Umbilical Hernia

An umbilical hernia is a soft swelling at or near the belly button. It happens when a part of the intestine or fat pushes through a weak area in the abdominal wall near the navel. In babies, the muscles around the umbilicus don't close completely after birth.

Very common in newborns — seen in 10–20% of babies, and more common in premature babies. Most close on their own by age 3–5 years without any treatment.

• Soft, painless swelling at the belly button
• Becomes bigger when the baby cries, coughs, or strains
• Goes back inside when the baby is calm or lying down
• Usually no pain or vomiting

Clinical examination by a paediatric surgeon is enough. Ultrasound is needed only in rare cases.

Observation: for hernias under 2 cm, wait till about 5 years. Binders, coins, and belts do not help.

Surgery (herniorrhaphy) is done if the hernia is still present after 5 years, is larger than 2 cm, is painful, or is increasing in size:

• 20–30 minute day-care surgery under general anaesthesia
• A small cut near the navel; the weak muscle is stitched, leaving a cosmetic scar
• The child goes home the same day; normal activities in 1–2 weeks

• Keep the wound clean and dry; sponge bath for 3 days
• Loose clothes for 1 week
• Avoid heavy play and jumping for 2 weeks
• Normal diet can be started once the child is comfortable