Background: Infection accounts for 13% of the approximately three million newborns deaths that
occur globally every year. Poor umbilical cord hygiene in the first week of life is a well documented
risk factor that increases the likelihood of neonatal infections. To curb this trend in developing
countries, the World health Organization in 2013 enlisted the use of antiseptic solution as an
essential medicine for cord care.
Aim: This study aims to describe umbilical cord care practices among mothers in Nigeria and its
association with development of fever in newborns in the first month of life.
Methods: This is a population based descriptive study using nationally representative data from
the 2013 edition of the Nigeria Demographic and Health survey (NDHS). For this study, 12113women aged 15-49 years were randomly selected from households using a stratified two-stage
cluster design. Logistic regression and chi-square was used in data analysis.
Results: Unhealthy umbilical cord care was practiced by 27.8% of the respondents. The World
Health Organization and national policy recommendation of cord care was significantly practiced
by older women (P=0.002), literate mothers (P=0.001), mothers with higher educational attainment
(P=0.001), mothers in the higher wealth class (P=0.001), those with access to print and electronic
media (P=0.001), mother who uses hospital based postnatal check-up (P=0.001) and mothers
resident in urban areas (P=0.001). Compared to newborns whose mothers applied nothing to their
umbilical stumps, the odds of developing fever in the first month of life was higher in newborns
whose mothers applied Oil (OR 1.79 CI 0.39-8.87); Ash (OR 3.37 CI 0.09-29.51); Toothpaste (OR
4.10 CI 1.01-16.68); Animal dung (OR 11.01 CI 1.11-111); and Other concoction (OR 2.58 CI 0.30-
22.22) to the umbilical stump and lower in newborns whose mothers applied Methylated spirit or
Chlorhexidine solutions (OR 0.68 CI 0.10-5.6) to the umbilical stump.
Conclusion: The need for proper hygiene of the umbilical cord using the recommended antiseptic
solution must be re-emphasized among health care providers particularly targeting traditional birth
attendants in rural settings. Female education and empowerment which has long been designated
as one of the child survival strategy and also highlighted in this study as a strong determinant of
healthy cord care practices is needed to promote this low cost and highly effective practices
amongst mothers.