Bibliographic information
GuidelineWHO recommendations on maternal and newborn care for a positive postnatal experience.
Year of Publication2022
Issuing InstitutionWorld Health Organization
Recommendation
Updated
Daily application of 4% chlorhexidine (7.1% chlorhexidine digluconate aqueous solution or gel, delivering 4% chlorhexidine) to the umbilical cord stump in the first week after birth is recommended only in settings where harmful traditional substances (e.g. animal dung) are commonly used on the umbilical cord.
Context specific recommendation
Only in specific contexts
Certainty of evidence
Low
Notes and Remarks
Remarks
- The Guideline Development Group conclusions are based on moderate-certainty evidence about the effects on neonatal mortality of applying 4% chlorhexidine in the first week after birth in newborns with non-hygienic (harmful) cord care. In newborns with non-hygienic cord care, chlorhexidine reduced mortality. In newborns without non-hygienic cord care, chlorhexidine did not reduce mortality.
- The recommendation is based on studies from Asia and Africa with high proportions of home births, low birthweight infants and neonatal mortality, conducted primarily between 2000 and 2010. The prevalence of omphalitis has decreased since that time.