Umbilical hernia in the newborn: what it is and when to intervene

By Cristiano Antonino On Feb 27, 2023

Umbilical hernia is a protrusion of a small portion of the intestine (omentum, intestinal loops) through the abdominal muscles, due to incomplete closure of the umbilical ring

It is a very common hernia in childhood, particularly in premature or low-weight infants and African-American children.

In infants, the umbilical hernia manifests itself following the fall of the umbilical cord and presents as a bulge at the umbilicus, of elastic consistency and variable size (from 1 cm to 5 cm), which tends to reduce with the simple pressure of a finger while it tends to become more evident in situations that cause an increase in intra-abdominal pressure (crying, coughing, straining).

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How to treat umbilical hernia in the newborn?

In most cases umbilical hernia is asymptomatic and tends to resolve spontaneously by 12-18 months of age, without resorting to medical treatment or the use of restraining devices (patches, elastic bands, coins, buttons).

Although the presence of an umbilical hernia in a newborn is a cause of anxiety and concern for parents, it is important to remember that the umbilical hernia rarely leads to complications, such as clogging or choking.

In both situations, where the swelling appears hard, painful and non-reducible, surgical evaluation in an emergency room is always necessary for immediate treatment.

Of course, periodic paediatric or surgical examinations should be performed to assess the evolution of the hernia and the appropriate treatment.

When to operate on the umbilical hernia?

In view of the benign course, surgery is indicated if the umbilical hernia does not resolve spontaneously, but only after 5 years of age, or in cases where the hernia becomes symptomatic or tends to progressively increase in volume.

The surgical procedure consists of reducing the herniated content in the abdominal cavity and closing the defect without the use of a prosthesis.

The operation is performed under general anaesthesia and Day Surgery, with discharge a few hours after the surgical procedure.

Children can resume school activities after 5-7 days, while they can resume sporting activities 2-3 weeks after surgery.