Arch Iranian Med 2006; 9 (1): 33 – 38 Archives of Iranian Medicine, Volume 9, Number 1, January 2006 33 THE EFFECT OF TOPICAL APPLICATION OF HUMAN MILK, ETHYL ALCOHOL 96%, AND SILVER SULFADIAZINE ON UMBILICAL CORD SEPARATION TIME IN NEWBORN INFANTS Mousa Ahmadpour-Kacho MD • , Yadollah Zahedpasha MD, Karimollah Hajian MD, Ghasem Javadi MD, Hamid Talebian MD Background: Several agents have been used for neonatal umbilical cord care, but we did not find any study evaluating the effect of human milk on umbilical cord separation time. The purpose of this study was to compare the effect of topical application of human milk, ethyl alcohol 96%, and silver sulfadiazine on umbilical cord separation time in newborn infants. This study was undertaken place at a primary-level newborn nursery at a university teaching hospital and a private hospital. Of 373 singleton near- to full-term newborns enrolled in the study, 312 completed the study. Methods: Newborns from birth were randomized to either: 1) mother's milk group, 2) alcohol group, 3) silver sulfadiazine group, and 4) control (no treatment) group. Mother's milk for group 1, ethyl alcohol for group 2, and silver sulfadiazine ointment for group 3 were applied to the umbilical stump three hours after birth and continued every eight hours until two days after umbilical cord separation. The time to umbilical cord separation and any discomfort such as infection, hemorrhage, and granuloma formation were reported by mothers. Nothing was applied to the umbilical stump of the control group and they received dry cord care only. Results: It was observed a significant difference in the mean cord separation time among the four group. No significant complications were observed in any group. Conclusion: Breast milk could be substituted for other topical agents for umbilical cord care, but a multicenter study is required in order to advise it for routine umbilical cord care. Archives of Iranian Medicine, Volume 9, Number 1, 2006: 33 – 39. Keywords: Breast milk • ethyl alcohol • newborn • silver sulfadiazine • umbilical cord Introduction he umbilical cord is an important site for bacterial colonization. 1 A possible consequence of bacterial colonization is cord stump infection, a factor that can greatly increase morbidity and mortality for infants in developing countries. 2 Because the vessel in the umbilical cord serves as a direct entry site for invasion of pathogenic microorganisms into the circulation of newborn babies, delays in cord detachment may increase risk of bacterial infection. For this reason, umbilical cord care seems to be very important. In 1998, the World Health Organization (WHO) established umbilical cord care recommendations at birth and after discharge from the hospital that are currently being observed in developed countries. 2 Although the American Academy of Pediatrics considers no antiseptic treatment to be superior to any other, they confirm its utility. 3 Although application of a topical antimicrobial to the cord stump after cutting the cord once a day for the first Original Article T Authors’ affiliation: Department of Pediatrics and Neonatology, Babol University of Medical Sciences, Babol, Iran. •Corresponding author and reprints: Mousa Ahmadpour-Kacho MD, Department of Pediatrics and Neonatology, Neonatal Intensive Care Unit (NICU), No. 19, Amirkola Children’s Hospital, Amirkola 47317- 4 115 1, Babol, Iran. Fax: +98-111-3240656, E-mail: mousa_ahmadpour@hotmail.com. Accepted for publication: 13 June 2005