What is an umbilical hernia?
An umbilical hernia is an opening in the abdominal wall around the belly button (umbilicus). In the developing baby (fetus), there is an opening in the abdominal wall just behind the umbilicus. This should generally close by the time the infant is born. Umbilical hernias are present when this process was not completed normally before birth.
Umbilical hernias occur in approximately 20 percent of all newborns, but are more common in African-Americans and premature infants.
In most cases, the umbilical hernias do not cause discomfort or pain and can be gently pushed back into the abdomen. It is very rare that an umbilical hernia causes pain in a child or becomes “stuck” or incarcerated. If this should occur your child should be seen right away.
Umbilical Hernia | Symptoms & Causes
What are the symptoms of an umbilical hernia?
Umbilical hernias look like a swelling or bulge at the belly button. The bulge generally feels soft and may appear and disappear. It is most often noticed when the child cries, coughs, strains, or stands.
There may appear to be extra skin present when the hernia is not bulging. These hernias vary greatly in size from very small to a significant bulge.
What causes an umbilical hernia?
An umbilical hernia occurs when the normal closure of the abdominal wall at the level of the belly button fails to occur normally. This allows either tissue or fluid to enter into the protruding sac.
Umbilical Hernia | Diagnosis & Treatments
How is an umbilical hernia diagnosed?
After a physical exam, your child’s doctor will let you know if your child has an umbilical hernia. In most cases, umbilical hernias close by themselves. Usually, the doctor will watch and wait to see that this happens by the time your child is 4 or 5 years of age.
How is an umbilical hernia treated?
If the umbilical hernia has not closed by the time your child is 5 years old, surgery may be suggested to close it.
If surgery is necessary, general anesthesia is given, and the surgeon will make a small incision on the lower rim of the belly button. The hole in the muscle layer is then closed with stitches that will dissolve on their own over time. The possibility of the hernia returning is very small.
Most children go home the day of surgery. However, some children need to spend a night in the hospital for observation. Your child may still look swollen around the belly button, but this will begin to go away within the first couple of weeks after the surgery.
How we care for umbilical hernias
The Boston Children’s Hospital Department of Surgery provides general and specialized surgical services to infants and children suffering from umbilical hernias. Our team will collaborate with you to design a treatment plan appropriate for your child.
Because the risk of incarceration (abdominal contents trapped in the sac) is rare, and many of these will close spontaneously on their own without requiring surgery, we generally observe children until they are 4 to 5 years of age before proceeding with surgical repair. When this is performed, it is generally performed as an ambulatory or “day surgery” procedure.