Umbilical hernia: Does my child need surgery?

We know that hernias are more prevalent in obese individuals (hiatal hernia) and the general male population (inguinal hernia), but did you know that hernias can be present in babies since birth as well? This type of hernia is known as an umbilical hernia. 

What is an umbilical hernia? 

Before a baby is born, the umbilical cord passes through the abdomen via a small opening in the abdominal muscles. The opening in these abdominal muscles usually closes after birth, but when it doesn’t, a part of the small intestine protrudes out through it, creating a soft bulge of tissue around the navel. This bulge is an umbilical hernia. 

The size of an umbilical hernia can vary; I’ve seen some as small as a pea and others the size of a plum. Some may also only be noticeable when the baby laughs, cries or coughs — this is usually the classic sign of an umbilical hernia. Although umbilical hernias are more prevalent in infants (about 20% of babies have one), they account for 10% of hernias in adults. Those that appear in adulthood are usually due to being overweight or obese, lifting heavy objects or having a multiple pregnancy. 

When should I worry about my baby’s umbilical hernia? 

Most umbilical hernias are harmless and nothing to worry about. They should go away on their own by the time the child reaches 4 or 5 years old. In most cases, a hernia that starts before 6 months of age closes by 1 year of age. But if the hernia is exceptionally large or does not go away by age 5, hernia surgery may be necessary as it can cause problems in adulthood. 

In addition, you should seek medical attention immediately if your child experiences the following symptoms: 

  • Appears to be in a lot of pain 
  • Vomiting 
  • Constipation 
  • Has tenderness, discolouration or swelling at the site of the hernia 
  • The hernia sticks out when your child is sleeping and you cannot push it back in 

Complications involving umbilical hernias are rare, but they can happen. A dangerous complication is when the hernia is incarcerated, causing reduced blood flow to the tissue. When the blood supply is cut off completely, it can result in gangrene or the death of body tissue, requiring emergency care. 

Baby's umbilical hernia

How do you fix a baby’s umbilical hernia without surgery? 

Children with umbilical hernias do not really require surgery unless the hernia does not go away by the time the child reaches 4 or 5, or if the hernia causes pain. I’ve heard a few myths regarding treating an umbilical hernia naturally, such as putting tape over the hernia to hold it in. 

Unfortunately, this is not true as hernias do not need to be pushed on or forcefully pushed in to disappear. In this sense, there are no home treatments to fix an umbilical hernia, and the only natural treatment is time — at least for young children. You can push the hernia back in yourself at home, but please do not put tape over the hernia as it may cause infection. 

In adults, surgery is elective and recommended. 

Surgery for an umbilical hernia involves: 

  • Making a small incision in the skin 
  • Moving the intestine back into place 
  • Closing the hole or weak spot in the muscle with stitches 
  • Closing the incision with absorbable sutures and tape strips. They will fall off on their own in 7-10 days. 

The surgery is done under general anaesthesia and takes about 20-30 minutes. 

Will the hernia come back after surgery?

For some patients, there is a possibility that the hernia may come back after surgery. While there are no immediate dietary requirements that can prevent this from happening, some habits may assist in preventing the hernia from coming back. They include: 

  • Drinking lots of water. Keeping hydrated can prevent constipation and strain during a bowel movement. I recommend drinking at least 8 glasses of water daily to soften stool. 
  • Eating high-fibre foods like fruits and vegetables. A diet high in fibre may prevent strain during a bowel movement, thereby reducing the chances of a hernia reappearing or growing. 

References 

  1. Chirdan, L. B., Uba, A. F., & Kidmas, A. T. (2006). Incarcerated umbilical hernia in children. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery … [et al] = Zeitschrift fur Kinderchirurgie, 16(1), 45–48. https://doi.org/10.1055/s-2006-923792
  2. Fall, I., Sanou, A., Ngom, G., Dieng, M., Sankalé, A. A., & Ndoye, M. (2006). Strangulated umbilical hernias in children. Pediatric surgery international, 22(3), 233–235. https://doi.org/10.1007/s00383-006-1634-7