A comprehensive 2026 systematic review found that applying 4.0% chlorhexidine antiseptic to umbilical cords likely reduces neonatal mortality in low- and middle-income countries.
The analysis covered 143,150 newborns across various settings. Chlorhexidine treatment may reduce newborn deaths by approximately three per 1,000 live births and decrease cord infections by 25 per 1,000 live births.
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The antiseptic does delay cord separation by approximately two days, which researchers note as a trade-off. Infections can develop when bacteria colonize the umbilical stump during the natural drying process.
The study indicates chlorhexidine provides the strongest evidence for preventing cord infections and reducing mortality in high-risk settings. In lower-risk environments, clean and dry cord care remains effective.
Researchers recommend considering local infection rates, healthcare availability, and existing newborn practices when implementing antiseptic protocols.