An umbilical hernia is part of a normal phenomenon. The blood vessels from the umbilical cord pass through a small circular opening in the fascia, or tough connective tissue that envelops the muscles. This begins to close spontaneously before birth. The size of the opening and rate of closure vary from child to child. It is not known why this hole sometimes does not close completely before birth. When the opening has not closed completely, intestine, fat, or fluid can push through the weak spot or hole in the baby’s stomach muscles. This causes a bulge near or in the belly button, making it look like the belly button is swollen.
Many children will have an umbilical hernia at birth. The hernia usually isn't painful or dangerous, and it often closes on its own without treatment. An umbilical hernia can usually be seen after the umbilical cord stump falls off. Some children don’t get a hernia until they're a little older. When a child has an umbilical hernia:
- You may notice a soft bulge under the skin of the belly button.
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The bulge may be easier to see when your child sits or stands upright or strains stomach muscles during normal activities such as crying, coughing, or having a bowel movement and should get smaller.
Umbilical hernias usually close on their own before a baby is 1 year old. If a hernia has not closed by the time the child is 5 years old, surgery may be needed.
Consider surgery before the age of 5 if:
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The hernia is large and has not shown any signs of closing by age 2.
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There is another problem, such as an infection.
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The way the hernia looks bothers you or your child.
Your child should be seen immediately if the hernia will not reduce (bulge does not get smaller), it is red/warm or seems painful to the touch, or if the child is vomiting. Surgery to repair the hernia is usually an outpatient procedure. Sometimes more surgery may be done to improve how the belly button looks. Problems from umbilical hernia repair are rare. Be sure to go to all follow-up exams so the doctor can make sure the child is healing well.
Today’s expert is Daniel Sutton, MD, ThedaCare Physicians-Waupaca.
