Umbilical Hernias in Babies: Everything You Need to Know

Umbilical hernias in babies are usually harmless and don't produce other complications. They usually go away on their own with time.

Umbilical hernias in babies are a fairly common condition and are related to the anatomical characteristics of newborns.

But how serious are they and how are they treated? We’re going to tell you everything you need to know about them. Keep reading!

What is an umbilical hernia?

An umbilical hernia is an opening in the anterior abdominal wall caused by a defect in the closure of the muscular ring surrounding the umbilicus. This remaining hole can cause abdominal fluids or organs to protrude through it.

It’s usually seen as early as the second or third week of life, when the umbilical cord is completely detached. Its size can vary from a small lump to a large bulge the size of a ping pong ball. And in turn, it can increase in size when the baby makes an effort with its belly, such as when crying, pooping, or coughing.

In principle, any baby can suffer from an inguinal hernia due to the immaturity of the abdominal wall. However, it’s more common in premature infants, those with low birth weight, or those with congenital malformations (such as Down syndrome).

Although their appearance is striking, most umbilical hernias are harmless and painless and tend to resolve on their own before the age of 5 years. However, there are some exceptions that you should know about, which we’ll tell you about briefly.

When umbilical hernias are accompanied by symptoms

As mentioned above, most umbilical hernias don’t cause any complaints or complications in babies. This is because the orifice isn’t usually large enough to allow entire viscera to pass through, as occurs in other types of hernias.

Therefore, the most common case is that of a soft, movable lump in the navel area, of variable size, which, when pushed, goes in, but comes out again.

However, when the hernia ring is very large (greater than 1.5 cm), it may lead to the exit of a loop of the small intestine. Although it’s not very frequent, a jamming of the viscera could occur right there. In a similar situation, some symptoms such as the following would develop:

• Swelling and redness at the hernia
• Pain in the area
• Hardening of the hernia
• Inability to reduce it (i.e., insert the hernia into the abdomen)
• Vomiting and general malaise
• Fever

These symptoms may indicate strangulation of the intestine, which implies an emergency situation that should be resolved as soon as possible. Therefore, if your child presents any of the above symptoms, go to the doctor immediately.

How are umbilical hernias in infants treated?

Umbilical hernias in infancy usually resolve spontaneously and an estimated 8 out of 10 cases close on their own before the age of 4 years (AEPed, 2008). This occurs because the umbilical ring contracts thanks to the muscular strengthening of the child’s abdomen.

Of course, this time is closely related to the diameter of the opening, and when it’s greater than 1.5 cm, resorting to surgical closure may be necessary. Some specialists recommend waiting until after the age of 4 or 5 years, to allow for the possibility of spontaneous closure.

Umbilical hernioplasty: What does it consist of?

This is the surgical intervention performed to close the hernial ring and is a fairly simple procedure. However, it requires general anesthesia, which is why it’s usually performed only when strictly necessary.

The procedure consists of making two small cuts above and below the navel to put the viscera back in place. The surgeon then closes the hole with stitches that bind the muscles and skin in the area. Sometimes laparoscopy can be used , which is a simpler and less invasive technique than the traditional one.

When the surgery is performed in the context of an emergency (such as strangulation of the intestines), the procedure may undergo variations and may even require the removal of the affected intestinal loop. For this reason, it’s essential to consult your child’s doctor in the case of the slightest symptom of suspicion.

In general, recovery from hernioplasty is quite fast and its risks are minor. It all depends on the severity of the condition and postoperative care.

Popular beliefs about umbilical hernia treatment

There are several myths surrounding umbilical hernias, which have no scientific basis. For example, the use of buttons, coins, chickpeas, and other objects placed tightly in the navel to eliminate this anatomical defect.

In addition to being ineffective measures, they’re potentially harmful to the baby, as the delicate skin in the area could be injured and lead to serious skin infections. Also, accidental ingestion of these elements could occur and eventually lead to airway obstruction.

In general, umbilical hernias in infants aren’t a serious health condition, and in most cases, don’t even produce symptoms. For this reason, it’s best to know what it is and to monitor its evolution over time during check-ups with a pediatrician.