57442157What is an Umbilical Hernia?

This condition is caused by a weakness in the abdominal wall muscles around the umbilicus (naval/belly button); this causes fatty tissue or a small part of the bowel to push through. When the baby develops in the uterus (womb) there is a small opening in the abdominal muscles which allows the umbilical cord to pass through. After the baby is born the abdominal muscles gradually grow together closing this gap. Sometimes, however, they do not meet completely and leave a weak spot allowing fatty tissue or a small loop of bowel to push through the gap, which causes a hernia.

 

What does it look like?

An umbilical hernia is seen as a lump around the umbilicus which can range from one to five centimetres in diameter. An umbilical hernia is often more noticeable when the baby is crying, coughing or straining to go to the toilet. It is a fairly common condition which is seen in ten per cent of babies. However, the condition is more commonly found in babies of Black African origin, low birth weight babies and particularly in babies who are born prematurely. When the hernia is touched it feels soft and does not cause the baby any pain or discomfort. If it is gently pressed, the loop of bowel will easily go back inside the baby’s abdomen. The hernia is also less noticeable when the baby is relaxed and/or is lying down on their back (supine).

How are they treated?

Umbilical hernias usually close on their own by the time the infant is two years of age, because the stomach muscles will have developed and become stronger. In 85% of cases, the umbilical hernia recedes and the muscles reseal before the infant’s first birthday. If however by the age of four years it has not resolved, surgery may be required to close the hole in the muscle layer beneath the skin. This operation is performed under a general anaesthetic and the loop of bowel is pushed back into its correct position and the muscles sewn together to close the gap. Sometimes it may be necessary to place a permanent mesh-like material across the area to help strengthen the abdominal wall muscles. After surgery, the bulge will have disappeared and your baby’s umbilicus (belly button/naval) should look normal.

When should I be concerned?

If you find a bulge around your baby’s naval and you are at all worried you should always contact your GP for their advice and get your baby checked. In addition to this, should your baby appear to be in pain, start vomiting, or if the lump becomes discoloured, it is important that you seek medical advice without delay. In less than one per cent of cases, the loop of bowel can get stuck outside of the abdomen; this can make your baby very unwell and can damage the bowel. Where this is the case, immediate surgery will be recommended in order to prevent bowel damage.

Complications associated with umbilical hernias are actually relatively rare, but it is always best to err on the side of caution when it comes to your baby’s health and wellbeing. If you have any concerns, always seek advice from your health professional.

NHS Choices www.nhs.uk/umbilicalhernia [Accessed 19 March 2013]

 

Achiron R, Soriano D, Lipitz S et al (1995). Fetal midgut herniation into the umbilical cord: improved definition of ventral abdominal anomaly with the use of transvaginal sonography. Ultrasound in Obstetrics and Gynecology 6(4):256-260.

Deshmukh HS, Caty MG, Ryan RM et al (2010). Intermittent `bulge’ in the umbilical cord. Journal of Perinatology 30(7):500-502.

Haas J, Achiron R, Barzilay E et al (2011). Umbilical cord hernias: prenatal diagnosis and natural history. Journal of Ultrasound in Medicine 30(12):1629-1636.

Wright V (1997). Postnatal management and outcome of anterior abdominal wall defects. Fetal and Maternal Medicine Review 9(1):49-60.

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