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What Parents Should Know About Umbilical Hernias

If your baby has an “outie” belly button, especially one that gets bigger when they cough, cry or strain, it could mean they have an umbilical hernia. Hearing the word “hernia” might make you frightened for your child. After all, most of the time we think of a hernia as a health problem that strikes adults. But children can develop hernias, too.

An umbilical hernia is a type of hernia that can develop when a baby is born. And while discovering a hernia in your child can be scary, umbilical hernias often aren’t worrisome.

We talked to Stuart Lacey, MD, a pediatric surgeon at Banner Children's Specialists Surgery Clinic in Glendale, AZ, to learn more and help alleviate parents’ fears. He explained what these hernias are, what causes them and when and how they need to be treated.

What is an umbilical hernia?

An umbilical hernia is a hole in the muscle at the belly button, which is the spot where the umbilical cord was attached to the baby before birth. It can cause an outie belly button or could appear as a lump close to the belly button.

What causes umbilical hernias?

Before a baby is born it needs to get nutrients so it can grow and develop. Those nutrients come from the mother to the baby through the umbilical cord. So, there’s a small hole in the muscle of the baby’s abdomen where the cord passes through. Most of the time, after the baby is born the muscles close around the hole. But if they don’t close properly, that’s when a baby can develop an umbilical hernia.

“Umbilical hernias aren’t caused by anything specific,” said Dr. Lacey. However, they can run in families, and they can be more common in certain populations. Premature babies and low birth weight babies are more likely to develop them.

How can you tell if your child has an umbilical hernia?

Typically, with an umbilical hernia, you’ll see a lump in or around your child’s belly button. The lump might not change, or it might be more noticeable at times such as when the baby cries, coughs or strains. Even though it might be noticeable at times when a baby appears unhappy, it doesn’t cause pain. “Most umbilical hernias go away or get smaller, but occasionally they can appear larger over time,” Dr. Lacey said.

How are umbilical hernias diagnosed and treated?

In most cases, umbilical hernias go away on their own, usually by the time a child reaches school age. Those that don’t clear up on their own will require surgery. Without surgery, there’s a risk of a complication called incarceration. That happens when the intestine gets trapped in the hole in the muscle, leading to severe illness and injury to the intestine.

Sometimes, children who are younger than school age have a hernia with a shape that makes the risk of incarceration high, so they will also need surgery. “A pediatric surgeon can evaluate your child’s hernia and recommend the appropriate treatment,” Dr. Lacey said.

If umbilical hernias go untreated until adulthood, they might need a mesh insert placed during surgery to reduce the risk of the hernia returning. But children don’t typically need these mesh inserts.

How are umbilical hernias different from other hernias in children?

Young children can develop a lot of different kinds of hernias, including inguinal hernias. These hernias, which are the most common type of hernias in children, can develop when a part of the intestine slips into the groin instead of staying in the belly. They often occur in a baby’s first year, and need to be repaired surgically. Umbilical hernias are different since they frequently go away on their own.

Rarely, children can also develop epigastric hernias, which occur between the chest and the belly button and usually require surgery. They may also develop hiatal hernias, where the stomach bulges through the diaphragm. Hiatal hernias may be small and hardly noticeable, or they could be larger and require surgery.

The bottom line

Umbilical hernias, which appear at the belly button, can develop in babies. While they may seem scary, they often go away on their own by the time a child reaches school age. If you have additional questions about caring for your baby, talk with your child's pediatrician.

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