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 isn't 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 doesn't close, tissue may bulge through the opening, creating a hernia.

Experts don't know why the hole sometimes doesn't close.

What are the symptoms?

An umbilical hernia can usually be seen after the umbilical cord stump falls off, within a few weeks after birth. But some children don't get a hernia until they're a little older.

When a child has an umbilical hernia:

• You may notice a soft bulge under the skin of the belly button.
• The doctor can 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 1 in. (2.5 cm) across. Most children don't feel pain from the hernia.

Talk to your doctor if your child is vomiting, has pain, or has a swollen belly.

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.

The doctor will want to check your child regularly to see if the hernia has begun to close. Be sure to bring your child in for these checkups.

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 shown any signs of closing by age 2.
• The way the hernia looks bothers you or your child.

If your child has pain, a swollen belly, or other signs that a part of the intestine is trapped in the hernia (incarcerated hernia), surgery will be needed right away. This problem is very rare.

Surgery to repair the hernia usually is an outpatient procedure, which means that your child can go home the same day the surgery is done. Sometimes more surgery may be done to improve how the belly button looks (for instance, if the hernia was very large or there was a lot of extra skin).

Problems from umbilical hernia repair are rare. Your child's doctor can tell you what to expect and what to watch for. Be sure to go to all follow-up exams so the doctor can make sure your child is healing well.