Umbilical Hernia in Children

What Is An Umbilical Hernia?

An umbilical hernia is an opening, or hole, in the abdominal wall at site of the belly button. Sometimes referred to as an “outy,” the hernia may allow abdominal contents such as fat or intestine to poke through. About 80% of umbilical hernias will close on their own by the time the child is four years old and will not require surgery. Occasionally, umbilical hernias—especially large ones–will not close on their own and should be repaired. If this is the case, the timing of repair will depend on several factors and your surgeon will help guide you so that your child receives the best possible care.

Types of Umbilical Hernias

There are different types of umbilical hernias:
  • The most common type is a congenital hernia, which is present at birth. Congenital umbilical hernias are more common in girl than boys. They are also more common in premature babies. Congenital umbilical hernias are usually small and do not cause any problems. They often close on their own by the time the child is 5 years old. However, if the hernia does not close on its own, surgery may be necessary to repair it.
  • Another type of umbilical hernia is an acquired hernia. Acquired hernias are not present at birth. They develop later in life, usually as a result of increased abdominal pressure. Increased abdominal pressure can be caused by obesity, pregnancy, or heavy lifting. Acquired umbilical hernias can be larger than congenital hernias. They may also cause pain or discomfort. If an acquired hernia does not close on its own, surgery may be necessary to repair it.

Umbilical Hernia Causes

The exact cause of umbilical hernias is not known, but there are a number of factors that may increase the risk of developing an umbilical hernia, including: 
  • Age: Umbilical hernias are more common in babies and young children. 
  • Gender: Umbilical hernias are more common in girls than boys. 
  • Prematurity: Umbilical hernias are more common in premature babies. 
  • Low birth weight: Umbilical hernias are more common in babies with low birth weight. 
  • Family history: People with a family history of umbilical hernias are at an increased risk of developing the condition. 
  • Obesity: Obesity can increase the risk of developing an umbilical hernia. 
  • Pregnancy: Pregnancy can increase the risk of developing an umbilical hernia. 
  • Chronic coughing or straining: Chronic coughing or straining can increase the pressure in the abdomen, which can increase the risk of developing an umbilical hernia. 

Is an umbilical hernia dangerous?

Umbilical hernias are common and typically are not considered dangerous.  With any hernia, there is always a risk of “incarceration.”  Incarceration means that things poking through the hole (fat, intestine, or other tissue) get stuck.  This can be very painful and can lead to “strangulation.”  Strangulation means that the things poking through the hole are so tightly trapped that they do not receive adequate blood flow and can die, potentially resulting in a severe problem for your child.  Fortunately, the risk of incarceration and strangulation with umbilical hernias is extremely low.  If you are a parent of a child with umbilical hernia, you should not fear that incarceration or strangulation are likely to happen.  Signs and symptoms of incarceration or strangulation include severe pain at the hernia site, redness at the hernia site, and vomiting.  Parents can try to reduce the hernia by applying gentle pressure at the site while your child is lying down.  If this is not successful, please contact us immediately or come to CHOC’s emergency department. 

Umbilical Hernia Repair Surgery and Treatment

Umbilical hernia repair involves a short operation, usually performed on an outpatient basis. Your child will be scheduled for surgery from our office.

Does repair surgery require anesthesia?

Anesthesia requirements include a period of not eating or drinking before the operation. The duration will depend on your child’s age. Your child will undergo a general anesthetic which will put him or her completely to sleep and prevents the sensation of pain. The full risks of anesthesia will be further explained by your child’s anesthesiologist. Learn how CHOC anesthesiologists are specifically trained in providing anesthesia for children.

How does umbilical hernia repair surgery work?

The operation consists of making an incision near the belly button, usually underneath. The repair is accomplished by placing stitches on both sides of the hole (the hernia) to bring the edges together. The belly button is then tacked down to make it look like an “inny.” Excess skin is often left in place because over time, this results in the best cosmetic appearance. Usually, a dressing is placed over the site which can be removed in four to five days. Surgical glue may also be used to cover the incision. Your child can take a shower but should wait seven days before bathing in a tub.

Umbilical Hernia Surgery Recovery

Once the operation is completed, your child will be taken to the recovery room where monitoring will continue for a short period. This is done to assure that waking up from the anesthetic is done safely. You will be able to go to this area so that waking up is less scary for your child. Your child may resume all activity after the follow-up visit, which is usually two to three weeks after the surgery. This allows for the repair to become a bit stronger before heavy stress is placed on the repair.

Treatment after repair surgery

Pain management consists of a local injection which helps numb the site for six to eight hours and then oral pain medication such as Tylenol.

Reir surgery follow-ups

Patients should be seen two to three weeks after the operation to evaluate the incision. There are no stitches to remove. There is no need to come back to the office unless specific problems are identified during the first follow-up visit.

Health Feature: Identifying Hernias

Cute smiling healthy baby boy

Umbilical hernias are what we call “outies,” Dr. Reyna says. This is a bulge in the belly button and it may not be seen until the baby’s umbilical cord falls off. “About 75-80 percent of umbilical hernias will close on their own by age two without treatment as the baby grows and develops anti-gravity muscles. If it’s still there when the baby is two, then you can see about getting it fixed,” Dr. Reyna says.

Frequently Asked Questions About Umbilical Hernias

Umbilical hernias are one of the most common conditions infancy and childhood. The true incidence is unknown because many resolve spontaneously.
Umbilical hernias don’t often incarcerate and do not represent an emergency. They should be evaluated immediately if they cannot be reduced or if there is associated pain and vomiting.
In most cases, there is no need to worry about a baby's umbilical hernia. Most umbilical hernias in babies close on their own by the time the child is 5 years old.
You should be concerned about an umbilical hernia if it is large, if it causes pain, or if it does not close on its own by the time the child is 5 years old. If you are concerned about your child's umbilical hernia, contact us!
An umbilical hernia is located near the belly button. It is a bulge or lump that can be seen or felt in the area of the belly button.
Yes, navel hernias, belly button hernias and umbilical hernias are all the same thing. They are a type of hernia that occurs when a loop of intestine or other tissue pushes through a weak spot in the abdominal wall near the belly button.
Yes, you can live a normal life with an umbilical hernia. Most umbilical hernias do not cause any problems and do not require treatment. However, if your umbilical hernia is large or causes pain, you may want to talk to your doctor about surgery.
The risk of recurrence is very low and depends on the initial care of the repair site. It is important to avoid infection and strenuous activity until the first follow-up visit.

Meet Our Pediatric Surgeons

Ahmad, Hira MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Ahmad is a board certified general surgeon and board eligible pediatric surgeon who is on medical staff at CHOC Hospital in Orange.

Awan, Saeed MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Saeed Awan is a board certified pediatric general and thoracic surgeon who treats children and teens at CHOC in Orange County.

Bone, Ashley NP

Specialty: Pediatric Surgery
Office: 714-364-4050

Ashley Bone is a nurse practitioner who provides care for kids and teens at CHOC Hospital in Orange.

Bragg, Kelcie NP

Specialty: General Surgery
Office: 714-509-4096

Kelcie Bragg is a nurse practitioner who is part of CHOC Surgical Services and provides care for kids and teens at CHOC Hospital in Orange.

Gholizadeh, Maryam MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr Maryam Gholizadeh is a board-certified pediatric surgeon who performs general and thoracic surgeries on infants, kids and teens at CHOC.

Gibbs, David L. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Gibbs is a pediatric surgeon, also serving as director of trauma services at CHOC and division chief of pediatric surgery.

Goodman, Laura F. MD

Specialties: Pediatric Surgery, Thoracic Surgery
Office: 714-364-4050

Dr. Goodman is a pediatric general and thoracic surgeon who performs surgery on infants and children at CHOC Hospital in Orange

Guner, Yigit S. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Yigit Guner is a board-certified pediatric surgeon who performs general and thoracic surgeries on infants, kids and teens at CHOC.

Hill, Melisa NP

Specialties: Pediatric Surgery, General Surgery
Appointments: 714-509-3575
Office: 714-509-3595

Melisa Hill a nurse practitioner who specializes in pediatric surgery for infants, kids and teens at CHOC Hospital in Orange, CA.

John, Rebecca NP

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Rebecca John is a nurse practitioner who specializes in pediatric surgery for infants, kids and teens at CHOC Hospital in Orange.

Kabeer, Mustafa H. MD

Specialty: Pediatric Surgery
Appointments: 714-364-4050
Office: 714-364-4050

Dr. Mustafa Kabeer is a board-certified pediatric surgeon at CHOC, performing all types of general surgery and specializing in pectus excavatum (sunken chest), lung resection, hernia and robotic surgery.

Kanamori, Lauren NP

Specialties: Pediatric Surgery, General Surgery
Appointments: 714-509-3575
Office: 714-509-3263

Lauren Kanamori is a nurse practitioner who specializes in pediatric and general surgery for infants, kids and teens at CHOC Hospital in Orange.

To schedule a consultation with a CHOC pediatric surgeon, please call 714-364-4050.