Umbilical Hernia

An umbilical hernia is most common in premature infants and children between the ages of 2 and 4.

The protruding tissue may include a loop of the intestine or omentum, fatty tissue covering the intestines. If left untreated, an umbilical hernia can become strangulated, meaning the blood supply to the tissue is cut off. When this happens, surgery is usually required.

Many cases of umbilical hernias resolve on their own by age 5 without any treatment at all. However, if the herniated tissue becomes trapped or strangulated and needs to be removed, your child's doctor may recommend surgery. Umbilical hernias that do not close or that become strangulated most commonly require surgical repair.

The most common symptom of an umbilical hernia is a bulge or lump near your baby's belly button. The bulge may become larger when your baby coughs, cries, or strains during a bowel movement.

Symptoms include pain in the stomach or groin, visible swelling around the belly button, and abnormal bulges in the abdomen. Umbilical hernias are harmless unless part of the intestine becomes trapped, which can cause a painful lump that is slow to go away.

Surgery is recommended only for babies who have a large hernia, or for those whose hernia does not go away by itself.

Other risks from an umbilical hernia include:

• Incarceration happens when the intestines or other abdominal contents become trapped in the hernia. This can cause pain and blockages.
• Strangulation is a medical emergency. It happens when the blood supply to the trapped intestines is cut off. Strangulation can cause death or serious damage to the intestines.

Umbilical hernias are more common in premature babies and babies of African descent. They are also more common in babies born to mothers who smoke during pregnancy.

If your baby has an umbilical hernia, you will be given instructions on how to care for it at home. Umbilical hernias do not need to be repaired until they get bigger or bother the baby. It is important not to put anything into the abdomen because this could make the hernia larger or cause a serious infection.

Most umbilical hernias are diagnosed during a physical exam. Your doctor will look for a bulge in the belly button area that becomes larger when your baby cries or strains.

Symptoms of a strangulated umbilical hernia include:

• The hernia becomes red, swollen, and warm
• It is painful to the touch
• Your baby has trouble breathing
• Your baby cries when moving
• Crying

If your baby has symptoms of a strangulated hernia, an ultrasound or CT scan may be done to check for a blockage in the intestine.

If your baby has a hernia that does not close on its own by age 5, surgery will be necessary to remove the blockage and repair the hernia. If your child is experiencing pain in his or her groin, ask your doctor about these symptoms:

• Trouble breathing
• Pain while sitting down
• Constipation and difficulty passing stool

If you think that your child's umbilical cord is showing signs of infection, contact your doctor immediately. If left untreated, the infection could spread to the belly button and intestines, causing serious health complications.

The factors that are considered when deciding if a baby needs surgery for an umbilical hernia include:

• The size of the hernia
• The age of the baby
• Whether or not the hernia is strangulated

There are two approaches to umbilical hernia repair, which include:

• Open Surgery: The open approach requires a larger incision than the closed technique and is associated with more postoperative pain. The main benefit of this type of surgery is that it will allow the doctor to examine your child's abdominal organs.
• Closed Surgery: Closed umbilical hernia repairs are generally less invasive and cause less discomfort after surgery because they do not require an incision. This procedure can be done in the operating room or ambulatory surgery center, which means your child may go home on the same day as his surgery.