Inguinal and Umbilical Hernias in Children
What are hernias in children?
A hernia is when a part of the intestine pushes through a weak spot in the belly (abdominal)
muscles. The hernia creates a soft lump or bulge under the skin.
In children, a hernia often happens in 1 of these 2 places:
- The groin area. This is called an inguinal hernia.
- Around the belly button. This is called an umbilical hernia.
What causes a hernia in a child?
A baby can develop a hernia in the first few months of life. This happens because
of a weakness in the belly muscles. Inguinal and umbilical hernias happen for slightly
During pregnancy, all babies have an area called the inguinal canal. This goes from
the abdomen to the genitals. In boys, this canal lets the testicles move from the
belly to the scrotum, the sac that holds the testicles. Normally, a baby’s inguinal
canal closes shortly before or after birth. But in some cases the canal doesn’t fully
close. Then a loop of intestine can move into the inguinal canal through the weak
spot in the belly wall. This causes an inguinal hernia. Most inguinal hernias happen
As an unborn baby develops during pregnancy, there is a small opening in the abdominal
muscles. After birth, this opening closes. But sometimes, these muscles don’t fully
close. A small opening is left. A loop of intestine can then move into the opening
between the belly muscles. This causes an umbilical hernia.
Which children are at risk for a hernia?
Hernias happen more often in children who have 1 or more of the following risk factors:
- Being born early, or premature
- Having a parent or sibling who had a hernia as an infant
- Having cystic fibrosis
- Having developmental dysplasia of the hip, a condition that is present at birth
- Being a boy with undescended testes. This means the testicles didn’t move into the
scrotum before birth.
- Having problems with urinary or reproductive organs
Inguinal hernias happen
- In children who have a family history of inguinal hernias
- More often in babies and children with other urinary or reproductive problems
- More often in the right groin area than the left, but can occur on both sides
Umbilical hernias happen
- More often in African-American children
- More often in infants who were born premature
What are the symptoms of a hernia in a child?
Hernias often happen in newborns. But you may not notice a hernia for a few weeks
or months after birth.
- Inguinal hernias appear as a bulge or swelling in the groin or scrotum.
- Umbilical hernias appear as a bulge or swelling in the bellybutton area.
In both cases, the swelling may be easier to see when your baby cries, coughs, or
strains to have a bowel movement. It may get smaller or go away when your baby relaxes.
If your child's healthcare provider pushes gently on this lump when the child is calm
and lying down, it will often get smaller. Or it may go back into the belly.
In some cases, the hernia can’t be pushed back into the belly. Then the loop of intestine
may be stuck in the weak spot of abdominal muscle. When this happens, symptoms may
- A full, round belly
- Belly pain and soreness
- Redness or discoloration near the hernia
If the stuck intestine is not treated, blood supply may be blocked to part of the
intestine. This is a medical emergency.
Hernia symptoms may seem like other health problems. Always talk with your child's healthcare
provider for a diagnosis.
How is a hernia diagnosed in a child?
Your child’s healthcare provider can diagnose a hernia by doing a physical exam. The
healthcare provider will see if the hernia can be gently pushed back into the belly.
This is called a reducible hernia. The provider may order abdominal X-rays or an ultrasound
to check the intestine more closely. This will likely be done if the hernia can’t
be pushed back into the belly.
How is a hernia treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Surgery is needed to treat an inguinal hernia. In many cases surgery is done soon
after the hernia is found. That’s because the intestine can become stuck in the inguinal
canal. When this happens, the blood supply to the intestine can be cut off. The intestine
can be damaged.
During hernia surgery, your child will be given anesthesia. A small cut or incision
is made in the area of the hernia. The loop of intestine is put back into the abdomen.
The muscles are then stitched together. Sometimes, a piece of mesh material is used.
This helps strengthen the area where the muscles are repaired.
Children who have surgery for an inguinal hernia can often go home the same day.
In many cases, an umbilical hernia closes on its own by the time a child is 1 year
old. Almost all umbilical hernias close without surgery by the time a child is 5
years old. Because of this, there are different opinions about when surgery is needed
for an umbilical hernia.
In most cases, your child's healthcare provider may suggest surgery if the umbilical
- Gets bigger with age
- Can’t be pushed back into the abdomen
- Is still there after age 3
Always contact your child's healthcare provider to see what is best for your child.
During surgery for an umbilical hernia, your child will be given anesthesia. A small
cut or incision is made in the belly button. The loop of intestine is put back into
the abdomen. The muscles are then stitched together. Sometimes a piece of mesh material
is used. This helps strengthen the area where the muscles are repaired.
Children who have surgery for an umbilical hernia may be able to go home the same
What are the possible complications of a hernia in a child?
Sometimes the loop of intestine that pushes through a hernia may get stuck. Then it
is no longer reducible. This means that the intestinal loop can’t be gently pushed
back into the stomach. If not treated, blood supply may be blocked to part of the
intestine. This is a medical emergency.
When should I call my child's healthcare provider?
Contact your child's healthcare provider right away if your child’s hernia:
- Becomes red or discolored
- Is painful
- Causes symptoms of vomiting or fever
If you see swelling near your child's belly button or in the groin area, have your
child checked by his or her healthcare provider.
Key points about hernias in children
- A hernia is when a part of the intestine pushes through a weak spot in the belly muscles.
- A hernia creates a soft lump or bulge under the skin.
- A hernia that happens in the belly button area is called an umbilical hernia.
- A hernia that happens in the groin area is called an inguinal hernia.
- Surgery is needed to treat an inguinal hernia. An umbilical hernia my close on its
- In some cases, hernias can get stuck. Blood supply may be blocked to part of the intestine.
This is a medical emergency.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.