Umbilical Hernia Treatment and Repair

Pediatric Basics

A small umbilical hernia
A small umbilical hernia would be likely to go away over time. RUTH JENKINSON/Getty Images

When most parents think of a hernia, they think of sports, pain, and the need for quick surgery. That is because hernias often affect young male athletes. Almost all hernias of this sort, known as inguinal hernias, need surgical repair.

They are often surprised that babies can get hernias, too, although they affect a different body part -- the belly button.

These are known as umbilical hernias.

Umbilical Hernia

An umbilical hernia occurs when the umbilical ring (belly button) doesn't close properly.

Although this defect occurs before a baby is born, usually for unknown reasons, parents often don't begin to notice the umbilical hernia until their baby is a few weeks old.

Once it starts, it is hard to miss though, since the baby's belly button bulges outward.

You are most likely to see the bulge when your baby is straining, coughing, or crying, but it is sometimes pretty obvious when the baby is just lying quietly. Keep in mind that straining or crying, like from constipation, didn't cause the hernia though.

Symptoms of an Umbilical Hernia

Unlike other types of hernias, an umbilical hernia is typically painless and the only real sign or symptom is that the baby's belly button will be swollen or "herniated" outward.

In rare instances, an umbilical hernia can become strangulated. This will cause the hernia to become painful won't reduce or go in when you push on it. Babies with a strangulated umbilical hernia need emergency medical attention.

Treatments for an Umbilical Hernias

Umbilical hernias typically don't need treatment. Many close or go away naturally by the time a baby is one or two years old, and almost all will resolve by a child's fourth or fifth year.

A pediatric surgeon may need to repair the hernia in the following cases:

  • The umbilical hernia is very big -- larger than 2 cm on a 1- or 2-year-old child, for example
  • The hernia is getting bigger
  • The hernia has not gone away by the time a child is four or five years old.

Your pediatrician will monitor your baby's umbilical hernia until it does go away.

What To Know About Umbilical Hernias

Although the cause is unknown, umbilical hernias are more common among black babies and babies born with a low birthweight.

It is known that it is not helpful to try and keep the umbilical hernia reduced by strapping something across your baby's belly, a common folk remedy.

School-age children are more prone to complications from their umbilical hernia, so, among this age group, hernias should be repaired to prevent future problems, such as strangulation.

In some cases, women who had unrepaired umbilical hernias may experience a recurrence or pain when they become pregnant as adults.

Sources:

Behrman: Nelson Textbook of Pediatrics, 17th ed.

Chirdan LB. Incarcerated umbilical hernia in children. Eur J Pediatr Surg - 01-FEB-2006; 16(1): 45-8

O'Donnell KA. Pediatric umbilical problems. Pediatr Clin North Am - 01-AUG-1998; 45(4): 791-9

Zendejas et al. Fifty-three–year experience with pediatric umbilical hernia repairs. Journal of Pediatric Surgery, Volume 46, Issue 11, November 2011, Pages 2151-2156

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