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Umbilical Hernia: Definition, Symptoms, and Treatment

While many babies are born with an umbilical hernia, they usually resolve without surgical intervention. Flo can give you all the information you need about this common condition.

What is an umbilical hernia?

While a baby is still in the womb, the umbilical cord (sometimes called the birth cord) is the long, tube-like structure that provides a connection to the mother through the placenta. The umbilical cord is vital to the normal growth and development of the baby because it supplies oxygenated, nutrient-rich blood from the placenta.

The cord passes through a small opening between the layers of the abdominal muscles, and this gap normally becomes sealed shortly after birth. An umbilical hernia results when the opening within the tissue of the abdominal muscle doesn’t fuse completely and allows the intestines and other tissues in this area to push through this weakened section of muscle.

This typically occurs around the area of the belly button, which is why the bulge of an umbilical hernia characteristically appears in this location. Umbilical herniation is a very common condition — according to some sources, up to 1 in 5 babies are born with one.

Umbilical hernia: symptoms in babies

The most obvious sign of an umbilical hernia is the distinctive and characteristic bulging that appears around the area of the belly button. Although this can be upsetting for parents and carers, the condition is usually painless and causes no discomfort to your little one — they won’t even know that they have one!

The telltale sign of a swelling or bulge in the area of the belly button is most obvious when your baby is crying, laughing, or straining during a bowel movement. This is because these actions increase the pressure inside the abdomen and make it more likely that the intestines and other tissues will bulge through the gap between the abdominal muscles.

It’s important to be aware of the effect of increased intra-abdominal pressure upon an umbilical hernia because the bulge may not appear when your child is relaxed.

What causes an umbilical hernia in babies?

Umbilical hernias can occur in adults when the abdominal muscles fail to close properly around the gap that allows the umbilical cord to pass through. However, they are much more common in babies.

There is no significant difference in the frequency of umbilical hernias between girls and boys, but certain groups are more likely to experience this condition than others. These include:

  • African-American and Hispanic babies
  • Premature babies
  • Babies born with low birth weight

Does a herniated belly button in babies need to be treated?

Fortunately for both parents and babies, the vast majority — up to 90% — of umbilical hernias disappear on their own without intervention. However, if the condition has not resolved by the age of 5 years, it will need to be treated.

During physical examination of your baby, a pediatrician or family doctor will check to see if the umbilical hernia can be pushed back into the abdomen or if it is fixed in place. These latter cases can result in serious complications because the tissues that are trapped within the hernia can become cut off from their normal blood supply  (so called strangulation of intestines). This can lead to death of the tissues.

When is an umbilical hernia surgery needed?

As we have described, most cases of umbilical hernia resolve on their own without surgical intervention. Your doctor is unlikely to suggest surgery unless one or more of the following are true:

  • The hernia is painful.
  • The hernia becomes fixed in place or causes a blockage of the intestines.
  • The hernia does not show any noticeable decrease in size by the time a child is 2, or it has not resolved by 5 years.

Signs an emergency surgery may be necessary include pain in the area of the hernia, tenderness, swelling or discoloration of the hernia, an inability to easily push in the hernia tissue, and vomiting or constipation.

Surgery for a typical umbilical hernia is a straightforward procedure lasting approximately 45 minutes. The surgery is performed under a general anesthesia, which means that your child or baby will be unaware of what happens during the procedure and won’t feel any pain. However, he or she may be a little sore around the area of the operation for some time afterwards as they recover.

The surgeon will make a small incision in the skin near the bulge of the hernia and then push the trapped intestines back into the abdominal cavity. The procedure ends with the gap in the abdominal wall being stitched closed.

When to call the doctor

As the parent or carer of a baby with an umbilical hernia, one of your key priorities is to be alert to the possibility of strangulation of the intestinal tissues. While uncommon, it's a serious condition that can lead to infection and, in rare cases, even death.

Abdominal herniation that involves strangulation of intestinal tissues must be treated by emergency surgical intervention. With careful monitoring, you can put yourself in the best position to notice and respond appropriately to the warning signs. Be particularly alert to any of the following symptoms:

  • Pain in the area of the hernia
  • Tenderness
  • Swelling or discoloration of the hernia
  • An inability to easily push in the hernia tissue
  • Vomiting or constipation

If you suspect that your baby is suffering from strangulated intestines, contact your doctor immediately or proceed directly to the emergency room.

Umbilical hernias are a common condition in newborns and typically resolve without surgical intervention by 5 years of age. But if you have any concerns about your child’s umbilicus, don’t hesitate to reach out to your trusted pediatrician or family doctor — they are in the best position to allay your concerns and offer you advice about investigation and treatment.







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