Inguinal Hernia in Babies

Overview

What are inguinal hernias in babies?

An inguinal hernia in an infant is a hernia that occurs in the groin. Inguinal means groin. The groin is the area between your child’s belly (abdomen) and thighs.

An inguinal hernia occurs when part of your child’s intestine pushes through an opening in their abdominal wall through their inguinal canal. The inguinal canal extends from your baby’s abdomen to their genitals.

The inguinal canal is supposed to close before birth, but sometimes it doesn’t close all the way. This leaves a hole for your child’s intestine to slide through. You can see and feel an abnormal bulge or mass in your child’s groin or scrotum. You may only notice the bulge when your child is crying, coughing or straining.

Inguinal hernias usually only develop on one side of your child’s groin. They develop on the right side more often than on the left side. About 10% of the time, inguinal hernias develop on both sides of the groin.

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Who do inguinal hernias affect?

Inguinal hernias can affect infants, toddlers, children and adults. In children, they’re most common in kids under 6 years old. About 90% of inguinal hernias in newborns are in baby boys. Inguinal hernias are more common in premature infants.

How common is this condition?

Inguinal hernias occur in 1% to 5% of healthy, full-term baby boys. Up to 30% of premature babies are born with an inguinal hernia.

What risks are associated with inguinal hernias?

Your child will need a simple surgery to fix the inguinal hernia. Rare but serious complications can develop if your child doesn’t receive treatment:

  • Incarcerated hernia: Incarceration occurs when the contents of the hernia get stuck. When this happens, your child’s healthcare provider can’t push the hernia back into your child’s abdomen.
  • Strangulated hernia: When a hernia gets stuck, strangulation can occur. This means the blood supply to your child’s intestines gets cut off. Lack of blood flow to your child’s intestines can cause tissue death. This is a very serious and painful condition that is a medical emergency.

Symptoms and Causes

What are the symptoms of inguinal hernia in children?

The main symptom of an inguinal hernia in your child is a bulge you can see under the skin in their groin or scrotum. It may get larger after your child has been crying or straining. The bulge may come and go. It may get smaller or go away when your child is relaxed or asleep. They may have a bulge in one or both sides of their groin.

Other inguinal hernia symptoms in kids may include:

  • Pain and discomfort that improves with rest.
  • Heaviness or pressure in their groin.
  • Swollen scrotum.
  • Burning at the site of the bulge.
  • Crankiness and difficulty feeding in infants.

If your child has an incarcerated hernia or a strangulated hernia, it’s a medical emergency. Get medical care for your child right away if they develop any of the following symptoms:

  • Severe pain or tenderness.
  • Redness and bruising around the site of the bulge.
  • No appetite.
  • Fever.
  • Nausea and vomiting.
  • Bloody poop (stool).

What causes an inguinal hernia in babies?

All babies are born with a tunnel-like passage called the inguinal canal. The inguinal canal extends from your baby’s belly (abdomen) to their genitals. During fetal development, a baby boy’s testicles form inside his abdomen. Then his testicles move through the inguinal canal into his scrotum.

Normally, the inguinal canal closes before birth. But sometimes, it doesn’t close all the way. This leaves an opening from your baby’s belly into the inguinal canal. When this happens, your baby’s intestines can slide through the opening, causing a hernia.

Inguinal hernias are rare in female babies, but they can occur. Female children have inguinal canals too. Inguinal hernias in baby girls may contain part of their reproductive system, such as an ovary.

Diagnosis and Tests

How is an inguinal hernia diagnosed?

Your child’s healthcare provider should be able to diagnose an inguinal hernia through a physical examination. They’ll look for a bulge in your child’s groin or scrotum while they’re crying or straining. They’ll determine if it goes away while your child is relaxed.

If your child is old enough, your provider may ask them to stand or cough while they look for a bulge. They may try to gently massage the hernia back into place. Rarely, your child’s healthcare provider may order a test such as an ultrasound to confirm the diagnosis.

Management and Treatment

What is the treatment for an inguinal hernia in babies?

Your child will need surgery to fix an inguinal hernia. The surgery usually takes less than an hour and is typically an outpatient procedure. This means your child can go home the same day as the procedure.

Before surgery

An anesthesiologist will give your child general anesthesia. An anesthesiologist is a physician who specializes in pain relief. General anesthesia relaxes your child's muscles and puts them to sleep. Your child will not feel pain during the surgery.

During surgery

Your child’s surgeon will make a small cut (incision) in the skin of your child’s groin. They’ll push the contents of the hernia back into your child’s abdomen. Then they’ll close the opening in the inguinal canal to prevent another hernia. Small strips of tape will cover and close your child's incisions.

After surgery

Your child should be able to go home a few hours after surgery. If your child was premature or has certain medical conditions, they may need to spend the night in the hospital for observation.

Your child’s healthcare provider will schedule a follow-up appointment for seven to 10 days after your child's surgery. They’ll want to assess your child's incision and make sure your child is making a full recovery.

How can I take care of my child after treatment?

Your child may have some mild pain or discomfort after surgery. The pain should lessen within one to two weeks. Your child’s healthcare provider may prescribe pain medications.

You may give your child a sponge bath the day after surgery. But don’t bathe your child in a bathtub for two to three days after surgery.

The small pieces of tape covering your child's incisions should gradually fall off on their own. Don’t pull these strips off yourself. If the strips don’t fall off on their own, your child’s healthcare provider will remove them at your child's follow-up appointment.

Prevention

How can I prevent an inguinal hernia in my baby?

If your baby was born with an opening in their inguinal canal, a hernia may develop at any time. There’s no way to prevent the development of a hernia.

Outlook / Prognosis

What can I expect if my child has an inguinal hernia?

Inguinal hernias in babies and children are common. Your child will need surgery to correct the hernia. But the procedure is quick and easy. The surgery is usually an outpatient procedure, so your child should be able to go home the same day.

When can my child resume normal eating habits and other activities?

As soon as your child is able, they can resume normal eating habits. They should be able to return to other normal activities within one to two weeks.

Living With

When should my child see their healthcare provider?

You may notice some minor swelling around your child’s incision. This is normal and could last a few weeks. But call your child’s healthcare provider if they develop any of the following symptoms:

  • Unable to pee (urinate).
  • Fewer wet diapers than usual.
  • Fever above 100.4°F (38°C).
  • Excessive swelling.
  • Redness around the incision site.
  • Bleeding from the incision site.
  • Increasing pain.
  • Vomiting.

Frequently Asked Questions

What’s the difference between an inguinal hernia and an umbilical hernia?

An umbilical hernia is a hernia that happens near your child’s belly button (navel). Fatty tissue or part of their intestine pushes through a hole in their abdominal wall. An umbilical hernia sometimes goes away on its own. An inguinal hernia occurs near your child’s groin and usually requires surgery.

What is the difference between an inguinal hernia and a hydrocele?

Hydroceles are sacs filled with fluid in your baby’s groin or scrotum. Hydroceles resemble inguinal hernias, but there’s no tissue in a hydrocele sac. About 10% of all baby boys have a hydrocele when they’re born. If your baby has a hydrocele, they won't need surgery right away unless it’s painful. Baby girls don’t get hydroceles, but they can get hernias.

A note from Cleveland Clinic

If your newborn has an inguinal hernia, you may be concerned. But inguinal hernias are common in infants and children. If you notice a bulging spot near your baby’s groin, take them to their healthcare provider right away. While inguinal hernias can look and sound scary, they’re a common diagnosis and easily treatable. Your child will need surgery to correct the issue. But they’ll be feeling better within days to weeks.

Last reviewed by a Cleveland Clinic medical professional on 03/08/2022.

References

  • American Academy of Pediatrics. Inguinal Hernia in Infants & Children. (https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Inguinal-Hernia.aspx) Accessed 3/8/2022.
  • American Urological Association. What are Hydroceles and Inguinal Hernias? (https://www.urologyhealth.org/urology-a-z/h/hydroceles-and-inguinal-hernia?article=129%2c129) Accessed 3/8/2022.
  • Merck Manual. Inguinal Hernia in Children. (https://www.merckmanuals.com/home/children-s-health-issues/digestive-disorders-in-children/inguinal-hernia-in-children) Accessed 3/8/2022.
  • National Institute of Diabetes and Digestive and Kidney Diseases. Inguinal Hernia. (https://www.niddk.nih.gov/health-information/digestive-diseases/inguinal-hernia) Accessed 3/8/2022.

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