Parent Education on Umbilical Hernia
Most umbilical hernias in children close spontaneously by age 3-4 years and rarely require surgical intervention unless they are large (>1 cm), persist beyond age 4, or develop complications. 1
What is an Umbilical Hernia?
An umbilical hernia occurs when there is:
- Incomplete closure or weakness of the umbilical ring
- Protrusion of intraabdominal contents through this opening
- Visible bulge at the belly button, especially when the child cries, coughs, or strains
![Umbilical Hernia Visualization: A circular protrusion at the navel that becomes more prominent when the child cries or strains. The skin over the hernia is normal, and the bulge can often be gently pushed back in when the child is relaxed.]
How Common Are Umbilical Hernias?
- Occurs in 1.9% to 18.5% of children in the white population 1
- More common in:
- Premature infants
- African-American children
- Children with certain medical conditions
Natural History and Management
Most umbilical hernias resolve without treatment:
- 80-90% close spontaneously by age 3-4 years
- Observation with periodic follow-up is appropriate in most cases 1
- No evidence supports using strapping or taping to improve or accelerate closure 1
When to Consider Surgery:
Surgery is generally recommended for:
- Defects greater than 1 cm that persist beyond age 3-4 years 1
- Hernias that enlarge during observation
- Hernias that cause symptoms (pain, discomfort)
- Complications such as incarceration (trapped contents)
Monitoring Your Child's Hernia
What to watch for:
- Size of the bulge (is it getting larger?)
- Ability to reduce the hernia (can you gently push it back in?)
- Pain or tenderness around the umbilicus
- Changes in skin color over the hernia
- Vomiting or constipation
Complications
Complications are rare but important to recognize:
- Incarceration (when intestine gets trapped in the hernia) occurs in approximately 1 in 1,500 umbilical hernias 2
- Signs of incarceration include:
- A firm, painful lump that cannot be pushed back in
- Redness or discoloration of the skin over the hernia
- Vomiting, abdominal pain, or irritability
- Refusal to eat
When to Seek Immediate Medical Attention:
Contact your doctor immediately if:
- The hernia becomes hard, discolored, or painful
- Your child develops vomiting or abdominal pain
- The hernia cannot be pushed back in
- Your child appears to be in pain or distress
Surgical Repair
If surgery is needed:
- It's typically a short, outpatient procedure
- The surgeon makes a small incision at the base of the umbilicus
- The protruding tissue is returned to the abdominal cavity
- The opening in the muscle is closed with stitches
- Recovery is usually quick with minimal discomfort
- Complications are uncommon but may include wound infection 3
Daily Care and Activities
Your child can:
- Bathe and shower normally
- Participate in regular activities and play
- Attend school or daycare as usual
- Eat a normal diet
No special care is needed for the umbilical hernia itself, though keeping the area clean and dry is always good practice.
Common Questions
Will my child outgrow this? Most children (80-90%) will outgrow umbilical hernias by age 3-4 years.
Does my child need to avoid certain activities? No, children with umbilical hernias can participate in normal activities.
Is an umbilical hernia painful? Most umbilical hernias are painless. Pain may indicate a complication requiring medical attention.
Will the belly button look normal after healing? After spontaneous closure or surgical repair, most children have a normal-appearing belly button.