Babies’ umbilical cords pass through a small opening in their stomach muscles. In most cases, the hole closes soon after birth. An umbilical hernia occurs when the stomach muscles do not join completely and the intestine bulges through this weak spot.
According to Cincinnati Children’s Hospital Medical Center, umbilical hernias occur in 10 to 20 percent of children (CCHMC).
Umbilical hernias are generally painless and should not cause discomfort. In many children, they will eventually close on their own. If an umbilical hernia does not close by the time a child reaches four years old, it will need to be resolved.
Umbilical hernias can usually be seen when your baby is crying, laughing, or straining to use the bathroom. The telltale symptom is a swelling or bulge near the naval area—a symptom not present when your baby is relaxed.
Adults can get umbilical hernias as well. The symptoms will be the same—a swelling or bulge near the navel area. These can be very painful and treatment is usually required.
Symptoms that indicate a more serious situation requiring medical treatment include:
- the baby is in obvious pain
- the baby is vomiting
- the bulge (in both children and adults) is tender, swollen, or discolored
In a majority of cases, umbilical hernias occur in babies. Babies who are African-American, premature, and of low birth weight are at even higher risk of developing an umbilical hernia. There is no noted difference in occurrence between boys and girls.
An umbilical hernia in adults usually occurs when too much pressure is put on a weak section of the stomach muscles due to:
- being overweight
- frequent pregnancies
- fluid in the abdominal cavity
- stomach surgery
A doctor will perform a physical exam to determine if an infant or adult has an umbilical hernia. He or she will sometimes take an X-ray or perform an ultrasound on the stomach area to ensure that no complications exist.
Complications from umbilical hernias rarely occur in children. However, if the umbilical cord is trapped, additional complications can occur in both children and adults.
Intestines that cannot be pushed back through the stomach wall sometimes do not get adequate blood supply. This can cause pain and even kill the tissue (gangrene), which could result in a dangerous infection. In addition, if an obstruction of the intestines occurs, emergency surgery might be required.
In adults, surgery is usually suggested to make sure that no complications develop. In children, umbilical hernias often fix themselves. Before choosing surgery, doctors will normally wait until the hernia:
- becomes painful
- bigger than a half inch in diameter
- does not shrink in size after one year
- does not go away by the time your child is three or four years old
- becomes trapped or blocks the intestines
Before the Surgery
Preparation for the surgery is minimal. You can continue to drink clear liquids up to three hours before surgery.
During the Surgery
The surgery will last about an hour. Doctors will make an incision at the belly button where the bulge is. The intestinal tissue is then pushed back through the stomach wall. In children, the opening is closed with stitches. Doctors will strengthen the stomach wall in adults with mesh.
Recovering from Surgery
Usually, the surgery is a same-day procedure. Activities for the next week or so should be limited, and individuals should not return to school or work during this time. In addition, sponge baths are suggested until three days have passed.
The surgical tape over the incision should fall off on its own. If it does not, wait until the follow-up appointment to have it removed.
Complications are rare, but can occur. Contact your doctor if the following symptoms are experienced:
- infection at the wound site
- recurrence of the hernia
- numbness in legs