What Is an Umbilical Hernia?

An umbilical hernia occurs when the muscle surrounding the belly button doesn't close properly, leaving an opening in the abdominal wall. As the intestines spill over into the opening, it creates a bulge in the belly button.

Although umbilical hernias are more common in newborns and babies under 6 months, older kids and adults can get them, too. In 90% of cases, the umbilical hernia will close on its own before the child reaches around 4 years of age without treatment. More severe cases may require umbilical hernia surgery. Treatment depends on the size of the hole in the abdominal muscle.

Symptoms

In infants, an umbilical hernia is typically painless. The only real sign or symptom is that the baby's belly button will swell or appear "herniated" outward. The bulge can appear and recede as the baby uses their muscles or strains, like when crying or going to the bathroom. In some babies and children, the hernia can grow, stretching the skin in the process.

An adult with an umbilical hernia may have pain or increased pressure in the navel area. Pain can increase when the person sneezes, coughs, lifts heavy objects, or has a bowel movement. Like babies, adults can have a bulging or protruding near the umbilical hernia. A strangulated umbilical hernia may cause nausea, fever, and vomiting as well.

Causes

When the umbilical cord is separated after birth, the connective tissue of the umbilical ring closes spontaneously in most babies. If this closure is delayed or does not occur at all, an umbilical hernia develops. It is not known why this occurs in some babies but not in others.

There are a few known causes of umbilical hernias in adults:

• Accumulation of fluid in the abdominal cavity
• Long-term dialysis to treat kidney failure
• Multiple pregnancies
• Obesity
• Prior abdominal surgery

Risk Factors

The risk factors for umbilical hernias are still unknown, although the condition is more common among Black infants (around 26.6%) and premature and low-birth-weight babies. In fact, 84% of babies born weighing between 1,000 and 1,500 grams (between 2.2 and 3.3 pounds) are likely to develop an umbilical hernia. It is not altogether clear why babies in certain populations have higher rates of umbilical hernias. Over time, research may lead to a better understanding of the correlation.

Adults who are obese, are receiving dialysis treatment, or have had previous abdominal surgery also have an increased risk of developing an umbilical hernia. Because of the added abdominal pressure, people who are pregnant may notice a preexisting umbilical hernia is more apparent, or they may develop a new one.

Complications

Most babies and children with an umbilical hernia do not have any complications, and the opening closes naturally over time without treatment.

In rare instances, however, an umbilical hernia can become strangulated. This occurs when the organs in the person's abdomen become trapped or "incarcerated" in the hernia sac, reducing their blood flow.

Signs of a strangulated umbilical hernia may include:

• Discolored bulge
• Fever
• Nausea
• Refusal to eat
• Severe pain
• Tender bulge
• Vomiting

Parents and caregivers who notice these symptoms in a child should seek emergency medical attention. Adults should seek prompt medical care if their umbilical hernia is growing or shows signs of possible strangulation. Unless the hernia is strangulated, a pregnant person with an umbilical hernia can generally schedule elective repair during or after pregnancy.

Umbilical Hernia Treatment

Umbilical hernias in babies rarely need treatment. Many close or go away naturally by the time a baby is 1 or 2 years old, and almost all will resolve by a child's fourth or fifth birthday. A pediatric surgeon may need to repair the hernia if it continues to get larger, is especially painful, or becomes strangulated.

Surgery to repair an umbilical hernia in patients of any age involves a small incision beneath the belly button. The surgeon pushes the contents of the hernia sac back into the abdomen and stitches or uses surgical mesh to close the hole. This is typically an outpatient procedure allowing patients to go home on the same day.

Frequently Asked Questions

How do you sleep after umbilical hernia surgery?

After a surgical umbilical hernia repair, it's best to sleep on your back in a half-lying, half-sitting position, with pillows propped behind your upper body. You can gradually lower the angle of incline by reducing the number of pillows as your incision heals.

What is an umbilical hernia in adults?

In adults, an umbilical hernia is caused by weakness in the muscles around the belly button and is more common in pregnant people and adults with obesity. Because the rate of recurrence is high in adult cases, elective surgical repair is recommended. Openings in the abdominal wall are repaired using sutures or mesh.

How do you heal an umbilical hernia without surgery?

In babies and young children, most umbilical hernias close without surgery. But larger umbilical hernias or those that become strangulated will require surgery. In adults, surgery is elective and recommended. There are no home treatments to "fix" an umbilical hernia without surgery.

How serious is an umbilical hernia?

In most cases, an umbilical hernia is not serious. However, surgery may be necessary if it does not go away or becomes larger or strangulated. Strangulation, when the organs are trapped in the hernia sac, is the most serious complication and requires immediate medical attention.

How do you fix an umbilical hernia?

In people with an umbilical hernia that does not go away on its own, it can be fixed surgically using stitches or mesh to repair the hole in the muscles around the belly button.

What causes umbilical hernia?

An umbilical hernia in babies occurs when the muscles around the umbilical cord do not close naturally after birth, causing the organs in the abdomen to spill through the hole and push the belly button outward. It is not known why this occurs in babies. In adults, increased abdominal pressure resulting from obesity or pregnancy can cause the condition.

A Word From Verywell

While it's normal to be concerned if your baby is born with a belly button that seems to protrude, take comfort knowing most umbilical hernias go away without treatment. Only a small number of cases require surgical repair. Be mindful to look for signs of pain or discomfort around the belly button and always contact your doctor with questions or concerns.