Umbilical Hernia in Children: In Infants and Newborns

An umbilical hernia in children is a bulge in the area of the navel in which part of the intestine or surrounding fat protrudes through a weak spot in the abdominal muscles. In infants and newborns this condition is common and in most cases resolves as the child grows. Below is a calm breakdown of what exactly happens, what it looks like, and at what point parents need a surgeon.

What an umbilical hernia in a child is

An umbilical hernia (hernia umbilicalis) is a condition in which the abdominal wall behind the navel is damaged and the navel can protrude outward. The bulge consists of abdominal fat located in the greater omentum, or sometimes parts of the small intestine. It can often be pushed back in through the opening in the abdominal wall, and it may "pop out" with coughing or other actions that increase intra-abdominal pressure. An umbilical hernia is not to be confused with an umbilical cord hernia (hernia funiculi umbilicalis) — these are different conditions.

Why an umbilical hernia appears in newborns and infants

Umbilical hernias are common in infants and young children. They occur when the muscles around the umbilical ring (where the navel is located) do not close properly after birth. Usually the hernia disappears as the child gets older. In adults the mechanisms are different — obesity, multiple pregnancies, conditions with fluid accumulation in the abdomen (ascites), for example in liver disease — but these causes do not apply to children.

What an umbilical hernia looks like in an infant

In most children the only symptom is a soft bulge or lump protruding from the navel. In infants and children the size of an umbilical hernia varies: from small, about the size of a pea, to larger, about 2 cm across. Umbilical hernias are usually painless.

Which signs are considered alarming

It is useful for parents to know what an uncomplicated course looks like and where normal ends. The benchmarks for seeing a doctor are described below.

• the lump has become painful, hard, or does not move;
• the bulge is increasing or does not go away;
• the child is nauseated, vomiting, or cannot keep food down;
• the hernia is more swollen than usual, the skin around it has changed color;
• there is no passing of gas or stool.

An umbilical hernia in an infant is not in itself a reason to call an ambulance. Call 103 or 112 if a child with an umbilical hernia develops very severe abdominal pain that does not go away, nausea, vomiting, or inability to keep food down, the hernia has become more swollen and the skin around it has changed color, or there is no passing of gas or stool.

What the doctor assesses during examination

During the examination the doctor looks at the bulge: its size, softness, and whether it can be pushed back in, as well as the condition of the skin around the navel.

When to see a doctor and possible complications

You should see a doctor if you suspect an umbilical hernia in your child, if the lump is painful, hard, or does not move, is increasing, or does not go away. Children usually do not require treatment: the hernia most often disappears by about age 5. Treatment is necessary only if the hernia is very large or does not disappear; in that case surgery is discussed — suturing the muscles, and for large hernias possibly with mesh. Complications of an umbilical hernia in children are very rare. The most serious is strangulation, when the blood supply to the intestine is impaired; this is an emergency condition requiring surgery as soon as possible. This material is informational: it explains terms and benchmarks but does not replace a doctor's consultation, who will examine the child and give a conclusion about their situation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer