Symptoms

An umbilical hernia creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you may notice the bulge only when he or she cries, coughs or strains. The bulge may disappear when your baby is calm or lies on his or her back.

Umbilical hernias in children are usually painless. Umbilical hernias that appear during adulthood may cause abdominal discomfort.

When to see a doctor 
If you suspect that your baby has an umbilical hernia, talk with your child's pediatrician. Seek emergency care if your baby has an umbilical hernia and:

• Your baby appears to be in pain
• Your baby begins to vomit
• The bulge becomes tender, swollen or discolored

Similar guidelines apply to adults. Talk with your doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful or tender. Prompt diagnosis and treatment can help prevent complications.

Causes

During pregnancy, the umbilical cord passes through a small opening in the baby's abdominal muscles. The opening normally closes just after birth. If the muscles don't join together completely in the midline of the abdomen, this weakness in the abdominal wall may cause an umbilical hernia at birth or later in life.

In adults, too much abdominal pressure can cause an umbilical hernia. Possible causes in adults include:

• Obesity
• Multiple pregnancies
• Fluid in the abdominal cavity (ascites)
• Previous abdominal surgery

Risk factors

Umbilical hernias are most common in infants — especially premature babies and those with low birth weights. Black infants appear to have a slightly increased risk of umbilical hernias. The condition affects boys and girls equally.

For adults, being overweight or having multiple pregnancies may increase the risk of developing an umbilical hernia. This type of hernia tends to be more common in women in their 50s or 60s.

Complications

For children, complications of an umbilical hernia are rare. Complications can occur when the protruding abdominal tissue becomes trapped (incarcerated) and can no longer be pushed back into the abdominal cavity. This reduces the blood supply to the section of trapped intestine and can lead to umbilical pain and tissue damage. If the trapped portion of intestine is completely cut off from the blood supply (strangulated hernia), tissue death (gangrene) may occur. Infection may spread throughout the abdominal cavity, causing a life-threatening situation.

Adults with umbilical hernia are somewhat more likely to experience incarceration or obstruction of the intestines. Emergency surgery is typically required to treat these complications.

Preparing for your appointment

If you or your child has signs or symptoms common to an umbilical hernia, make an appointment with your family doctor or your child's pediatrician.

Here's some information to help you prepare for your appointment and what to expect from your doctor.

What you can do

• List any signs or symptoms you or your child has had, and for how long.
• Bring in a photo of the hernia if signs of the problem aren't always evident.
• Write down key medical information, including any other health problems and the names of any medications you or your child are taking.
• Write down questions you want to be sure to ask your doctor.

Questions to ask your doctor 
If any additional questions occur to you during your visit, don't hesitate to ask.

• Do I or my child have an umbilical hernia?
• How large is the defect?
• Are any diagnostic tests needed?
• What treatment approach do you recommend, if any?
• Is surgery an option in this case?
• Might surgery become an option if the hernia doesn't get better?
• How often should I or my child be seen for follow-up exams?
• Is there any risk of complications from this hernia?
• What emergency signs and symptoms should I watch for at home?
• How soon do you expect signs and symptoms to improve?
• Do I or my child need to follow any activity restrictions?
• Should a specialist be consulted?

What to expect from your doctor 
Your doctor is likely to ask you a number of questions, such as:

• What signs and symptoms have you noticed?
• When did you first notice these signs and symptoms?
• Have these signs and symptoms gotten worse over time?
• Are you or your baby in pain?
• Have you or your baby vomited?
• If you are the one affected, do your hobbies or your work involve heavy lifting or straining, or have you recently gained a significant amount of weight?
• Have you or your child recently been treated for any other medical conditions?

Tests and diagnosis

An umbilical hernia is diagnosed during a physical exam. Sometimes imaging studies — such as an abdominal ultrasound or X-ray — are used to screen for complications.

Treatment and drugs

Most umbilical hernias in babies close on their own by 18 months. Your doctor may even be able to push the bulge back into the abdomen during a physical exam. Don't try this on your own, however. Although some people claim a hernia can be fixed by taping a coin down over the bulge, this "fix" doesn't help and germs may accumulate under the tape, causing infection.

For children, surgery is typically reserved for umbilical hernias that:

• Are painful
• Are bigger than 1.5 centimeters in diameter (slightly larger than a 1/2 inch)
• Don't decrease in size after six to 12 months
• Don't disappear by age 3
• Become trapped or block the intestines

For adults, surgery is typically recommended to avoid possible complications — especially if the umbilical hernia gets bigger or becomes painful.

During surgery, a small incision is made at the base of the bellybutton. The herniated tissue is returned to the abdominal cavity, and the opening in the abdominal wall is stitched closed. In adults, surgeons often use mesh to help strengthen the abdominal wall. Recurrences are unlikely.