An umbilical hernia refers to a condition found most commonly in newborns, though it can also occur in adults. It’s estimated that as many as 20% of newborns may have umbilical hernias. With this particular type of hernia, part of the intestine, usually right near the belly button, is able to extrude out past the stomach muscles. In newborns and young children, you may notice a rounded bump poking out from the stomach, especially when babies use their stomach muscles for stretching, crying or having a bowel movement.
The good news about an umbilical hernia in a baby is that it seldom requires surgery. In most newborns and babies diagnosed with one, doctors do little but wait and watch. They are not considered painful, though they may be so in adults. Parents are asked to watch for signs that the baby is in distress, vomiting, and are told to look for any changes to the hernia bump, including enlargement and discoloration. Rarely, the part of intestine outside the muscle can get trapped by the muscle tissues, and lose needed oxygen to remain healthy. When this occurs, surgery is indicated to push the intestine back and build up the stomach muscle so the hernia doesn’t recur.
Children may require surgery if the umbilical hernia hasn’t resolved by the time they are four, though recommendations on surgery may vary with different doctors. Adults will usually require surgery shortly after they develop an umbilical hernia since adults can find these hernias highly painful. Risk factors for adults are very different than those for kids. Babies are more likely to have umbilical hernias if they had a low birth weight or were born prematurely. Adults may develop these hernias if they are obese or have engaged in excessive physical activity like heavy lifting. Having several pregnancies close together can also damage stomach muscles and make an umbilical hernia more likely to occur.
Surgery for adults and kids, unless complications have occurred and the intestinal tissue is damaged, may be an outpatient procedure. Commonly, the protruding intestine is pushed back behind the muscle tissue and the muscle is stitched together to prevent recurrence. This procedure may be done laparoscopically, so that a very tiny incision is required. Instead of stitches, surgeons may use mesh or netting that helps to shore up the muscle wall.
Whether or not surgery is required, once an umbilical hernia resolves, there is very low chance that the condition will recur. Although it’s frightening for parents to have to deal with any medical condition a child may have, it’s important to remember that this condition is generally easily fixed, and may never require surgery. Even when a child does need surgery, bear in mind that repair has an extremely high rate of success and low rate of complications.
An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). The bulge may range from less than 1/2 inch to about 2 inches (about 1 to 5 centimeters) in diameter.
If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.
Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.
If you suspect that your baby has an umbilical hernia, talk with your child's pediatrician. Seek emergency care if your baby has an umbilical hernia and:
Your baby appears to be in pain
Your baby begins to vomit
The bulge becomes tender, swollen or discolored
Similar guidelines apply to adults. Talk with your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications.
Most umbilical hernias close on their own by age 1. Your doctor may even be able to push the bulge back into the abdomen during a physical exam. Don't try this or anything like it on your own, however. Although some people claim a hernia can be fixed by taping a coin down over the bulge, this "fix" doesn't help and germs may accumulate under the tape, causing infection.
For children, surgery is typically reserved for large or painful umbilical hernias or those that:
Get bigger after age 1 or 2
Don't disappear by age 4
Become trapped or block the intestines
For adults, surgery is typically recommended to avoid possible complications — especially if the umbilical hernia gets bigger or becomes painful.
During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. Most people are able to go home within a few hours after surgery and resume typical activities within two to four weeks. Recurrences are unlikely.