What Is an Umbilical Hernia?
An umbilical hernia is a lump that appears when part of your intestines or other tissue sticks out through your abdominal muscles near your navel. It looks like a bulge around the belly button.
In a newborn, before the umbilical cord falls off, you may notice that the area seems to stick out a little more when the baby cries. Or once the cord is gone, you see that their navel pokes out (commonly called an "outie"). In some cases, even if you can’t see a bulge, you might be able to feel one.
It's estimated that between 10% and 20% of babies develop an umbilical hernia. In most babies, they go away on their own. They're much less common later in life, affecting only about 2% of adults. But these typically need surgery.
Umbilical Hernia Causes
During pregnancy, the umbilical cord is connected to your baby through a small hole in their abdominal muscles. This usually closes up soon after the baby is born. Sometimes it doesn't, and an umbilical hernia forms. It's unclear exactly why this hole, called the umbilical ring, doesn't close in some babies. But it has nothing to do with the way the doctor cuts or clamps the cord after delivery.
What causes umbilical hernia in adults?
Even when the umbilical ring does close, that area may always be weak. Over time, stress can cause an umbilical hernia to form. This comes from things that strain your abdominal muscles or put pressure on your abdominal wall, such as:
- Pregnancy
- Being overweight
- Extra belly fluid
- Chronic cough
- Problems urinating because of a large prostate
- Constipation
- Vomiting often
- Heavy lifting
- Surgery or other procedures that weaken the abdominal wall
Umbilical Hernia Types
Umbilical hernias can be classified into two main types, depending on exactly where they're located.
Direct umbilical hernia. This type is located right inside the belly button, in the umbilical ring that the cord passed through. This may also be called a "true" umbilical hernia. It's the most common type in babies.
Indirect umbilical hernia. Located just above or just below the belly button, it may also be called an "oblique" or "paraumbilical" hernia. It's more likely to develop later in infancy or adulthood and is less likely to go away on its own. This is the most common type in adults.
Umbilical Hernia Risk Factors
In infants, umbilical hernias are more common in babies that:
- Are born prematurely
- Have a low birth weight
- Are Black
- Have certain genetic disorders, including trisomy 13 and Down syndrome
In adults, umbilical hernias are much more common in women and people assigned female at birth. You're more likely to get an umbilical hernia if you have:
- Multiple pregnancies
- A BMI over 30
- A medical condition that damages your connective tissue
- Liver disease that causes fluid to build up in your abdomen
Umbilical Hernia Symptoms
In a baby, you’ll be able to see the hernia most clearly when your child cries, coughs, or strains while trying to poop. That’s because all of these things put pressure on the abdomen. When your child rests, you might not be able to see the hernia. Usually, they don’t hurt.
Your child’s doctor can tell if there’s a hernia during a physical exam.
It doesn't happen often, but you’ll want to keep a close eye on your child’s umbilical hernia for signs that the intestine has become trapped in the hole and can’t go back in. Doctors call this an incarcerated hernia. Symptoms include:
If you notice any of these symptoms, take your baby to the emergency room.
Umbilical hernia symptoms in adults
As an adult, you'll probably also notice a bulge in or around your belly button. You may only see it at certain times, like when you cough or lift something. You may not realize you have an umbilical hernia until a doctor finds it during an exam or imaging test for some other reason.
Adults are more likely to have pain with an umbilical hernia. It's also a bit more likely for the hernia to become incarcerated. You should be alert for symptoms including:
- Sudden, sharp pain
- A hernia that's hard or turns red or purple
- Nausea and vomiting
- Bleeding when you poop
- Constipation
If you have any of these symptoms, you need to get checked out right away. An incarcerated hernia can become strangulated, which means the blood supply to the trapped intestines is cut off. You'll need emergency surgery to keep the tissue from dying.
Umbilical Hernia Diagnosis
If you think you or your child has an umbilical hernia, the doctor will feel and look at the area. They’ll also ask about any symptoms. The doctor may try to see if they can gently push the bulge of the hernia back into the abdomen. Sometimes, a doctor may suggest you get an ultrasound to check for complications.
Umbilical Hernia Treatment
Most umbilical hernias in children don’t need any treatment. Usually, the hole heals on its own by the time your child is 4 or 5 years old. Even if it doesn’t, it’ll likely get smaller. That’ll make surgery a bit easier.
You might think it looks like your child needs to have an operation, but their doctor might suggest you wait to see if the problem goes away on its own.
In adults, umbilical hernias usually need to be repaired with surgery. If yours is small and you don't have pain or other symptoms, your doctor may suggest waiting. But it's likely to get larger over time and cause complications.
Surgery is usually needed if the hernia is:
- Painful
- Larger than 1/2 to 3/4 inch
- Not getting smaller by age 2
- Growing larger
- Trapped or blocking intestines
Umbilical hernia surgery
This is done in a hospital or outpatient surgery center. It takes about 45 minutes, depending on the type of procedure, and you or your child will be given anesthesia and won’t be awake.
In an open procedure, the surgeon will make a small cut just below the belly button. If any part of the intestine pokes through, it will be put back where it belongs. The doctor will use stitches to close the hernia. They’ll also sew the skin under the navel to give it an "innie" look. Then, the cut will be sealed either with surgical glue or adhesive strips that'll hold the edges of the wound together. Those come off by themselves once the site heals.
For a larger umbilical hernia, the surgeon may sew a piece of mesh over the hole inside your abdomen. That increases the chances that the repair will be successful and the hernia won't come back.
In some cases, a laparoscopic procedure is an option. The surgeon makes several smaller cuts on the sides of your belly and inserts a camera and instruments to repair the hernia from the inside.
After the procedure, you or your child will stay at the hospital while you recover from the anesthesia. Most people can go home a few hours later.
After Umbilical Hernia Surgery
You or your child may have pain for a day or two after umbilical hernia surgery. Doctors typically recommend over-the-counter pain relievers such as acetaminophen and ibuprofen, but adults can be prescribed something stronger. Your doctor may give you directions for applying an ice pack to the area several times a day.
Your doctor will want a follow-up visit in two to four weeks.
Call your doctor right away if you or your child has:
You'll need to take it easy for several days after surgery. If your job involves strenuous activity, you may need to take off a week or more. You won't be allowed to lift anything heavy for several weeks, although your doctor will want you to start light activity and exercise as soon as you feel up to it. Certain activities that put stress on your torso, such as Pilates and golf, will have to wait until your surgeon says they're safe.
Your child will probably be able to go back to school in a day or two, but they'll have to sit out gym class and contact sports until the surgeon gives the OK -- usually after several weeks.
Umbilical Hernia Complications
Complications from umbilical hernias aren’t common. If the hernia becomes incarcerated, the tissue can cause pain or begin to die. This is a serious complication that can cause infection inside your abdomen and even death.
Adults are more likely to have an intestinal blockage as a complication of a trapped hernia. If you have a blockage, you’ll need emergency surgery.
Umbilical Hernia Outlook
Most umbilical hernias in babies go away on their own by the time your child is 2. If you have surgery to repair your umbilical hernia, your recovery time will depend on its size and how difficult your surgery was.
It's possible for an umbilical hernia to come back after it's repaired, but that doesn't happen often.
Umbilical Hernia Prevention
You can't prevent your child from developing an umbilical hernia, but keep in mind that they very rarely cause problems. Most close up on their own in a baby's first few years.
As an adult, you can't necessarily prevent an umbilical hernia either, but you can do things to lower your risk, such as:
- Watch your weight.
- Treat conditions that lead to strain on your abdominal wall, such as fluid buildup, constipation, and chronic cough.
- Be careful with heavy lifting.
Those tips will also lower the chances of your umbilical hernia coming back after surgery. So will following your doctor's instructions about limiting your activity while you're healing.
Takeaways
An umbilical hernia is a gap in the abdominal muscles behind your belly button that allows tissue to poke through. It's not unusual in an infant and most of the time it will close on its own. It's less common in adults and will probably have to be fixed. Most of the time, umbilical hernias are harmless, but if a section of the intestine gets trapped in the opening, you may need emergency surgery. Tell your doctor if you notice a bulge around your or your child's belly button.
Umbilical Hernia FAQs
How serious is an umbilical hernia?
Most umbilical hernias aren't serious. However, there's a risk that a loop of your intestines can get trapped, cutting off the blood supply. That can cause the tissue to die, leading to infection inside your abdomen or even death.
Do umbilical hernias require surgery?
Most don't. In babies, surgery is only recommended if the hernia isn't closing on its own or is causing complications. In adults, umbilical hernias tend to get bigger over time, and surgery is usually needed.
Can an umbilical hernia heal itself?
Yes. In fact, 90% of umbilical hernias in babies close on their own as the child grows. In adults, however, an umbilical hernia won't heal without treatment.
Can you get a second umbilical hernia?
Yes. Although it's unlikely, surgery to repair an umbilical hernia sometimes needs to be repeated.
