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A hernia is when a part of the intestine pushes through a weak spot in the belly (abdominal) muscles. The hernia creates a soft lump or bulge under the skin.
In children, a hernia often occurs in one of these two places:
A baby can develop a hernia in the first few months of life. This happens because of a weakness in the belly (abdominal) muscles. Inguinal and umbilical hernias happen for slightly different reasons.
During pregnancy, all babies have an area called the inguinal canal. This goes from the abdomen to the genitals. In boys, this canal lets the testicles move from the abdomen to the scrotum, the sac that holds the testicles. Normally, a baby’s inguinal canal closes shortly before or after birth. But in some cases the canal doesn’t fully close. Then a loop of intestine can move into the inguinal canal through the weak spot in the belly wall. This causes an inguinal hernia. Most inguinal hernias occur in boys.
As an unborn baby develops during pregnancy, there is a small opening in the abdominal muscles. After birth, this opening closes. But sometimes, these muscles don’t fully close. A small opening is left. A loop of intestine can then move into the opening between the abdominal muscles. This causes an umbilical hernia.
Hernias occur more often in children who have 1 or more of the following risk factors:
Inguinal hernias occur:
Umbilical hernias occur:
Hernias often occur in newborns. But you may not notice a hernia for a few weeks or months after birth.
In both cases, the swelling may be easier to see when your baby cries, coughs, or strains to have a bowel movement. It may get smaller or go away when your baby relaxes. If your child's healthcare provider pushes gently on this lump when the child is calm and lying down, it will often get smaller. Or it may go back into the abdomen.
In some cases the hernia can’t be pushed back into the abdomen. Then the loop of intestine may be stuck in the weak spot of abdominal muscle. When this happens, symptoms may include:
If the stuck intestine is not treated, blood supply may be blocked to part of the intestine. This is a medical emergency.
Hernia symptoms may seem like other health problems. Always see your child's healthcare provider for a diagnosis.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Surgery is needed to treat an inguinal hernia. In many cases surgery is done soon after the hernia is found. That’s because the intestine can become stuck in the inguinal canal. When this happens, the blood supply to the intestine can be cut off. The intestine can be damaged.
During hernia surgery, your child will be given anesthesia. A small cut or incision is made in the area of the hernia. The loop of intestine is put back into the abdomen. The muscles are then stitched together. Sometimes, a piece of mesh material is used. This helps strengthen the area where the muscles are repaired.
Children who have surgery for an inguinal hernia can often go home the same day.
In many cases, an umbilical hernia closes on its own by the time a child is 1 year old. Almost all umbilical hernias close without surgery by the time a child is 5 years old. Because of this, there are different opinions about when surgery is needed for an umbilical hernia.
In most cases, your child's healthcare provider may suggest surgery if the umbilical hernia:
Always contact your child's healthcare provider to see what is best for your child.
During surgery for an umbilical hernia, your child will be given anesthesia. A small cut or incision is made in the belly button. The loop of intestine is put back into the abdomen. The muscles are then stitched together. Sometimes a piece of mesh material is used. This helps strengthen the area where the muscles are repaired.
Children who have surgery for an umbilical hernia may be able to go home the same day.
Contact your child's healthcare provider right away if your child’s hernia:
If you see swelling near your child's belly button or in the groin area, have your child checked by his or her healthcare provider.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.