Health Library

Umbilical Hernia

Umbilical hernias are very common in babies and young children:

• They affect about 10% to 20% of all children.
• They are more common in African American children.
• Premature babies and those with low birth weight are more likely to have one.
• Both boys and girls can get umbilical hernias equally.

What Are the Signs and Symptoms of Umbilical Hernias?

Umbilical hernias appear as a bulge or swelling in the belly button area. The swelling may become more noticeable when the baby cries, strains, or sits up. Additionally, it may become smaller or disappear when the baby is quiet, relaxed, or lying down. If a doctor gently pushes on the bulge when a child is lying down and calm, it will usually get smaller or go back into the abdomen.

Sometimes the intestines get trapped within the umbilical hernia. This is referred to as an incarcerated hernia. When this occurs, the child usually has severe pain and the bulge may be firm and red. Urgent medical evaluation to exclude an incarcerated hernia is required to prevent possible damage to the intestines. It is uncommon for this to occur.

What Causes Umbilical Hernias?

As the fetus develops during pregnancy, there is a small opening in the abdominal muscles that allows the umbilical cord to pass through, connecting mother to baby.

As the baby grows after birth, this opening in the abdominal muscle closes. Sometimes, however, these muscles do not meet and grow together completely, and a small opening remains. This opening is called an umbilical hernia.

How Are Umbilical Hernias Diagnosed?

Physical examination by a doctor can diagnose an umbilical hernia and can also determine if there are any abdominal contents caught in the hernia sac.

How Are Umbilical Hernias Treated?

Many umbilical hernias close on their own between the ages of 3 to 4. If closure does not occur by this time, surgical repair is advised. In younger children, if there is an episode of incarceration or if the hernia is very large, surgical repair may be recommended.

Surgery to repair the hernia is performed under general anesthesia.

A small incision is made at the base of the belly button. If any intestine is present in the hernia, it is placed back into the abdominal cavity. The opening in the muscle is then repaired with multiple layers of stitches to prevent another hernia. A dressing and/or incision glue is placed to keep the belly button flat.

While premature infants and children with certain medical conditions may require overnight observation in the hospital, most children are able to return home within a few hours after surgery.

What is the Prognosis for Children with Umbilical Hernias?

Most children recover quickly and have no problems after surgery. Once the hernia is closed, it is unlikely that it will reoccur. However, the risk of recurrence is increased in patients who have wound infections following surgery.