An umbilical hernia happens when a portion of the intestine, lining of the abdomen, or fluid from the abdomen, pushes through the muscle of the abdominal wall. They typically appear as an abnormal bulge that can be felt near or at the belly button. Umbilical hernias most often occur in newborns and 90% will close naturally by the time the child turns five years old.¹

Did you know: Unlike most hernias which develop in adolescence or adulthood, 20% of babies are born with umbilical hernias?¹
 

The most common sign of an umbilical hernia is a bulge on or near your belly button. In some cases, the bulge is always visible. In others, it may only appear when pressure is placed on the abdomen—for example, when lifting something heavy. In babies and young children, the bulge may only be noticeable when they are crying. While usually painless in children, adults with umbilical hernias are more likely to experience discomfort, dull pain or pressure.²

Contact your healthcare provider immediately if you or your child experiences severe symptoms/complications of an umbilical hernia including:¹

• Pain, tenderness, swelling, or discoloration of the hernia site
• Vomiting
• Fever
• Constipation
• Full, round abdomen

These may signify a serious condition called ‘strangulation’ where an obstruction of your intestines can cut off blood flow causing intestinal or bowel tissue to die, which can lead to emergency surgery.

As the fetus develops during pregnancy, a small opening in the abdominal muscle allows the umbilical cord to pass through and connects the baby to the mother. After birth and as the child grows, the opening in the abdominal muscle closes. However, if these muscles do not meet and grow together, a small opening (called an umbilical hernia) remains.
 

While umbilical hernias in adults are fairly uncommon (only 2% of the adult population show occurrences),⁴ it is possible for an umbilical hernia to appear during adulthood. Causes are different in children than in adults. In adults, umbilical hernias happen when pressure in your abdomen causes weaknesses in your abdominal wall muscles. Parts of your small intestine and related tissue can bulge through the weakened muscle. Several factors can increase your risk, of developing an umbilical hernia as an adult, including:

• Women are more likely to have umbilical hernias, especially those who have given birth multiple times 
• Obesity
• Fluid buildup in your abdomen (ascites)
• Previous abdominal surgeries
   

Specific treatment for an umbilical hernia will be determined by your doctor and depends on many factors, including the severity of your symptoms, the size of your hernia, and your general health.

Umbilical hernias in adults⁵

For adults, surgery is typically recommended to avoid possible complications—especially if the umbilical hernia becomes painful or gets bigger. However, if your umbilical hernia is small-to-moderate in size, your doctor may recommend you ‘watch and wait’ where your condition will be monitored by your doctor to see if symptoms progress.

Umbilical hernias in babies and children⁵

Most umbilical hernias in babies close by the time a child turns 5 years old. Your child’s doctor may even be able to push the bulge back in during a physical exam. For children, surgery is typically reserved for umbilical hernias that:

• Are painful
• Are larger than 1/4 to 3/4 of an inch (1-2 centimeters) in diameter and don’t decrease in size over the first 2 years
• Don’t disappear by age 5
• Become strangulated
   

To treat an umbilical hernia, patients now have options when it comes to both surgical methods and materials (i.e., mesh). The appropriate type of surgery to treat your hernia will depend on individual patient factors. Be sure to discuss your options with your doctor in a shared care collaborative approach. Regardless of the method, umbilical hernia surgery is usually performed under general anesthesia.³

Surgical methods

• Open surgery: In an open repair, an incision is made at the site of the hernia. The mesh is placed between layers of muscle to help provide support for a durable repair.⁶ Depending on your surgical history, such as if a previous surgery has caused scar tissue, doctors may opt for this more traditional approach.
• Laparoscopic surgery: Laparoscopy is a type of minimally invasive surgery that requires a few small ‘keyhole’ incisions and uses a small camera. Patients may experience a faster recovery, less pain, and fewer complications following laparoscopic repair compared to an open surgery.^7,8
• Robotic surgery: Similar to laparoscopic repair, a robotic hernia repair is a minimally invasive surgery requiring small incisions where the surgeon controls the procedure from a specialized robotic console.⁶ Patients may also experience a faster recovery, less pain, and fewer complications following robotic surgery compared to an open surgery.^7,8

Types of hernia mesh

• Synthetic mesh: Synthetic meshes made from plastic materials (e.g., polypropylene, polyester, etc.) are permanent implants used to repair hernias. These non-absorbable meshes remain in the body to provide support to the site of the repair and are considered a more traditional approach.^10,11
• Bioabsorbable mesh: Bioabsorbable (or “absorbable”) mesh is an alternative to synthetic mesh designed to degrade over time. It provides temporary support to the tissue while healing, leaving no residual material after about 18 months, minimizing the risk of chronic infection and eliminating the need for explantation in the case of reoperations.¹²
• Non-mesh tissue repair: In some cases, a surgeon may repair the hernia using the patient's own tissue without an implant. This approach may be considered for smaller hernias, certain patient profiles, or when mesh is not appropriate. Hernia recurrence rates are generally higher with non-mesh repairs than with mesh.¹³

Your surgeon can help determine which approach is right for your specific situation. Learn more about surgical techniques and mesh options.
 

If you or your child has symptoms of an umbilical hernia, contact a healthcare provider as soon as possible to have it diagnosed and/or treated. Visit our Surgeon Finder to find hernia care near you and download our Doctor Dicsusion Guide to help you on your journey.

The guidance provided in this article follows general rules that should be discussed with your doctor. TThis article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.