What is an Umbilical Granuloma?
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
An umbilical granuloma is a moist, fleshy lump of excess tissue in the center of a baby's belly button that forms when the skin does not properly close after the cord stump falls off. It may ooze or bleed slightly but is not painful. It is usually treated with silver nitrate or tied off, since untreated it raises infection risk. [1]
What the research says
Umbilical granulomas are common, and most heal with first-line treatment. In a Japanese hospital study of 6,680 newborns, 395 (5.9%) had an umbilical granuloma, and the yearly rate ranged from 3.8% to 7.3%. Gestational age, birth weight and meconium-stained amniotic fluid were associated with granulomas. Healing rates during the initial treatment period were 91% with silver nitrate, 97.7% with topical betamethasone, 88% with ligation and 60% with ethanol disinfection (Iijima, Journal of Clinical Medicine, 2023). [2]
Topical steroid ointment healed granulomas about as often as silver nitrate. In a randomised trial of 207 newborns, healing after 2 weeks was 87.5% (91/104) with silver nitrate and 82% (82/100) with steroid ointment; after 3 weeks it was 91.0% with silver nitrate and 90.4% with steroid ointment. The trial did not formally prove non-inferiority of the steroid, and no major complications occurred in either group (Ogawa et al., PLoS ONE, 2018). [3]
Table salt appears effective in small studies, but the evidence is limited, so ask your pediatrician first. A scoping review of 24 articles (including 6 randomised controlled trials) found an overall success rate of 93.91% (1,033 of 1,100) with common salt, with no reported complications or recurrences. The authors noted a lack of well-designed randomised trials (Banerjee et al., Journal of Pediatric Surgery, 2023). [4]
Key Takeaways
Feature | Details |
Medical Name | Umbilical Granuloma |
Prevalence | 4% to 7% of all newborns |
Primary Cause | Overgrowth of granulation tissue during healing |
Defining Symptom | Moist, pink/red lump in the belly button |
Pain Level | Asymptomatic (no pain for the baby) |
Common Treatment | Silver nitrate application or ligation |
Recovery Time | Usually 1 to 2 weeks with treatment |
Risk of Infection | Low with timely treatment; higher if left untreated |
Understanding Umbilical Granulomas
The transition from an umbilical cord to a healed belly button is a natural process that typically takes about two weeks. However, in some newborns, an umbilical granuloma forms. This is a small, soft, and moist lump of excess tissue that remains after the cord stump has fallen off.
While the appearance of a red or pink lump in a baby’s belly button can be alarming, it is important to know that these granulomas are not tumors and are not painful. They are simply an overgrowth of "granulation tissue," which is the same type of tissue the body uses to heal other wounds.
Symptoms and Appearance
Umbilical granulomas are generally easy to identify during routine baby care. They typically appear within the first few weeks of life and have several characteristic features:
Color: They are usually bright pink, red, or slightly darker than the surrounding skin. [1]
Texture: The tissue is soft, fleshy, and often moist or wet to the touch. [1]
Discharge: A clear or yellowish mucus may ooze from the lump, which can sometimes lead to a mild, unpleasant odor.
Size: They are small, ranging from the size of a crayon tip (3mm) to the size of a green pea (10mm). [1]
If you notice that the lump is accompanied by significant redness spreading to the surrounding skin, warmth, or if the baby seems in pain, it could indicate a secondary infection that requires immediate medical attention. [1]
Causes and Risk Factors
The exact reason why some babies develop granulomas while others do not is not fully understood. However, the mechanism involves a delay in the skin-closing process. After the cord falls off, the body produces granulation tissue to fill the gap. If new skin cells do not grow over this tissue quickly enough, the tissue continues to grow, forming a granuloma. [1]
Several factors may increase the likelihood of a granuloma forming:
Prematurity: Babies born early or with low birth weights are at higher risk. [1]
Delayed Cord Detachment: If the umbilical cord stump takes longer than two weeks to fall off.
Excess Moisture: Keeping the belly button area wet or covered by a diaper can encourage tissue overgrowth.
Environmental Factors: The presence of foreign objects or frequent irritation of the area.
Granuloma vs. Umbilical Hernia
It is common for parents to confuse a granuloma with an umbilical hernia, but they are very different conditions.
Feature | Umbilical Granuloma | Umbilical Hernia |
Description | Excess tissue on the surface. | Bulge caused by intestines under the skin. |
Appearance | Moist, red/pink, and fleshy. | Skin-colored bulge that may pop out when crying. |
Treatment | Requires medical treatment to remove. | Usually resolves on its own without treatment. |
Pain | Painless. | Painless, unless the hernia is "strangulated." |
Treatment and Management
Unlike a hernia, an umbilical granuloma will not go away on its own and requires professional treatment to prevent infection. [1]
Professional Medical Treatments
Silver Nitrate: This is the most common treatment. A pediatrician applies a small amount of silver nitrate to the granuloma using a wooden applicator. This chemical cauterizes the tissue, causing it to shrink, turn black, and eventually fall off. [1]
Ligation: If the granuloma has a distinct stalk, the doctor may tie it off with surgical thread. This cuts off the blood supply, causing the tissue to shrivel and detach. [1]
Topical Steroids: In some cases, a prescription steroid cream may be used to reduce the tissue growth. [1]
Home Care Tips
While you wait for your medical appointment, you can take steps to manage the area:
Keep it Dry: Expose the belly button to air as much as possible. [1]
Diaper Placement: Fold the top of the diaper down so it sits below the belly button. [1]
Cleaning: Gently wipe away discharge with a damp cloth, but always pat the area thoroughly dry afterward. Avoid using alcohol, as it can irritate the skin and delay healing. [1]
Conclusion
An umbilical granuloma is a minor hurdle in the first weeks of a newborn’s life. With a simple, painless procedure from a healthcare provider, the tissue typically heals within a week or two. By keeping the area dry and following your pediatrician’s advice, your baby’s belly button will soon be perfectly healed.
For more information on infant health and visual care guides, explore Rinnit's infographic templates.
Frequently Asked Questions
Is an umbilical granuloma a sign of a serious health problem?
No, it is a localized overgrowth of healing tissue and is generally not serious if treated promptly.
Does silver nitrate hurt the baby?
No, the granuloma tissue does not have nerve endings, so the application of silver nitrate is painless.
Can I use salt at home to treat it?
Some doctors recommend salt treatments, but you should only do this under the specific guidance of your pediatrician.
What happens if I don't treat the granuloma?
It may continue to grow, ooze fluid, and eventually become infected, which can lead to serious complications.
Why does the area turn black after silver nitrate?
Silver nitrate causes the tissue to cauterize and die; the black color is a normal part of that process.
Can a granuloma cause a fever?
A granuloma itself does not cause a fever, but a fever could indicate that the area has become infected.
How long does the silver nitrate treatment take to work?
Most granulomas heal after one to three applications, usually within a week or two.
Is it okay if the granuloma bleeds a little?
Minor spotting or bleeding is common if the tissue is rubbed by a diaper or clothing.
Can I give my baby a bath with a granuloma?
You can, but it is better to stick to sponge baths until the area is fully healed to keep it as dry as possible.
Does a granuloma affect the shape of the belly button?
Once healed, it typically does not have a permanent effect on whether the baby has an "innie" or an "outie."
Can a granuloma come back after treatment?
It is rare, but if the tissue isn't fully removed, it can regrow and require another treatment.
What is omphalitis?
Omphalitis is a potentially serious bacterial infection of the umbilical stump and surrounding skin.
Is the discharge from a granuloma contagious?
No, the fluid is a byproduct of the healing tissue and is not contagious to others.
Can I put a bandage over the granuloma?
It is generally better to leave it uncovered to allow air circulation, unless your doctor tells you otherwise.
How do I know if the granuloma is infected?
Signs of infection include spreading redness, warmth, swelling, pus, a very bad smell, or the baby seeming in pain.
Can a granuloma form months after birth?
No, they almost always appear within the first few weeks after the umbilical cord falls off.
Is there a way to prevent granulomas?
Keeping the umbilical stump dry and clean is the best way to encourage proper healing.
Does alcohol help dry out a granuloma?
Doctors now recommend against using alcohol on the umbilical area, as it can actually delay the healing process.
What is necrotizing fasciitis?
It is a very rare but severe "flesh-eating" bacterial infection that can start in an infected belly button.
Can a granuloma be caused by a dirty diaper?
While moisture and bacteria from a diaper can contribute to infection, the granuloma itself is caused by a healing abnormality.
Should I try to pull the granuloma off?
Never attempt to pull or cut the tissue yourself; this can cause severe bleeding and infection.
What if the silver nitrate gets on the surrounding skin?
Silver nitrate can cause a temporary gray or black stain on healthy skin, which will eventually wear off.
Is a granuloma the same as a "true knot"?
No, a true knot is a physical knot in the umbilical cord itself, which happens before birth.
Can breastfeeding prevent granulomas?
There is no known link between breastfeeding and the prevention of umbilical granulomas.
Are boys or girls more likely to get them?
They affect both male and female infants equally.
What is "granulation tissue"?
It is new connective tissue and tiny blood vessels that form on the surface of a wound during the healing process.
Does the size of the granuloma matter?
Larger granulomas might require more treatments or a different method like ligation, but the outlook is the same.
Can a granuloma cause the baby to be fussy?
Since they are painless, a granuloma shouldn't make a baby fussy unless it has become infected.
What is ligation?
It is a procedure where a doctor ties a piece of thread around the base of the tissue to stop blood flow.
How common is omphalitis?
It is very rare in developed countries with good newborn care, but it is a serious condition when it occurs.
Can I use antibiotic ointment on a granuloma?
You should only use ointments if they are specifically prescribed by your pediatrician.
What if the cord stump is still there after 3 weeks?
If the cord hasn't fallen off after 3 weeks, you should consult your pediatrician.
Does a granuloma smell bad?
A mild odor is common due to the moisture, but a very strong, foul smell can be a sign of infection.
Can a granuloma be misdiagnosed as a tumor?
While they look like small growths, pediatricians can easily distinguish them from more serious conditions.
What is meconium?
It is a baby's first stool; if it stains the amniotic fluid, it may be a risk factor for cord issues.
Can a granuloma cause permanent scarring?
Once treated and healed, they typically leave no permanent scar or mark.
Is the silver nitrate stick like a match?
It looks like a long wooden match with a chemical tip that is activated by moisture.
Can I use a "belly band" on the granuloma?
No, these can trap moisture and irritate the tissue; it is best to keep the area open to the air.
What if the granuloma doesn't turn black?
If it doesn't respond to silver nitrate, your doctor may try a different treatment method.
Is a granuloma related to the baby's diet?
No, the baby's nutrition does not play a role in the formation of a granuloma.
Can a granuloma cause the belly button to bleed?
Yes, minor bleeding is one of the common symptoms, especially if the area is irritated.
How do I clean the area after treatment?
Follow your doctor's instructions, which usually involve keeping it dry and gently wiping away any black residue.
Can a granuloma affect the baby's internal organs?
No, a granuloma is strictly a surface tissue issue and does not connect to the inside of the body.
Is the ligation thread left in place?
Yes, the thread stays on until the tissue dies and falls off, which usually takes a few days.
What if the baby has a fever and a granuloma?
Contact your pediatrician immediately, as this could be a sign of an infection spreading from the belly button.
Can a granuloma be caused by the way the cord was cut?
No, the way the cord was clamped or cut at birth does not cause granulomas.
Is silver nitrate safe for newborns?
Yes, it is a standard medical treatment that has been used safely for many decades.
Can I wait until the next checkup to treat it?
It is best to call your pediatrician when you first notice it, rather than waiting weeks for a scheduled visit.
Does a granuloma mean the cord was infected?
Not necessarily; it is usually just a variation in the normal healing process.
What is the success rate of treatment?
The success rate is extremely high, with almost all granulomas resolving quickly after medical intervention.
Related Reading
Omphalitis Guide: Understanding and Treating Umbilical Cord Infections in Newborns explains the signs of an infected umbilical cord stump.
The Umbilical Cord: Function, Anatomy, and Newborn Care covers how to care for a newborn's cord stump.
Umbilical Hernia in Babies and Adults: When It Closes on Its Own and When Surgery Is Needed explains belly button bulges and when they need treatment.
Understanding the Navel: Anatomy, Function, and Care of the Belly Button describes how the belly button forms and how to keep it clean.
References
Cleveland Clinic. Umbilical Granuloma: Causes & Treatment. Cleveland Clinic Health Library. Last updated April 29, 2026. https://my.clevelandclinic.org/health/diseases/umbilical-granuloma
Iijima S. Umbilical granuloma: frequency, associated factors, 10-year treatment trends, and effectiveness at a single hospital in Japan. J Clin Med. 2023;12(18):6104. PMID 37763044. https://doi.org/10.3390/jcm12186104
Ogawa C, Sato Y, Suzuki C, et al. Treatment with silver nitrate versus topical steroid treatment for umbilical granuloma: a non-inferiority randomized control trial. PLoS One. 2018;13(2):e0192688. PMID 29438425. https://doi.org/10.1371/journal.pone.0192688
Banerjee A, Munghate G, Bodhanwala M, et al. Treatment of umbilical granuloma in infants with topical application of common salt: a scoping review. J Pediatr Surg. 2023;58(9):1843-1848. PMID 37024416. https://doi.org/10.1016/j.jpedsurg.2023.03.007
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment.
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