Chlorhexidine Technical Brief: Umbilical Cord Cleansing Saves Newborn Lives

Summary

Background

Each year 3.1 million newborns die globally, and infection causes more than one third of these deaths. In resource poor, high mortality settings, infections can account for over half of all neonatal deaths. Lack of hygiene and antisepsis at birth and in the first week of life increases the risk of deadly but preventable infections. While the World Health Organization (WHO) guidelines recommend clean and dry umbilical cord care, they also include application of topical antiseptics to the cord stump in areas with high infection risk as acceptable. 

Recent community‐based randomized trials in rural areas in Bangladesh, Nepal and Pakistan have shown that applying 4% chlorhexidine (7.1 % chlorhexidine digluconate) to the umbilical cord stump prevents infection and saves newborn lives. These trials and concurrent research support chlorhexidine cord cleansing as an efficacious, acceptable, feasible and cost‐effective newborn care intervention.

This brief outlines the key evidence from trials in Bangladesh, Nepal and Pakistan, discusses acceptability and feasibility of this intervention as well as delivery strategies and cost.

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