Umbilical Hernia in Children
What is an umbilical hernia?
An umbilical hernia is a common condition in babies and young children where a small opening remains in the abdominal muscles around the belly button (umbilicus). This allows a small amount of tissue or intestine to bulge through, creating a soft swelling at the belly button.
Umbilical hernias are very common, particularly in newborn babies and those born prematurely. In most cases, they are harmless and gradually close on their own as the abdominal muscles strengthen during early childhood. Unlike an inguinal hernia, an umbilical hernia rarely causes complications and does not always require surgery.
Our paediatric surgeons can assess your child's hernia, monitor its progress and advise whether treatment is necessary.
What are the symptoms?
The most obvious sign is a soft lump or bulge at the belly button. This swelling often becomes more noticeable when your child cries, coughs, laughs or strains, and usually disappears or becomes smaller when they are relaxed or lying down.
Most children with an umbilical hernia:
- Do not experience any pain
- Feed and grow normally
- Remain active and well
- Have a lump that is soft and easily pushed back into the abdomen
Although uncommon, a hernia that becomes painful, firm or discoloured should be assessed urgently.
When should I seek medical advice?
Most umbilical hernias can be assessed during a routine outpatient appointment and do not require emergency treatment.
However, you should seek urgent medical attention if your child develops:
- A painful or tender lump
- A lump that cannot be gently pushed back in
- Redness or discolouration over the hernia
- Persistent vomiting
- A swollen abdomen
- Your child appears unusually sleepy or unwell
These symptoms may suggest that the hernia has become trapped, although this is very rare with umbilical hernias.
If the hernia is still present after your child reaches four to five years of age, or if it becomes larger or causes symptoms, a surgical assessment is recommended.
How is an umbilical hernia diagnosed?
Umbilical hernias are usually diagnosed during a physical examination. Your consultant will examine your child's abdomen and assess the size of the hernia and whether it can be gently reduced back into the abdomen.
Further investigations are rarely required, as the diagnosis is usually straightforward. If there are concerns about another underlying condition, additional tests may occasionally be recommended.
What treatment is available?
Most umbilical hernias close naturally without treatment by the time a child reaches four or five years of age.
Surgery may be recommended if:
- The hernia persists beyond four to five years of age
- The hernia is particularly large
- It causes discomfort or pain
- It becomes trapped (incarcerated), although this is uncommon
- There are cosmetic concerns in selected cases
The operation is called an umbilical hernia repair. It is performed under a general anaesthetic through a small incision hidden within or just below the belly button. The opening in the abdominal wall is closed with strong stitches, and the procedure is usually completed as a day-case operation.
Recovery after surgery
Children generally recover very quickly following umbilical hernia repair. Mild soreness around the belly button is expected for a few days and is usually well controlled with simple pain relief.
Most children return to nursery or school within a few days and can gradually resume normal activities as advised by their surgeon. Swimming, contact sports and rough play should be avoided until the wound has healed.
The surgical scar is usually very small and becomes less noticeable over time.