What is an umbilical hernia?
An umbilical hernia is an abnormal bulge, or protrusion, that can be seen or
felt over the belly button (the umbilicus). An umbilical hernia develops when a
portion of the intestine, along with fluid, bulges through the muscle of the
abdominal wall.
Umbilical hernias in children result from a weakness in the
abdominal wall that is present at birth. The bulge in the umbilicus may be
present all the time or may only be noticed when the child is crying, coughing,
or straining during a bowel movement. It may disappear when the child is quiet.
Umbilical hernias occur in one of every six children, and affect
boys and girls equally. Umbilical hernias are more common among African-American
children than Caucasian children. In addition, low birth weight and premature
infants are more likely to have umbilical hernias.
What causes an umbilical hernia?
During a baby's development in the womb, the abdominal organs are formed on
the outside of the baby's body and return to the abdominal cavity around the
tenth week of gestation. If the muscles of the abdominal wall fail to close
around the abdominal organs, an umbilical hernia may form.
Sometimes, the intestines can get trapped in this muscular
defect and cause umbilical pain and tenderness. This is called an incarcerated
hernia and needs to be evaluated by a medical professional to prevent damage to
the intestines. With an incarcerated hernia the child usually has severe pain
and the bulge may be red and firm.
When should an umbilical hernia be repaired?
Ninety percent of umbilical hernias heal on their own by the time the child
is 3 or 4 years old. Therefore, your surgeon will probably recommend waiting
until your child is 3 or 4 before advising surgical repair. However, if the
umbilical hernia is incarcerated or the defect is greater than 1.5 cm in
diameter, it is unlikely to spontaneously heal and will need to be surgically repaired.
Before the surgery
Umbilical surgery takes about an hour and is usually performed as an
outpatient procedure (which means the patient can go home the same day of the procedure).
Dietary guidelines
Strict guidelines are enforced regarding the child's diet the morning of the
surgery. These guidelines will help reduce the risk of vomiting and aspiration
(inhaling fluids) while your child is under anesthesia.
Your child can have his or her regular diet up to 8 hours before
surgery, milk or ice cream up to 6 hours before surgery, and clear liquids
(water, apple juice, gelatin, broth, etc.) up to 3 hours before surgery. After
that time, your child should not eat or drink anything else until after the surgery.
During the surgery
- An anesthesiologist (a doctor who specializes in sedation and pain
relief) gives your child general anesthesia, which relaxes your child's
muscles and induces sleep. Your child will not feel pain during the surgery.
- A small incision, or cut, (from 2 to 3 cm) is made at the base of the belly button.
- The hernia "sac" containing the bulging intestine is identified.
- The surgeon pushes the intestine back into its proper place behind the muscle wall.
- The hernia sac is removed.
- The muscle wall is reinforced with multiple layers of stitches to
prevent another hernia.
- The skin around the belly button is sewn down to the underlying muscle
so it will look like an "innie" instead of an "outie."
- A bulky pressure dressing is applied over the incision to provide
support to the repaired muscle and tissue.
After the surgery
Most children will be able to go home a few hours after surgery. However,
premature infants and children with certain medical conditions may need to spend
one night in the hospital for observation.
Caring for your child after surgery
Usually, your child will feel fine again the evening after surgery or by the
next morning. You will be given a prescription for pain medication for your child. Most parents find that only two or three doses are all the child needs for pain control. After that, over-the-counter analgesics are usually enough to keep the child comfortable.
As soon as your child is able, he or she can resume normal eating habits.
Your child's activities will be temporarily restricted to
prevent damage to the operative site. Your child should not ride a bike, play on
a jungle gym, wrestle, or participate in organized sports until the surgeon
re-evaluates your child at the follow-up visit.
You may give your child a sponge bath the first few days after
surgery. Tub baths are permitted 3 days after surgery, and the bulky dressing
can be removed at this time.
A small piece of tape (called a steri-strip) will remain over
the incision and will gradually fall off on its own. Do not pull this
strip off yourself. If the strip does not fall off on its own, your health care
provider will remove it at your child's follow-up appointment.
When to call your child's care provider
You may notice some minor swelling or discoloration around the incision.
This is normal. However, call your health care provider if your child is unable
to urinate, or has a fever, excessive swelling, redness, bleeding, or increasing pain.
A follow-up appointment will be scheduled from 7 to 10 days after your child's surgery.
Your health care provider will assess your child's wound site and his or her recovery.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
Ask a Health Educator, Live!
Know someone who could use this information?...send them this link.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/27/2009…#6241
