What are the other Names for this Condition? (Also known as/Synonyms)

• Omphalocele in Children
• Pediatric Omphalocele
• Pediatric Umbilical Hernia

What is Umbilical Hernia in Children? (Definition/Background Information)

• When a part or whole of an internal organ protrudes through weak areas of the adjoining abdominal wall muscles, the condition is termed as a hernia
• Medically, there are various types of hernia, and these are called:
  • Inguinal hernia
  • Incisional hernia
  • Femoral hernia
  • Umbilical hernia
  • Hiatal hernia
• Umbilical Hernia in Children is a common occurrence. It is either a congenital abnormality or an acquired condition
• An abnormal bulge is seen or felt over the child’s navel (belly button). This bulge becomes prominent, when the child strains its stomach muscles during coughing, crying, or during bowel movements
• Many cases of Umbilical Hernias in Children resolve on their own, while others may require surgical corrections
• The prognosis with proper treatment is usually excellent

Who gets Umbilical Hernia in Children? (Age and Sex Distribution)

• The incidence of Congenital Umbilical Hernia is about 10-16%, or 1 in every 6-10 children have the condition at birth
• The abnormality can be seen after birth, or after the umbilical cord stump falls-off
• Both male and female babies are equally affected
• It is more common among African-American children than in children of other races

What are the Risk Factors for Umbilical Hernia in Children? (Predisposing Factors)

The risk factors associated with Umbilical Hernia in Children are:

• Low birth weight and preterm babies
• Children born to African American parents seem to have a higher risk. The reason for this is unknown
• Babies born with certain genetic disorders, such as Down syndrome, Edwards syndrome, and Patau syndrome
• Accumulation of fluid in the abdomen (ascites), due to various cancers
• Chronic coughing, due to allergies or frequent respiratory infections
• Obesity can weaken the muscles of abdominal wall

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Umbilical Hernia in Children? (Etiology)

• Pediatric Umbilical Hernia is either a congenital abnormality or an acquired condition
• The congenital cause of umbilical hernia is due to weaknesses in the abdominal wall, near the region of the umbilicus. Such a congenital weakness occurs due to a developmental defect of the abdominal wall, while the child is in the womb, during the pregnancy. The abdominal contents protrude through this defect
• The acquired cause of umbilical hernia is due to increase in pressure in the abdomen from a variety of causes that include:
  • Obesity
  • Ascitis (fluid accumulation in the abdomen)
  • Chronic coughing

What are the Signs and Symptoms of Umbilical Hernia in Children?

The signs and symptoms due to Umbilical Hernia in Children may be:

• A soft usually painless bulge under the skin of the belly button (about 1-5 cm in size)
• The bulge is more prominent, when the baby cries, coughs, or strains its stomach muscles
• Redness or swelling in and around the bulge
• The bulge may disappear, when the child is quite or lies on its back

How is Umbilical Hernia in Children Diagnosed?

Umbilical Hernia in Children may be diagnosed through:

• A physical examination by a qualified physician or pediatrician
• A thorough medical history is also very important
• It is important to recognize the signs and symptoms of obstruction and strangulation of the bowel, in umbilical hernias. These include:
  • Pain at the hernia site
  • Nausea and vomiting
  • Reddish discoloration over the skin of the umbilical hernia
• Imaging studies may be required to screen for any complications

Note: It is important to differentiate between an umbilical hernia and para-umbilical hernia. Para-umbilical hernia usually occurs in adults and is present near the umbilicus, but not at the umbilicus.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Umbilical Hernia in Children?

The possible complications of Umbilical Hernia in Children may include:

• Strangulation of bowel tissue
• Obstruction of Intestine leading to damage of bowel
• Rarely obstruction and strangulation leads to perforation of the bowel wall, which is a medical emergency

It has been postulated that the size of the base of the umbilical hernia defect is an important factor, when it comes to strangulation and obstruction.

• Larger the hole in the base of the umbilical hernia defect, the lower is the chances for strangulation and obstruction
• Similarly, smaller the hole in the base of the umbilical hernia defect, higher is the chance for strangulation and obstruction

How is Umbilical Hernia in Children Treated?

Usually, Umbilical Hernias in Children disappear on their own, within the first 12-18 months. For other cases, the following treatment methods may be necessary:

• If the hernia persists, a surgery might be recommended. A physician would usually wait until the baby is 4-6 years old, before performing any invasive procedures
• Also, a physician recommends surgery based on the risk factors in the child. These include, if the umbilical hernia is incarcerated, or is more than 1.5 cm in diameter
• Incarcerated hernias are those which cause severe umbilical pain, tenderness, and redness. These need to be evaluated by a physician and treated, in order to prevent any intestinal damage

How can Umbilical Hernia in Children be Prevented?

Currently, there are no definitive methods available to prevent Umbilical Hernias in Children.

What is the Prognosis of Umbilical Hernia in Children? (Outcomes/Resolutions)

• Umbilical Hernia in Children is usually not a life-threatening condition. in many children, the hernias disappear spontaneously, around the age of 1-3 years, without any treatment
• The prognosis for umbilical hernia with treatment and surgery (if required) is excellent. Most children are able to lead normal and active lives thereafter
• If Umbilical Hernia in Children results in obstruction or strangulation of the bowel wall, then the prognosis can be guarded without prompt treatment

Additional and Relevant Useful Information for Umbilical Hernia in Children:

Mothers usually tend to push the belly-button inside, to make the hernia disappear. This should be strictly avoided, as it might lead to other complications.