The most common cause of an umbilical enlargement or mass in neonates is an umbilical granuloma. It is persistent granulation tissue that remains on the umbilical stump after separation of the cord. This tissue has incomplete epithelialization and is friable tissue that may appear soft and wet. Parents will report continued non-purulent drainage from the umbilicus following cord separation, often noticed on the diaper or clothing. These infants are well appearing without fever, swelling, increased warmth or tenderness. The site should be kept dry and exposed but may also be treated with possible cauterization or topical steroids.