Umbilical hernia

What is umbilical hernia?

Umbilical (belly button) hernia is a defect or hole in the wall of the tummy at the belly button. This causes a bulge and sometimes the bowel or fat from inside the tummy can come up into the hernia through the belly button.

What cause umbilical hernia?

Umbilical hernia is present in all babies before birth as the bowel develops outside the tummy. By the end of the pregnancy the opening is smaller and it eventually closes after delivery, this may take many months.

In some children, this opening fails to close and the umbilical hernia persists. You may notice the hernia becomes bigger when your child is laughing or crying but this is very normal.

When to treat umbilical hernia?

Umbilical hernias almost never cause any problems in children. There is no need to cover it or to push it back in. In most children the hernia gets better by itself and the opening closes over time. When the opening has not closed by the age of 4 years a surgery is considered.

What will surgery involve?

Umbilical hernia surgery is done as a day case operation (in and out of hospital on the same day) under a general anaesthetic. The hernia is fixed through a cut made just above or below the belly button. The bowel or fat related to the hernia is pushed back to the tummy and the hole is closed using stitches. The surgery usually takes about 30 minutes with extra time to go to sleep and wake up.

Your child will need painkillers after the surgery. The surgeon will often use a “pressure dressing” to reduce bruising as a result of the operation. This is usually removed after 48 hours.

Complications of the surgery

Risks of the operation include:

• infection of the wound
• return of the hernia (recurrence)
• bleeding
• bruising

These risks are usually very low and the risk of the hernia coming back is about 1 in 100. There is a very small chance of damaging the bowel if it is in the hernia.

What will it be like after the operation?

Recovery from the operation is usually very quick, especially in babies, infants and young children. Food and drinks are usually allowed as soon as your child has woken up.

The area will be sore for a couple of days, but children are usually back to their normal activity within a few days. Regular paracetamol and ibuprofen are useful for pain and keeping them comfortable.

There may be dressing on the wound so the doctor or nurse will give you some instructions of what to do with this.

Your child can go back to swimming after a week. In older children it is best to keep them off games, PE and sports for 2 weeks.