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Umbilical Hernia in Children
Topic Overview
What is an umbilical hernia?
An umbilical hernia happens when intestine, fat, or fluid pushes through a weak spot or hole in your baby’s stomach muscles. This causes a bulge near or in the belly button, or navel. It may look like your child’s belly button is swollen.
Many children have an umbilical hernia at birth. The hernia usually is not painful or dangerous, and it often closes on its own without treatment.
What causes an umbilical hernia?
The ring of muscle and other tissue that forms where blood vessels in the umbilical cord enter a fetus's body is known as the umbilical ring. This ring usually closes before the baby is born. If it does not close, tissue may bulge through the opening, creating an umbilical hernia.
Experts don't know why the hole sometimes doesn't close.
What are the symptoms?
An umbilical hernia is usually seen after the umbilical cord stump falls off, within a few weeks after birth. But some children don’t get a hernia until they are infants or toddlers. Symptoms may include the following:
- You may notice a soft bulge under the skin of your child’s belly button.
- The doctor is able to push part of the bulge back in.
- The bulge may be easier to see when your child sits or stands upright or strains stomach muscles during normal activities such as crying, coughing, or having a bowel movement.
Umbilical hernias can vary in size. They are rarely bigger than about 2 cm (1 in.) across. Most children don't feel pain from the hernia.
Talk to your doctor if your child is vomiting and has signs of infection, such as redness and swelling within the bulge of the hernia.
How is an umbilical hernia diagnosed?
Doctors usually can tell that a child has an umbilical hernia by how the belly looks. If your child has a hernia, your doctor will check its size and shape and see whether the hernia can be pushed back in.
How is it treated?
Umbilical hernias usually close on their own before a baby is 1 year old. If a hernia has not closed by the time your child is 5 years old, your child probably will need surgery to close it.
You may want your child to have surgery before he or she is age 5 if:
- The hernia is large and has not closed by age 2.
- There is another problem, such as an infection.
- The way the hernia looks bothers you or your child.
Do not use folk remedies, such as strapping a coin over the hernia or using a band or a strap to try to make it smaller. These do not help and may make the hernia worse.
Frequently Asked Questions
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Treatment Overview
Almost all umbilical hernias close on their own without treatment, usually by the time the child is 1 year of age. If an umbilical hernia does not close on its own by age 5, surgical repair usually is needed. For more information, see:
Types of surgery that may be done include:
- Umbilical hernia repair. Umbilical hernia repair is the main surgery used for an umbilical hernia that does not correct itself. It is usually an outpatient procedure with low risk. Your child can go home the same day surgery is done. During the procedure, your child is given general anesthesia. A small incision is made just below the navel (umbilicus), and any loops of the intestines and other tissue that have protruded into the hernia sac are pushed back inside the belly. Then the muscles and connective tissues of the umbilical ring are repaired, and the incision is closed, leaving a small scar inside the navel.
- Surgery to improve the appearance of the navel. Sometimes the navel looks abnormal after surgery. This is more likely to occur if the umbilical hernia was very large or if excess skin was over the hernia (proboscoid hernia). In these cases, additional surgical techniques may be used to help improve how the navel looks.
Problems caused by umbilical hernia surgery are very rare but may include:
- Infection.
- Localized swelling caused by the accumulation of fluid at the site of the wound (seroma).
- Bleeding or blood clots at the site of the wound (hematoma).
- Recurrence of the hernia.
- Part of the intestine being injured during surgery.
What to Think About
Surgery to repair an umbilical hernia before a child is 5 years old is usually not necessary. But surgery may be done earlier if:
- The hernia is large [1.5 cm (0.6 in.) or more across] and has not shown any signs of closing on its own by age 2 years.
- The child or the parents want the hernia repaired for social, cosmetic, or other reasons. This may be a consideration if the child has a proboscoid hernia. Some children or their parents may find this type of hernia distressing, or the child may play with or irritate the protrusion of skin.
- Complications, such as a loop of the intestines becoming trapped in the hernia sac (incarceration or strangulation), require emergency surgery.
Last Revised: June 8, 2010
Author: Healthwise Staff
Medical Review: John Pope, MD - Pediatrics & Thomas Emmett Francoeur, MD, MDCM, CSPQ, FRCPC - Pediatrics
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