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Newborns with Herniated Belly Buttons
Author: Dr. Anna Kaplan
A herniated belly button is another name for an umbilical hernia. If your baby has one, you will see a swelling in the area of his belly button. A hernia is a weakness in the lining of the abdomen. In the case of an umbilical hernia, the weakness is in the umbilical ring below the belly button. Intestines, which obviously belong inside the abdomen, can protrude out through the weak wall of a hernia. With a belly button hernia, you may see a mass in the area of the belly button. It can get bigger when your baby is crying, because crying increases the pressure inside. It may disappear completely when he is quiet. A herniated belly button is soft and you can push it back.
The belly button, or umbilicus, is where the umbilical cord connected your blood supply to your baby while you were pregnant. After birth, the skin in the area heals, the stub of the umbilical cord normally falls off, and the umbilical ring below closes. If the ring does not close, the baby will have an umbilical hernia. This usually appears during the first few months of the baby’s life and is more common in premature babies and African-American babies.
Most small umbilical hernias close by the time the baby is four or five years old; however, hernias bigger than two centimeters in diameter usually do not close. If your baby has a large hernia, or one that has not closed by around age four, it will need to be repaired by a surgeon (some surgeons will consider a repair at a slightly earlier age).
Up until that point, parents and pediatricians just need to keep an eye on the hernia. It is rare with this type of hernia (one case for every 1,500 hernias), but if the intestines get caught in the hernia and can’t get back into the abdomen, their blood supply will get cut off. If this happens, the baby will have a hard mass in the area that you cannot push back inside. The baby will be crying and refusing to eat. This is an emergency and you must get medical care for the baby immediately.
If the hernia does not close, surgery will be scheduled on a non-emergency basis. It is usually a same-day surgery, meaning your child will not have to stay overnight in the hospital. If this happens, your child cannot have food or water from about midnight the night before, until after the surgery. You will take him to the hospital, and they will do the surgery, which is under general anesthesia. After he is awake, you will probably be able to take him home. He will probably have pain from the surgery, and the surgeon will give you recommendations about pain medicine. He may have nausea and vomiting from the anesthesia.
The good news is most children recover very quickly and there is really no visible scar because the surgery was in the belly button. After it closes on its own, or is repaired surgically, the umbilical hernia is no longer a problem.
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