What Is an Umbilical Hernia?

It is a type of hernia that develops due to the failure of the fascia — which surrounds the area where the umbilical cord exits and provides structural support — to close properly. The peritoneum and small intestine herniate through this opening. The size of the hernia defect can range from a few millimeters to 3–4 cm. As the opening becomes larger, the likelihood of spontaneous closure decreases.

Umbilical hernias are observed in approximately 25–50% of children. They occur equally in both male and female infants and have a strong familial predisposition. They are more commonly seen in premature babies and those with low birth weight. In most infants, the defective fascial ring typically closes on its own within the first two years of life. After age two, defects larger than 2 cm — and all defects persisting beyond age four — should be surgically repaired.

The risk of incarceration (strangulation) in umbilical hernias is quite low.

How Is the Diagnosis Made?

A temporary swelling may occur at the belly button during crying or straining. It typically disappears on its own when the baby relaxes. In necessary cases, a definitive diagnosis can be made using ultrasonography.

What Are the Principles of Treatment?

In most cases (around 90%), the condition resolves spontaneously without the need for treatment by the age of 2. If it does not resolve, it can be corrected with a simple day-surgery procedure, similar to the treatment of epigastric hernia.

When should these patients undergo surgery?

• If it has not resolved by age 2 in girls or age 3 in boys
• If incarceration (strangulation) has occurred even once

How Is the Surgery Performed?

Surgical treatment is performed through a semicircular incision made below the navel. The hernia sac is identified and excised, then the intact fascial tissue is closed using absorbable sutures.

What Should Be Done Until the Umbilical Hernia Closes or Until the Child Reaches the Age for Surgery?

In babies with umbilical hernia, no treatment is required during the first two years. Even if the swelling protruding from the abdomen increases in size over time, it will most likely heal spontaneously as the abdominal wall develops. In particular, defects smaller than 1 cm in diameter have a higher and earlier likelihood of closing on their own.

Methods such as taping a coin to the navel or tying off the umbilical cord do not increase the likelihood of healing and should not be used, as they may cause skin necrosis and adhesive allergies.

What Is a Paraumbilical Hernia?

It is a hernia located just above and very close to the umbilicus. It may sometimes occur together with an umbilical hernia. Unlike an umbilical hernia, the hernia sac is not attached to the subcutaneous tissue. Therefore, simply closing the fascial defect is sufficient.

It does not resolve spontaneously, so surgical intervention is recommended after diagnosis. However, because it is very close to the umbilical ring, it may be confused with an umbilical hernia, so careful evaluation is necessary. The diagnosis, treatment, and surgery of this condition are similar to that of an epigastric hernia.

*** The information provided here is intended to inform visitors—particularly families—through the content of this website. None of the information should be considered as medical advice or be used as the basis for any decision or action. Families should always have their child examined by a pediatric surgery specialist and make decisions based on direct consultation with that professional.