'Stumped' by the newborn umbilical cord

The Outcome of Salt Treatment for Umbilical Granuloma: A Systematic Review

BACKGROUND

An umbilical granuloma is one of the common umbilical masses in young children which appears after the cords fall off, mainly due to an inflammatory reaction to subclinical infections. Though there are different recommendations of treatment modalities, which management modality is the best is not clear yet.

OBJECTIVE

This systematic review aimed to assess the effectiveness of salt treatment in terms of complete resolution of the granuloma, any adverse effect, and any recurrence risk in those patients treated as inpatient or outpatient care.

METHODOLOGY

The literature search was done using search engines including Google scholar, PubMed, and Medlin. Articles published since 1990 and written in the English language with a target population of young children (less than 24 months) were included. To retrieve the articles, umbilical granuloma, treatment of umbilical granuloma, salt treatment, and neonatal umbilical disorder were used as keywords.

RESULTS

This systematic review indicated that the majority of the studies done on salt treatment for umbilical granuloma show excellent response (complete resolution of the granuloma/discharge) with no adverse effect and no recurrence in the subsequent follow-up of the patients in almost all cases of the treatment group. Salt inside the occluded hyperosmolar chamber causes shrinkage of granuloma by a desiccant effect.

CONCLUSION

Cooking salt treatment for umbilical granuloma is effective, cheap, available, and easy to apply by non-health professionals. No side effects have been reported yet and a recurrence of the granuloma after treatment seems to be null.

Common parenting misconceptions regarding infant care: setting the record straight for parents (and some pediatricians)

PURPOSE OF REVIEW

First-time parents often turn to friends and family for advice regarding feeding, sleeping, bathing, diapering and toilet training, and childhood illnesses. Unfortunately, parents may at times be given incorrect and potentially dangerous advice as several widely embraced parenting practices are no longer deemed appropriate. In addition, young children are cared for by family and friends - many of whom are older and may still subscribe to outdated parenting practices.Parents and grandparents are not the only ones who subscribe to child care myths and misconceptions. Pediatricians also believe in the effectiveness of some outdated child care practices. Although some of these parenting myths are relatively benign, others may indeed pose a significant health risk or safety hazard to a young child. The purpose of this article is to review 10 commonly held myths or misconceptions regarding infant care.

RECENT FINDINGS

In this review article, we not only highlight many of the studies that document which outdated health beliefs are still endorsed by parents and/or pediatricians, but also review the specific health risks associated with these parenting myths or misconceptions.

SUMMARY

It is important that pediatricians educate parents and other primary caregivers about the potential risks of following outdated parenting practices.

"Nailing" the management of the ingrown great toenail

"Nailing" the management of the severely ingrown great toenail, commonly encountered in the adolescent population, is an important tool in the pediatrician's armamentarium. I have found great toenail removal to be worthwhile, with straightforward indications; and quite rewarding for my patients in terms of time, convenience, and costs. The key to the procedure is to keep it simple. Four basic vital steps are involved: (1) operative permit and explanation; (2) performing a careful complete digital nerve block; (3) removing the entire toenail; and, importantly, (4) performing a partial chemical matricectomy--with readily available silver nitrate sticks--to prevent frequent recurrences.