skin around turns red.
If you have at least one of the above symptoms, you should consult a doctor and refuse self-medication.
Young parents are especially worried in the early days of their newborn. How to give the baby everything you need and at the same time not to fall tired of yourself - read in our article.
The rules for caring for a child in 1 month of life are here. In fact, everything is not as complicated as it might seem at first glance.
Newborn navel care at home
So that everything goes without complications, you need to learn a few simple rules for caring for your belly button, namely:
- Try to provide free access to the umbilical cord air, which is the best means for its normal drying. Here you can recall that air baths for several minutes will be useful for the baby's butt.
- Make sure that the diaper does not rub the umbilical cord. To do this, hold the diaper just below the belly button or use disposable diapers with an opening for the umbilical cord.
- No need to help the umbilical cord fall off, this should happen naturally. It was previously advised to wipe the umbilical cord with liquids containing alcohol. However, modern studies have proved that this is not necessary, the drying process of the umbilical cord can be accelerated only by increasing the time it takes to expose it to air.
- After surgical cutting off or falling off of the umbilical stump for several days in the umbilical wound, transparent yellowish or bloody crusts may form. They should be removed from the wound, as this is an excellent medium for the propagation of pathogenic microbes. To do this, use hydrogen peroxide. Using a pipette, pour a little peroxide on the crusts and pat them with a cotton swab or gauze. Repeat the procedure several times until the wound is cleaned or until the crusts are easily separated. Remove them with careful movements with a cotton swab, and then grease the wound with an antiseptic solution (brilliant green). A similar procedure should be carried out 1-2 times a day.
You should not try to change the shape of the navel by applying coins or fixing the desired shape with a band-aid. This can cause various complications in the future. It will be better for your baby if you leave the navel as it was created by nature.
We are of the opinion that while the remains of the umbilical cord still remain in the newborn baby, it is better not to bathe him in the bath (so as not to immerse the umbilical cord in water) and limit yourself to washing only certain parts of the body with water or rubbing the baby’s skin with a damp sponge. When the umbilical wound heals, you can start bathing the baby in the bath or adult bath.
It is important not to miss the infection of the navel: this is especially true in the first weeks of your baby’s life. Be sure to consult your pediatrician in the following cases:
if after the umbilical cord disappears, the baby remains swollen in the umbilical region, moderate discharge from it continues for a long time, the umbilical ring does not contract for a long time, if you find that the area around the umbilical cord has turned red and swollen, if pus is released, an unpleasant odor has appeared. Redness of the skin around the navel can be caused by rubbing it. Try to eliminate the cause of rubbing and see if the redness disappears. If it remains or has increased, consult a doctor.
Sometimes in the first days of life, the navel may bleed a little. Treat the bleeding area with hydrogen peroxide, and if bleeding does not stop after 5-7 minutes, you should immediately consult a doctor.
If you notice that the baby in the umbilical ring has a protrusion of a round or oval shape, increasing with the cry of the child, most likely this is an umbilical hernia. In this case, the baby also needs a pediatrician consultation.
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When it fell away
Once the umbilical cord has disappeared, the treatment of the umbilical wound should be mandatory and daily. For some time after the mummified residue of the umbilical cord with the brace of the child falls out, you should leave it in a supine position with an open tummy so that the wound dries out a little.
In the future, it is important to ensure that the diaper does not cover it, and the clothes are comfortable.
Parents should understand that a small amount of blood in the umbilical wound, as well as the formation of crusts in it, is a normal and natural phenomenon. Do not try to tear off these crusts at all costs. To process the wound you will need:
- cotton pads,
- cotton buds,
- Zelenka (1%)
- hydrogen peroxide (3%),
- antiseptic for the treatment of adult hands.
With clean, washed, without a long manicure hands, treated with an antiseptic, mom should carefully push the edges of the wound and drip a few drops of hydrogen peroxide inside with a pipette. Make sure that the peroxide is not cold, otherwise the baby will be unpleasant, he will worry and cry during the procedure. The optimal temperature of all medicines for navel processing is room temperature.
A cotton swab carefully removes excess peroxide. After 30-40 seconds, you can begin to clean the wound. With a cotton swab dipped in hydrogen peroxide, carefully remove the crusts and other contents of the wound. After this, the wound should be allowed to dry a little and after a couple of minutes you can proceed to instill the greenback. It is collected in a pipette and 1-2 drops are dropped directly onto the wound.
You need to bathe the child after the wound has healed. Usually this process ends by the 20th day of birth, that is, at the age of three weeks, the baby may well bathe. Prior to this, from the moment the umbilical cord falls off, the baby is wiped with wet wipes moistened with a diaper soaked in warm water, avoiding water entering the unhealed umbilical wound.
Signs of infection
You should call a doctor if the umbilical wound begins to fester, if a greenish or yellowish thick liquid with an unpleasant odor is released from it, if the space around the navel is inflamed, swollen, reddened and causes unpleasant sensations to the baby when touched.
In this case, after consulting a doctor, additional manipulations associated with the use of antibiotics are prescribed - locally in the form of ointments or systemically, if the inflammation is severe.
You will learn more about the rules for processing the umbilical cord in a newborn from the following video.
medical observer, specialist in psychosomatics, mother of 4 children
How to dress and how to lay a newborn whose umbilical wound has not yet healed
Clothing. There are no special warnings in terms of clothes - all children's clothes are made, as a rule, from natural fabrics. Therefore, even a “packaged” in five clothes, the baby will receive his portion of the air necessary for the healing of the umbilical wound. The only thing - make sure that the elastic band from the panties (if you put them on your baby at all) does not touch the navel area.
Diapers. Nowadays, many manufacturers of diapers offer special models for newborns for their customers - some have a "low waist", others have a special notch in the navel area. But even the most ordinary diaper, in principle, does not threaten an unhealed umbilical wound, provided that you do not fasten it too tightly.
Sleep on my stomach. Many parents are worried about whether it is possible to lay the newborn on the stomach if the umbilical wound is still wet and has not healed. Can. Even in this position, air easily penetrates the skin, drying the navel. But another thing is that sleeping on the stomach for infants up to a year (including for newborns) is not desirable in itself - it can create the conditions for the emergence of a terrible and yet obscure syndrome of sudden infant death in a dream.
Three weeks later, the wound should completely heal. If in doubt whether the desired effect has been achieved, consult a pediatrician. He will promptly tell whether it is still worth continuing the daily treatment of the umbilical wound, or whether your baby has already successfully outgrown the status of a newborn.
What to do with the dropped cord
This question will not be solved for you. If you believe in folk signs, then:
- putty on the mummification in the doorway,
- put it in your baby’s pocket
- dig in
- hang on a tree
- place under a jar of grain,
- after 6-7 years, hide in the school bag,
- or do with him what you think is the most prudent.
In fact, nothing depends on the location of the mummified umbilical cord: neither mental ability, nor physical strength, nor future well-being. But your communication, constant support and love really can work wonders.
Possible pathological processes in the navel
Omphalitis is an inflammatory process in the tissues of the navel. He can be:
- catarrhal (with weakly expressed infiltration by immune cells), manifested by redness, swelling, a slight increase in local temperature, weak soreness,
- phlegmonous (with severe infiltration and the release of copious amounts of exudate), in which the skin acquires a dull gray-green hue, the navel in the newborn festers, becomes sharply painful, and the general body temperature rises,
- gangrenous (with the necrosis of tissues impregnated with pus), which differs from phlegmonous also with a fetid odor.
Omphalitis is treated depending on the stage - from hypertensive dressings to antibiotics and immunostimulants.
Fungus - the healing of the umbilical wound is not primary, as it should be, but secondary tension. That is, through the stage of granulation. At the same time, young granulation tissue grows, which protrudes above the surface of unchanged skin. This process does not bring much discomfort to the baby, and is a purely aesthetic problem, since in the future granulations mature and coarsen. They are also disposed of in different ways: small granulations are cauterized with lapis, massive growths are removed surgically.
Umbilical hernia is a physical defect associated with the expansion of the umbilical ring and does not depend on the processing conditions of the navel. At the same time, during straining, coughing, crying or crying under the skin in the umbilical region, a loop of intestines protrudes. With the training of the press, the weak spot in the anterior abdominal wall is gradually tightened, but sometimes medical intervention, even surgery, is required. If a hernia is suspected, you should contact a pediatrician, and in no case try to “treat” it yourself with a coin or other hard objects.
Useful video and conclusion
The umbilical cord leaves on its own in 5-10 days, but the umbilicus heals much longer. For processing, it is advisable to use hydrogen peroxide, brilliant green or chlorophyllipt, or chlorophyllong, while you can not be afraid to touch the wound. It is necessary to keep the wound and the area around it clean, and for this you can not cover the place with diapers.
And finally, the authoritative opinion of Dr. Komarovsky on the rules for caring for the navel:
You can bathe the baby, but before that, the water is disinfected by boiling, it is not recommended to use potassium permanganate. At the first sign of infection, consult a doctor.
Hygiene of a newborn with an unhealed umbilical wound
Until the umbilical wound is completely healed, you must maximize the hygiene of the navel. However, this does not mean that it is necessary to create complete sterility. In no case should you refuse to bathe the newborn during this period or cover the wound with a sterile dressing. Such actions are incorrect.
The navel should always be open, because it will dry faster. While the dressing, especially if it is saturated with secretions that can ooze from the wound, will become a favorable place for the reproduction of bacteria.
Especially stupid will be the rejection of daily bathing for the baby (read the current article: How to bathe a newborn? >>>). This procedure is necessary to maintain the cleanliness of the skin of the newborn, including around the navel, and also helps to cleanse the umbilical wound. It is recommended to use boiled water and add to it a weak solution of potassium permanganate or decoctions of herbs (chamomile, string, nettle), which will contribute to faster healing. Important article: Herbs for bathing a newborn >>>
It is important to show a sense of proportion in the question of how often to process the navel of a newborn. It is enough to do this 2 times a day. Full treatment is recommended in the morning, and in the evening after bathing only lubricate the wound with an antiseptic. If she is constantly bleeding, then such procedures can be carried out 3 times a day.
Important! More frequent treatment with alcohol can lead to a burn on the navel and provoke infection.
Also, until the navel heals completely, you will need to adhere to the following hygiene requirements:
- Before starting to treat the wound, wash and disinfect your hands thoroughly,
- Several times a day, change the sliders and vests, even if they are dry,
- Iron all children's clothes with an iron.
Special attention should be paid to putting on a diaper. His belt should not touch the navel. It is recommended to purchase special models, in which a cutout is made in the front center, or to “correct” ordinary diapers on their own in the same way. You can also wrap the front edge of the girdle out or tuck a blouse into it.
When the umbilical wound heals
The average duration of the process is from 10 days to 2-3 weeks. In addition to hygiene and proper treatment, the healing time also depends on the size of the navel: a large navel heals longer. This is all subject to the initial tension of the wound surface. If complications arise, epithelization may be delayed. Especially dangerous are phlegmonous and gangrenous omphalitis, requiring inpatient treatment.
So, here are all the factors on which how much the navel in a newborn will heal:
- care and hygiene
- resistance of the child's body,
- navel sizes,
- the presence or absence of umbilical hernia.
What to do if a navel is bleeding in a newborn?
Parents who do not know what to do if blood appears on the umbilical wound, initially you need to understand why the navel in a newborn is bleeding.
Sometimes the causes of this phenomenon are simple and understandable. The umbilical wound is bleeding if occurred traumatizationwhen the baby is swaddled, wiped or bathed. The diaper should be put on very carefully until the wound has completely healed. Some mothers too actively clean the wound of crusts, thereby causing injury.
Navel can bleed due to education umbilical granuloma (fungus) If the umbilical cord was thick, after cutting it remains a wide umbilical ring, and it heals for a long time. As a result, granulation grows, and the navel resembles a mushroom in its shape. This formation is painful, and even with swaddling, hooking it, you can provoke the appearance of pain. And even after a minor injury, the umbilical wound in this case begins to bleed.
If blood appears from the umbilical wound, proceed as follows:
- If blood appeared due to careless handling of the wound, you need to drip a few drops of hydrogen peroxide on the umbilical wound.
- No need to put the baby on his stomach.
- Air should be accessible to the navel.
- During the period when the umbilical wound is bleeding, you can not bathe the baby. You need to wait until the navel completely stops bleeding, and a crust appears on it.
But it is best to still consult a doctor, show him the baby, provided that blood flows from the wound.
It is especially important to immediately show the child to the pediatrician if he not only has an umbilical wound, but his general condition has worsened. In such a situation, it is better to urgently go to the hospital or call an ambulance.
What to do if a newborn's belly button is festering?
If the navel of a newborn does not heal for a long time, special attention should be paid to this. When the so-called wet navel is noted, this indicates the first stage omphalitis- The inflammatory process of the umbilical wound. During this period, the navel does not fester yet, however, a serous discharge of a light color appears from the wound, and the skin around it turns a little red. In this case, the baby feels fine.
In such a situation, local treatment is practiced - you must first disinfect the navel with hydrogen peroxide, and then treat it with brilliant green. This procedure should be repeated 3-4 times a day.
In some cases, additional use is indicated. ultraviolet radiation. If the navel in a newborn dries, the use of ointments or powders containing antibiotics. Treatment of a weeping navel in a newborn involves the use of Baneocinointments containing bacitracin and polymyxin.
Provided that the inflammation has not been stopped in a timely manner, the wound may begin to appear pus. In such a situation, the umbilical ring turns red, swelling appears. Gradually, the navel turns out, the skin on it and nearby becomes hot and red. With omphalitis, body temperature rises, the child is capricious a lot, reluctantly takes his chest, becomes lethargic.
In this case, it is very important to immediately consult a doctor and ensure the correct treatment. Otherwise, pus will begin to spread into the subcutaneous tissue, go to other organs, which can subsequently lead to development sepsis.
Such babies undergo treatment in inpatient departments of the pathology of newborns. They are definitely prescribed antibacterial treatment.
If the baby’s temperature is very high and there are signs of severe intoxication, the baby can be administered intravenously with the necessary medications.
Sometimes after seeding for sterility, the presence of staphylococcus in the umbilical wound. In this case, the treatment is applied antistaphylococcal immunoglobulin.
It is necessary to treat the inflamed areaantiseptic agentsby doing this several times a day.
Provided that the body temperature has stabilized, you can carry out physiotherapy, namely - microwave.
Thus, you need to be very careful about the wound until the navel heals.
Parents should not exert extra effort to speed up the healing process. Let everything happen by itself.
It is important to remember that the navels in babies are very different.In some children they are in-depth, in others they bulge. You should not practice any actions to change the form, since such actions can provoke irritation and the inflammatory process.
In general, caring for an umbilical wound is not difficult, the main thing is to strictly follow all the recommendations and not rush things.
Education: She graduated from the Rivne State Basic Medical College with a degree in Pharmacy. She graduated from Vinnitsa State Medical University. M.I. Pirogov and an internship based on it.
Experience: From 2003 to 2013, she worked as a pharmacist and manager of a pharmacy kiosk. She was awarded letters and distinctions for many years of conscientious work. Articles on medical topics were published in local publications (newspapers) and on various Internet portals.