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Umbilical hernia in children

Umbilical hernia is when the belly button pops outwards due to a weakness in the muscles in or around the belly button.

There is a separate factsheet available for adults who are considering having an umbilical hernia repair - Umbilical hernia in adults.

Your child's care will be adapted to meet his or her individual needs and may differ from what is described here. So it's important that you follow the surgeon's advice.

  • About umbilical hernia
  • Diagnosis
  • Preparing for your child's operation
  • About the operation
  • What to expect afterwards
  • Recovering from an umbilical hernia repair
  • What are the risks?
  • Sources
  • Related topics

About umbilical hernia

An umbilical hernia is common in children under two years old. It usually heals without treatment. However, your child may need an operation if it doesn't get better by the time he or she is of school age or if the hernia becomes large or causes discomfort.

Diagnosis

The doctor will examine your child's belly button. The belly button will usually bulge out if your child has an umbilical hernia.

Preparing for your child's operation

Umbilical hernia repair is usually done as a day-case procedure under general anaesthesia. This means your child will be asleep during the procedure. Typically, your child must not eat or drink for about six hours beforehand. However, some anaesthetists allow occasional sips of water until two hours before a general anaesthetic.

At the hospital a nurse will ask you questions about your child's general health and check that he or she hasn't had anything to eat or drink. The nurse will also measure your child's heart rate and blood pressure. You must tell the nurse if your child has any allergies or if there is any history of bleeding problems in the family.

A consent form must be signed before the operation can go ahead. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

If you have parental responsibility for the child, you will be asked to sign the consent form. People with parental responsibility are usually, but not invariably, the child's birth parents. Older children may wish to sign this form too. In some circumstances, a child can sign their own consent form independently, provided that he or she understands what they are being asked to do.

About the operation

The operation usually takes 20 to 30 minutes. The aim of a hernia repair operation is to push the contents of the bulge back into the abdomen (tummy) and strengthen the abdominal wall. In children this is usually done using open surgery.

A small cut is made just above or below the belly button, and the bulge is pushed back into place. Strong stitches are used over the weak spot to strengthen the wall of the abdomen. The skin cut is closed with dissolvable stitches and covered with a dressing.

Your child may be given a local anaesthetic before he or she wakes up, either by injection or by gel applied to the area. This means that your child will feel less pain immediately after the operation.

What to expect afterwards

Your child will be monitored for a short while. He or she will be groggy, and may feel or be sick. He or she will need to rest on the bed until the effects of the general anaesthetic have passed.

The surgeon may prescribe antibiotics for a few days, although this is very rare. If your child is prescribed antibiotics, it's important that he or she finishes the course.

A nurse will give you advice about caring for your child's healing wound and a date for a follow-up appointment before you go home.

Recovering from an umbilical hernia repair

A district nurse may visit your child the day after the operation. He or she will check on your child's progress and answer any questions you may have.

For pain relief, you can give your child over-the-counter painkillers such as paracetamol or ibuprofen syrup (for example, Calpol or Calprofen). Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice. Do not give aspirin to children under 16.

Contact your GP or the hospital if your child complains of severe pain or shows signs of worsening pain. For example young children cry more when they are in pain and are difficult to settle.

Your child should wear loose clothing until the wound is fully healed. The area should be kept dry for 48 hours after the operation - so don't give your child a shower or bath for the first two days. After this, give your child a warm bath once or twice a day, without adding bubble bath or scented soaps. These may irritate the healing wound. When you do bathe him or her, the dressing may come off. This is normal and it doesn't need to be replaced.

Dissolvable stitches will disappear on their own in seven to 10 days.

Your child may need to take a few days off school and shouldn't ride a bike or swim for at least two weeks.

What are the risks?

Umbilical hernia repair is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted, but mostly temporary effects of a successful procedure, for example feeling sick as a result of the general anaesthetic. Your child will have some pain, bruising and minor swelling in the lower abdomen for a week or two.

Complications

This is when problems occur during or after the operation. Most children are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or infection. Complications may require further treatment such as returning to theatre to stop bleeding, or antibiotics to deal with an infection.

There's a chance the umbilical hernia may re-occur.

The exact risks are specific to your child and differ for every person, so we have not included statistics here. Ask the surgeon to explain how these risks apply to your child.

Sources

  • McLatchie GR, Leaper DJ. Oxford Handbook of Clinical Surgery. Oxford: Oxford University Press, 2002:388
  • Golladay ES. Abdominal hernias. Emedicine. www.emedicine.com, accessed 14 February 2008
  • Morris PJ, Malt RA (eds). Oxford Textbook of Surgery: Volume 1. Oxford: Oxford Medical Publications, 1994:1409

Related topics

Caring for surgical wounds

General anaesthesia