Umbilical Hernias in Babies and Children: Answers to Common Parent Questions

If you have noticed a swelling at your baby's belly button, you might be wondering what it is and whether you should be concerned.

What is an umbilical hernia?

An umbilical hernia is a condition where part of the intestine protrudes through a weak spot in the belly button. This creates a visible bump under the skin that may get bigger or smaller depending on the pressure in the abdomen. For example, the hernia may become more noticeable when the baby cries, coughs, or strains to poop, and less noticeable when the baby is calm or lying down.

An umbilical hernia is not painful and does not harm the baby. Most umbilical hernias close on their own by the time the child is 4 or 5 years old, without any medical intervention. However, in some rare cases, the intestine may get trapped or twisted in the hernia, which can cause complications such as pain, vomiting, or infection. This is called an incarcerated or strangulated hernia, and it requires immediate medical attention.

What causes an umbilical hernia?

An umbilical hernia is caused by an incomplete closure of the umbilical ring, which is a muscle that surrounds the belly button. During pregnancy, the umbilical cord passes through this opening to bring blood and nutrients to the developing baby. After birth, the umbilical cord falls off and the umbilical ring should close by itself. However, sometimes this does not happen completely, leaving a small gap where the intestine can poke through.

An umbilical hernia is not caused by anything that the mother did or did not do during pregnancy or delivery. It is also not related to how the doctor cut or clamped the cord when the baby was born. Umbilical hernias are more common in premature babies, low birth weight babies, and babies with certain genetic conditions that affect connective tissue.

How is an umbilical hernia diagnosed?

An umbilical hernia can usually be diagnosed by a physical examination of the baby's abdomen. The doctor will look for a bump or swelling near the belly button that changes in size or shape with abdominal pressure. The doctor may also gently try to push the hernia back into place to see if it is reducible (meaning that it can be easily moved) or incarcerated (meaning that it is stuck).

Sometimes, the doctor may order imaging tests such as ultrasound or CT scan to check for complications or other conditions that may cause abdominal swelling.

How is an umbilical hernia treated?

Most umbilical hernias do not need any treatment and will go away on their own by the time the child is 4 or 5 years old. The doctor will monitor the hernia regularly to make sure that it does not cause any problems. There is no need to tape, bandage, or apply pressure to the hernia, as this will not help it close faster and may irritate the skin.

Surgery is only recommended if:

- The hernia does not close by age 4 or 5

- The hernia becomes incarcerated or strangulated

- The hernia causes cosmetic concerns for the child or parent

Surgery for an umbilical hernia is a simple and safe procedure that involves making a small incision near the belly button, pushing the intestine back into place, and closing the hole or weak spot in the muscle with stitches. The surgery is done under general anesthesia so that the child does not feel any pain. The recovery time is usually short and there are minimal risks of complications.

When should I call the doctor?

You should call your doctor if you notice any of these signs of an incarcerated or strangulated hernia:

- The baby has severe pain around the belly button area

- The baby has swelling, redness, or discoloration of the belly button area

- The baby has fever

- The baby has vomiting

- The baby has difficulty passing stool or urine

These symptoms indicate that there may be a blockage or infection in the intestine that needs urgent medical attention.

Summary

An umbilical hernia is a common condition in babies and children where part of the intestine bulges through a weak spot in the abdominal wall near the navel. It is not harmful and usually goes away on its own by age 4 or 5. However, if it causes pain, vomiting, infection, or cosmetic concerns, surgery may be needed to repair it. If you have any questions or concerns about your baby's umbilical hernia, talk to your doctor.