Umbilical granuloma

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Counseling

The area may turn gray or black for a few days after treatment, which is expected. Recommended supportive care with an emphasis on keeping the area clean and dry and folding the diaper below the belly button. Return precautions given including redness spreading around the belly button, fever, poor feeding, drainage of urine or stool, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

The surgeon will look for a connection that has not closed, which is usually fixed with a small procedure. Recommended supportive care with an emphasis on keeping the area clean and dry. Return precautions given including redness spreading around the belly button, fever, poor feeding, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for emergency evaluation today, and the caregiver will take the baby now. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Umbilical granuloma
• Small, moist, pink umbilical granuloma without surrounding redness
• Treated with silver nitrate without complication
• Follow up in 1 week if not resolved

The area may turn gray or black for a few days after treatment, which is expected. Recommended supportive care with an emphasis on keeping the area clean and dry and folding the diaper below the belly button. Return precautions given including redness spreading around the belly button, fever, poor feeding, drainage of urine or stool, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Granuloma vs drainage vs omphalitis
Silver nitrate; repeat; surgery; ED

Return precautions in the template

redness spreading around the belly buttonfeverpoor feedingdrainage of urine or stool

Sources

AAP Clinical Practice Guideline for Diagnosis and Management of Faltering Weight. Pediatrics 2026;157(4):e2025075764
AAP Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics 2022;150(1):e2022057988. Recommendations read
Thomas J et al; AAP Section on Breastfeeding. Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants: Clinical Report. Pediatrics…
Shaw BA, Segal LS; AAP Section on Orthopaedics. Evaluation and Referral for Developmental Dysplasia of the Hip in Infants. Pediatrics 2016;138(6):e20163107.…
Krowchuk DP et al. Clinical Practice Guideline for the Management of Infantile Hemangiomas. Pediatrics 2019;143(1):e20183475. Highlights and selected KAS read
AAP Clinical Report: Prevention and Management of Positional Skull Deformities in Infants (Laughlin, Pediatrics 2011;128(6):1236). Retired February 2018 (not…

Few formal guidelines cover this topic, so the template also leans on expert opinion.