Baby bellybuttons: What's that drainage?

February 24, 2017 Robert L. Weinsheimer, MD


Fairly often, I see infants of worried parents in my pediatric surgery office to investigate the cause of bellybutton drainage.  Fortunately, it’s almost always a simple issue, but sometimes it’s the tip of a very interesting iceberg!

The typical umbilical cord naturally separates from a newborn’s bellybutton (umbilicus), and the area heals nicely over the following several days.  If there’s persistent drainage, there are four possible causes.  

A sign of healing: granuloma

Far and away, the most common cause is due to something called a granuloma.  This is simply the body’s attempt to heal the area. But instead of a dry scar forming, the body creates granulation tissue to seal the opening. 

Granulation tissue has a moist, red appearance and often secretes some mucus. If flat, this tissue can be treated with a topical medicine such as silver nitrate.  If protruding on a stalk, granulation can be simply tied off with a suture and allowed to fall off over the next couple of days, creating a normal-looking bellybutton. 

A true emergency: omphalitis

Uncommonly, bellybutton drainage can reflect something more serious.  If there is pus (creamy, often yellow or white in color) seeping out, spreading redness and fever, this represents an infection of the area called omphalitis. This is a true emergency and needs immediate medical attention. 

Conditions involving the bladder, intestines

Drainage also can mean that a connection between the mother and the fetus didn’t close properly. Interestingly, aside from blood vessels that exit a fetus’ body, the umbilical cord also has connections to the fetus’ bladder and intestines!  

If either of these connections remains open, surgery is necessary. The drainage would look like pee (urine) in the case of the connection to the bladder (urachus). In the case of the intestines, (patent omphalomesenteric duct), the drainage would look like poop (stool).

Surgeries in both cases have a very high success rate and a low risk of complications.

So, next time someone makes light of a bellybutton, be sure to educate them about all that passes through this little area!

If you have concerns about your child’s bellybutton, talk to a Swedish pediatrician or call Pediatric Specialty Care Services. You can reach both departments at 1-800-793-3474.

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