Paediatric Umbilical Hernia

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An umbilical hernia happens when a portion of the abdominal contents, such as fat or bowel, pushes through the abdominal wall near the belly button. This condition is quite common in infants and young children, affecting approximately one in five babies during their first few months of life. It is also more frequently observed in individuals of African descent. Print Version

Why Do they Occur?

Umbilical hernias occur when the abdominal muscles do not fully close around the belly button after birth. Before birth, the umbilical cord passes through an opening in the baby's abdominal muscles to supply nutrients. Normally, this opening closes soon after birth, but if it doesn't, a gap remains in the abdominal wall, allowing fat or a portion of the bowel to push through, creating a hernia.

Certain factors can increase the risk of umbilical hernias, including:

• Premature birth – Babies born early are more likely to have weaker abdominal muscles
• Low birth weight – Underdeveloped muscles may not close properly
• Genetic factors – A family history of umbilical hernias may increase the risk
• Certain medical conditions – Conditions like Down syndrome or hypothyroidism can weaken muscle development

In most cases, umbilical hernias close on their own by the age of 4–5, but larger hernias or those that persist beyond early childhood may require surgical repair.

How to know if a child has umbilical hernia?

An umbilical hernia appears as a swelling at the belly button, which can vary in size. The swelling often becomes more noticeable when a child cries or strains during a bowel movement. When the child is relaxed, the lump feels soft and is sometimes described as 'squidgy.' An experienced doctor can often push the swelling back in, making it temporarily disappear.

Umbilical hernias usually do not cause pain, and some children may even play with them. Unlike umbilical hernias in adults, which can sometimes lead to complications, they are generally harmless in children. However, in rare cases, the hernia can become trapped (incarcerated), leading to pain, redness, and tenderness. If this occurs, it is important to seek medical attention immediately. Print Version.

How to Treat umbilical hernia?

In most cases, an umbilical hernia in a young child will resolve on its own without the need for treatment. However, if the hernia persists beyond the age of four, medical intervention may be recommended. In certain situations, treatment may be considered earlier, such as when the hernia has a large defect and is unlikely to close naturally or if it becomes trapped (incarcerated).

The standard treatment for an umbilical hernia is a surgical procedure known as an umbilical hernia repair.