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Umbilical hernias in children

Children and infants can suffer from both umbilical and inguinal hernias. Fortunately, umbilical hernia surgery is an available treatment option to treat an infant umbilical hernia.

surgeon chops mesh for hernia
An umbilical hernia is a lump at the umbilicus (belly button).

The abdominal cavity contains the intestines and other structures. These are protected by the abdominal wall, which is made up of four layers.

The inner layer is a membrane. The second layer is a wall made of muscle. A layer of fat separates the muscle from the outer layer of skin.

This produces a lump called a hernia. If your child has an umbilical hernia, surgery can fix it.

An umbilical hernia in newborns is relatively common, particularly in premature babies. Umbilical hernias in newborns can form when the opening for the umbilical cord does not close properly. This causes the abdominal lining and bowel to bulge out to form a lump.

An umbilical hernia in a toddler is also common, forming from weak spots in the abdominal muscles.

In many instances, the umbilical hernia goes back in and the muscles heal before the child's first birthday.

The operation is performed under a general anaesthetic and usually takes about an hour.

Your Consultant will make a small cut around half of the umbilicus. Then, they will close the opening in the tough layer of the abdominal wall with strong stitches.

Your child should no longer have the hernia.

Surgery should prevent your child from having any of the serious complications that a hernia can cause in adult life.

It is unusual for an umbilical hernia to cause serious problems, such as the bowel getting stuck in the hernia (known as strangulation).

So, it is safe in young children to wait and see if the hernia will close without surgery.

If your child is over three years old and they still have an umbilical hernia, the hernia is unlikely to close. 

Like all surgical procedures, there are some levels of risks to consider. Some of these can be serious. However, you can speak to your Consultant about the following general and specific complications that may worry you.

General complications of any operation

Specific complications of umbilical hernia surgery

  • Developing a lump under the wound caused by stitches, or a collection of blood or fluid;
  • Injury to structures within the hernia that come from the abdomen, and
  • Unsightly appearance, as the skin of the umbilicus may continue to stick out.

Your child may feel tired or cry regularly after the operation. This is normal, so don't be worried.

Most adults and children can go home a few hours after surgery.

Your Consultant will keep you informed with key information about the recovery time and managing your child's healing at home.

An inguinal hernia happens when the contents of the abdomen push down towards the scrotum in boys.

In the case of an inguinal hernia in a baby girl, contents of the abdomen push down towards the labia (folds of skin at the entrance of the vagina).

If your child has an inguinal hernia, hernia repair surgery can fix it.

Inguinal hernias can be repaired using keyhole surgery, also known as laparoscopic surgery, but most inguinal hernias in children are repaired through a cut on the groin.

The operation is performed under a general anaesthetic and usually takes about an hour.

Your Consultant will make a cut on the groin and find the hernial sac.

In boys, the sac is stuck on to the blood vessels that supply the testicle. It is also stuck on to the vas, the tube that will carry sperm away from the testicle.

In girls, the hernia can contain an ovary or part of the fallopian tube. Your Consultant will put back the contents of the sac into the abdominal cavity and peel the sac away before tying it off.

Your child should no longer have the hernia.

Surgery should prevent your child from having any of the serious complications that a hernia can cause and allow them to return to normal activities.

Unfortunately, a hernia will not get better without surgery.

  • Developing a collection of blood or fluid under the wound;
  • Developing a hydrocele, which is a swelling around the testicle;
  • Injury to structures within the hernia that come from the abdomen;
  • Damage to nerves that supply the skin around the groin;
  • Damage to the blood supply to the testicle;
  • The testicle may come to lie higher in the scrotum, and
  • Damage to the vas.

Your child should be able to go home the same day.

They should be able to return to school after a week, but should refrain from strenuous activities for six weeks.

Most children make a full recovery. It is always a good idea to phone your Consultant for any advice throughout your child's recovery period.

If your child is over three years old, surgery is recommended to prevent serious complications that can happen in adult life.

Unfortunately, a hernia will not get better without surgery.

Book an appointment online, or find out more by calling us on  0141 300 5009.

Acknowledgements

  • Authors: Mr Shailinder Singh DM FRCS (Paed. Surg.), Mr Jonathan Sutcliffe FRCS
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