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Umbilical hernia

Definition

An umbilical hernia is an outward bulging (protrusion) of the abdominal lining or part of the abdominal organ(s) through the area around the belly button.

Causes, incidence, and risk factors

An umbilical hernia in an infant occurs when the muscle through which blood vessels pass to feed the developing fetus doesn't close completely.

Umbilical hernias are common in infants. They occur slightly more often in African Americans. Most umbilical hernias are not related to disease. However, umbilical hernias can be associated with rare conditions such as mucopolysaccharide storage diseases, Beckwith-Wiedemann syndrome, and Down syndrome.

Symptoms

A hernia can vary in width from less than 1 centimeter to more than 5 centimeters.

There is a soft swelling over the belly button that often bulges when the baby sits up, cries, or strains. The bulge may be flat when the infant lies on the back and is quiet.

Signs and tests

The doctor can find the hernia during a physical exam.

Treatment

Usually, no treatment is needed unless the hernia continues past age 3 or 4. In very rare cases, bowel or other tissue can bulge out and lose its blood supply (become strangulated). This is an emergency needing surgery.

Expectations (prognosis)

Most umbilical hernias get better without treatment by the time the child is 3 - 4 years old. Those that do not close may need surgery. Umbilical hernias are usually painless.

Complications

Strangulation of bowel tissue is rare but serious, and needs immediate surgery.

Calling your health care provider

Call your health care provider, or go to the emergency room if the infant is very fussy or seems to have bad abdominal pain, or if the hernia becomes tender, swollen, or discolored.

Prevention

There is no known way to prevent an umbilical hernia. Taping or "strapping" an umbilical hernia will not make it go away.

References

Carlo WA. The Umbilicus. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 99.


Review Date: 8/2/2011
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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