Whether you just had your first child or are a seasoned veteran, one of the first things you are attuned to as a parent is if something is “wrong” with your child. Umbilical hernias are among those conditions that are often misunderstood by parents and a cause of concern. Education and working closely with your child’s doctor can help bring understanding about this common condition.
What is an umbilical hernia? An umbilical hernia is a protrusion of the abdominal contents through the belly button — through a ring of muscles that fail to close shortly after birth. An umbilical hernia can usually be seen after the umbilical cord stump falls off, within a few weeks after birth. But some children don’t get a hernia until they’re a little older.
At first, parents may notice a bulge near their child’s belly button. It is common for this bulge to get larger and become harder when your child cries or strains. This is because the pressure in the abdomen is increased, forcing intestinal materials, fluids, or fat out into the hernia. Upon relaxation, the contents of the hernia are easily returned back into the abdomen, allowing the hernia to become soft again. Parents unfamiliar with this condition can become alarmed because the hernia becomes prominent and firm. They may misinterpret the crying as a sign of pain, but umbilical hernias are usually not painful. As startling as this may appear, it is typically not a cause for concern.
Umbilical hernias are common in children and occur in 3 to 4 percent of Caucasian children and in approximately 30 to 40 percent of African-Americans. This abnormality is also more commonly seen in premature infants.
The good news is, in about 85 percent of cases physicians will just monitor the umbilical hernia over time, and it will close spontaneously by 5 years of age. When needed, surgical repair is an outpatient procedure and usually reserved for children with larger hernias or those that don’t close by themselves by age 5. Surgical repair is also warranted with “incarceration.” Incarceration occurs when abdominal contents become stuck within the umbilical ring and hernia sac. Incarceration, fortunately, a rare event, is a surgical emergency and occurs in less than 1 percent of children with umbilical hernias. Consultation with a pediatric surgeon is appropriate when parents are anxious or as their children approach 3 to 4 years of age.
If parents notice bulges in the groin area, this may be a different type of hernia – an inguinal hernia. It should be promptly evaluated by a pediatric surgeon.