Umbilical cord cleansing with Chlorhexidine

Since 1998, the World Health Organization has recommended promotion of clean and dry cord care for newborn infants, while noting that topical antiseptics may be used where risk of infections is high [1]. A Cochrane review by Zupan et al included 21 trials involving 8959 subjects and covered all types of antiseptics applied to
umbilical cord [2]. All of the included studies were conducted in hospital settings and, with the exception of one
trial from Thailand, in high income countries. There were no systemic infections or deaths, the primary outcomes
considered by the review, in any of the trials. Risk of umbilical cord infection was approximately half as likely when a
topical antiseptic was applied, as compared with dry cord care or placebo, but the combined result did not reach sta-
tistical significance (RR = 0.53; 95% CI 0.35 –1.13). Topical triple dye seemed to be more effective than alcohol (RR=
0.30; 95% CI: 0.19–0.49) or povidone-iodine (RR = 0.15, 95% CI: 0.07–0.32) in preventing cord infection, however
no specific recommendations were made in favor or against of an antiseptic, as the overall evidence was
inconclusive.

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