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Umbilical Hernia in Children

Summary

An umbilical hernia occurs when a small opening in the abdominal muscles at the belly button (umbilical ring) fails to close after birth, allowing tissue to bulge out. This condition is common in infants and usually resolves on its own by age 4 to 5 without treatment.

Umbilical hernias are typically painless and do not cause complications. Rarely, the hernia can become incarcerated (trapped) or strangulated (losing blood supply), which requires urgent medical attention.

Diagnosis and When to Seek Help

Parents should consult a doctor if their child has:

  • A soft bulge at the belly button, which may become more noticeable when crying or straining
  • A hernia that persists beyond 5 years of age
  • Signs of pain, redness, swelling, or firmness at the site, which could indicate a complication

Most umbilical hernias are diagnosed through a physical exam. Imaging (such as an ultrasound) is rarely needed unless complications are suspected.

Management

  • Observation: Most umbilical hernias close naturally within the first few years of life.
  • Surgery: A simple surgical procedure is recommended if the hernia:
    • Persists beyond age 4–5
    • Becomes larger over time
    • Causes pain or discomfort
    • Becomes trapped or strangulated

Compression therapy, such as abdominal binders or taping, is not effective and may even be harmful.

Follow-Up and Monitoring

For most children, routine check-ups are sufficient to monitor the hernia’s progress. After surgical repair, recovery is usually quick, with low recurrence rates. The most common post-surgical complications are minor bleeding and infection, which are rare.

If you notice a persistent or painful bulge in your child’s belly button, a doctor can help determine whether treatment is needed.

History and Exam

Key diagnostic factor

  • Presence of risk factors
  • Present since birth
  • Bulge at the umbilicus
  • Change in size/tension during movement

Other diagnostic factors

  • Intermittent discomfort

Risk factors

  • Low birth weight
  • African ancestry
  • Beckwith-wiedemann syndrome (BWS)
  • Trisomy 21, 18, 13

Diagnostic Investigations

1st investigations to order

  • Diagnosis is clinical

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    acute abdominal pain

    abscess drainage

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      1 Reason for referral *

      2 Parent Surname *

      3 Patient First Name *

      4 Email *

      5 Patient Surname *

      6 Phone *

      7 Child’s date of birth *

      8 ADDRESS