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Decision Point

Umbilical hernia: Should my child have surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

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Umbilical hernia: Should my child have surgery?

Get the facts

Your options

  • Schedule surgery to fix the hernia.
  • Wait and see if the hernia closes on its own.

Key points to remember

  • There is a good chance that your child's umbilical hernia will close on its own. Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.1
  • Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.
  • You may choose to have surgery for personal reasons. If the hernia looks odd or bothers your child, it can be fixed with surgery before age 5.
  • Having an umbilical hernia poses no health risks, unless your child gets an infection or has other rare problems, such as the hernia breaking open or part of the intestine getting trapped in the hernia sac.
FAQs

What is an umbilical hernia?

An umbilical hernia is a bulge near the belly button, or navel. The hernia has a sac that may hold some intestine, fat, or fluid. These tissues may bulge through an opening or a weak spot in the stomach muscles. This weak spot forms when muscle and other tissue around the umbilical cord do not close properly.

About 15 out of 100 babies have an umbilical hernia.2 Babies who weigh less than 5.5 lb (2.5 kg) at birth are more likely to have hernias than babies who weigh more.1 Most of the time, these smaller babies are born early.

Between 2% and 12% of all children have an umbilical hernia at 1 year of age.3 This means that out of 100 1-year-old children, between 2 and 12 of them have a hernia, and 88 to 98 of them do not.

A hernia doesn't hurt. A hernia poses no risks except if rare problems occur, such as the hernia breaking open or part of the intestine getting trapped in the hernia.

Umbilical hernias almost always close on their own as a child grows. But sometimes surgery is needed.

What happens in surgery for an umbilical hernia?

During the surgery, the doctor makes a small cut, or incision, just below the navel. Any tissue that bulges into the hernia sac is pushed back inside the belly. The muscles and tissues around the navel are repaired, and the cut is closed with stitches. Usually there is only a small scar inside the navel.

This surgery has few risks.

Children who have surgery to repair a very large hernia may end up with a navel that doesn't look normal. But most of the time, a surgeon can fix this.

Why might your doctor recommend surgery?

Most umbilical hernias heal on their own, but your doctor may recommend surgery if:

  • Your child's hernia is 1.5 cm (0.6 in.) wide or larger. Hernias can range from less than 1 cm (0.4 in.) to more than 4 cm (1.6 in.) across. Larger hernias that measure 1.5 cm (0.6 in.) or more are less likely to close on their own.1
  • The hernia starts after 6 months of age or gets much bigger after 1 to 2 years of age.1
  • It causes symptoms or other problems. A rare but major problem can occur when the intestine gets trapped in the hernia sac and loses its blood supply. Another rare problem occurs when the hernia breaks open.
  • The hernia hasn't closed by the time your child is 5 years of age. If a hernia has not closed on its own by this age, it probably won't.
  • The hernia bothers you or your child. Some umbilical hernias have an extra skin flap over them. These hernias look odd and are more visible than other kinds of umbilical hernias.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have surgery Have surgery
  • Your child will have general anesthesia and go home on the same day as the surgery.
  • The cut will leave a small scar inside the belly button.
  • Your child will need over-the-counter pain medicine for a few days.
  • You will need to keep the surgery site clean and dry.
  • Your child will need follow-up visits with the doctor to check that the wound is healing.
  • Surgery removes a hernia that is not closing on its own.
  • Your child avoids rare problems such as the hernia breaking open or part of the intestine getting trapped in the hernia.
  • All surgery has risks, including infection, bleeding, and risks linked to use of anesthesia.
  • Rare problems linked to hernia surgery include:
    • Swelling from a buildup of fluid near the incision.
    • Blood clots.
    • A hernia that comes back.
    • An injury to part of the intestine.
Wait and see if hernia heals on its own Wait and see if hernia heals on its own
  • Your child will need follow-up visits with the doctor to see if the hernia is closing on its own.
  • You watch for signs of problems related to the hernia, such as the hernia breaking open or part of the intestine getting trapped in the hernia.
  • The hernia may close on its own.
  • Your child avoids the risk of surgery.
  • You avoid the cost of surgery your child may not need.
  • There is a rare risk of the hernia breaking open or part of the intestine getting trapped in the hernia.
  • Your child may still need surgery if the hernia does not heal on its own.

Personal Stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Read More
close

Personal stories about surgery for an umbilical hernia

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My baby was born with an umbilical hernia that really wasn't too noticeable most of the time. My doctor suggested waiting to see if it would go away on its own—and it did. By the time Ross was 9 months of age, the hernia was gone. I'm glad we didn't try surgery on such a little baby. I would have felt terrible putting him through that when it just went away on its own.

Jeannette, age 27

Sierra, my little girl, developed a large umbilical hernia around her first birthday. It was really horrible to look at and scared her sometimes. Plus, she'd fiddle with it and scratch it in her sleep. We waited a little while to see if it would get better, but before her second birthday, we decided to have it surgically repaired. It was really hard to do it, but I'm glad we did. She looks perfect and we don't have to worry about it anymore.

Loni, age 33

My son, Johnny, had an umbilical hernia that we noticed shortly after his umbilical cord stump fell off. It was disconcerting to see it, but we decided that if the doctor wasn't too worried about it yet, we wouldn't be either. It didn't change much over the next 2 years, but then finally went away. Since it didn't bother any of us very much, it wasn't hard to try the "wait and see" approach.

Paco, age 41

My daughter was born with really big bulging skin around her belly button. It was awful-looking. It scared me to even touch it. My wife and I decided there was no way we could wait 4 to 5 years to see if it would go away. Once she got a little bigger and stronger, we asked if she could have surgery. She had it and looks great now. I'm glad that's over and she looks like a normal baby again.

Dustin, age 22

For more information, see the topic Umbilical Hernia in Children.

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose surgery

Reasons to wait and see if the hernia closes on its own

The way the hernia looks bothers me.

I don't mind the way the hernia looks.

More important
Equally important
More important

I want to take care of the problem now.

I don't mind waiting to see if surgery is really needed.

More important
Equally important
More important

It's okay if my child is given general anesthesia.

I don't want my child to have general anesthesia.

More important
Equally important
More important

I know that surgery has risks, but I think the benefits are worth it.

I don't want my child to have surgery.

More important
Equally important
More important

I'm worried about the risks of having a hernia.

I'm not worried about the risks of having a hernia.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Surgery

Learning toward waiting

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

Do most umbilical hernias close on their own?

  • YesYou're right. There's a good chance that your child's umbilical hernia will close on its own. Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.
  • NoSorry, that's not right. There's a good chance that your child's umbilical hernia will close on its own. Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.
  • I'm not sureIt may help to go back and read "What is an umbilical hernia?" Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.
2.

Are there any risks to having an umbilical hernia?

  • YesYou're right. There are some rare risks, such as the hernia breaking open or parts of the intestine getting trapped in the hernia sac.
  • NoSorry, that's not right. There are some rare risks, such as the hernia breaking open or parts of the intestine getting trapped in the hernia sac.
  • I'm not sureIt may help to go back and read "What is an umbilical hernia?" There are some rare risks, such as the hernia breaking open or parts of the intestine getting trapped in the hernia sac.
3.

Are there some kinds of hernias that require surgery?

  • YesYou are right. Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.
  • NoSorry, that's not right. Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.
  • I'm not sureIt may help to go back and read "Why might your doctor recommend surgery?" Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decisionWarning: Incomplete Items

Next Steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the factsWarning: Incomplete Items

Key concepts that you understood

Key concepts that may need review

Getting ready to actWarning: Incomplete Items

Patient Choices

What matters to youWarning: Incomplete Items

Credits and references

Credits
AuthorCaroline Rea, RN, BS, MS
EditorSusan Van Houten, RN, BSN, MBA
Associate EditorPat Truman, MATC
Primary Medical ReviewerMichael J. Sexton, MD - Pediatrics
Specialist Medical ReviewerBrad W. Warner, MD - Pediatric Surgery
References
Citations
  1. Stoll BJ, Kliegman RM (2006). The umbilicus. In RE Behrman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 775. Philadelphia: Saunders.
  2. Papagrigoriadis S, et al. (1998). Incarceration of umbilical hernias in children: A rare but important complication. Pediatric Surgery International, 14(3): 231–232.
  3. Marion RW (2001). Umbilical hernia section of Umbilical anomalies. In RA Hoekelman et al., eds., Primary Pediatric Care, 4th ed., p. 1891. St. Louis: Mosby.

Umbilical hernia: Should my child have surgery?

You can use this information to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Schedule surgery to fix the hernia.
  • Wait and see if the hernia closes on its own.

Key points to remember

  • There is a good chance that your child's umbilical hernia will close on its own. Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.1
  • Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.
  • You may choose to have surgery for personal reasons. If the hernia looks odd or bothers your child, it can be fixed with surgery before age 5.
  • Having an umbilical hernia poses no health risks, unless your child gets an infection or has other rare problems, such as the hernia breaking open or part of the intestine getting trapped in the hernia sac.
FAQs

What is an umbilical hernia?

An umbilical hernia is a bulge near the belly button, or navel. The hernia has a sac that may hold some intestine, fat, or fluid. These tissues may bulge through an opening or a weak spot in the stomach muscles. This weak spot forms when muscle and other tissue around the umbilical cord do not close properly.

About 15 out of 100 babies have an umbilical hernia.2 Babies who weigh less than 5.5 lb (2.5 kg) at birth are more likely to have hernias than babies who weigh more.1 Most of the time, these smaller babies are born early.

Between 2% and 12% of all children have an umbilical hernia at 1 year of age.3 This means that out of 100 1-year-old children, between 2 and 12 of them have a hernia, and 88 to 98 of them do not.

A hernia doesn't hurt. A hernia poses no risks except if rare problems occur, such as the hernia breaking open or part of the intestine getting trapped in the hernia.

Umbilical hernias almost always close on their own as a child grows. But sometimes surgery is needed.

What happens in surgery for an umbilical hernia?

During the surgery, the doctor makes a small cut, or incision, just below the navel. Any tissue that bulges into the hernia sac is pushed back inside the belly. The muscles and tissues around the navel are repaired, and the cut is closed with stitches. Usually there is only a small scar inside the navel.

This surgery has few risks.

Children who have surgery to repair a very large hernia may end up with a navel that doesn't look normal. But most of the time, a surgeon can fix this.

Why might your doctor recommend surgery?

Most umbilical hernias heal on their own, but your doctor may recommend surgery if:

  • Your child's hernia is 1.5 cm (0.6 in.) wide or larger. Hernias can range from less than 1 cm (0.4 in.) to more than 4 cm (1.6 in.) across. Larger hernias that measure 1.5 cm (0.6 in.) or more are less likely to close on their own.1
  • The hernia starts after 6 months of age or gets much bigger after 1 to 2 years of age.1
  • It causes symptoms or other problems. A rare but major problem can occur when the intestine gets trapped in the hernia sac and loses its blood supply. Another rare problem occurs when the hernia breaks open.
  • The hernia hasn't closed by the time your child is 5 years of age. If a hernia has not closed on its own by this age, it probably won't.
  • The hernia bothers you or your child. Some umbilical hernias have an extra skin flap over them. These hernias look odd and are more visible than other kinds of umbilical hernias.

2. Compare Options

Have surgery Wait and see if hernia heals on its own
What is usually involved?
  • Your child will have general anesthesia and go home on the same day as the surgery.
  • The cut will leave a small scar inside the belly button.
  • Your child will need over-the-counter pain medicine for a few days.
  • You will need to keep the surgery site clean and dry.
  • Your child will need follow-up visits with the doctor to check that the wound is healing.
  • Your child will need follow-up visits with the doctor to see if the hernia is closing on its own.
  • You watch for signs of problems related to the hernia, such as the hernia breaking open or part of the intestine getting trapped in the hernia.
What are the benefits?
  • Surgery removes a hernia that is not closing on its own.
  • Your child avoids rare problems such as the hernia breaking open or part of the intestine getting trapped in the hernia.
  • The hernia may close on its own.
  • Your child avoids the risk of surgery.
  • You avoid the cost of surgery your child may not need.
What are the risks and side effects?
  • All surgery has risks, including infection, bleeding, and risks linked to use of anesthesia.
  • Rare problems linked to hernia surgery include:
    • Swelling from a buildup of fluid near the incision.
    • Blood clots.
    • A hernia that comes back.
    • An injury to part of the intestine.
  • There is a rare risk of the hernia breaking open or part of the intestine getting trapped in the hernia.
  • Your child may still need surgery if the hernia does not heal on its own.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

For more information, see the topic Umbilical Hernia in Children.

Personal stories about surgery for an umbilical hernia

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

" My baby was born with an umbilical hernia that really wasn't too noticeable most of the time. My doctor suggested waiting to see if it would go away on its own—and it did. By the time Ross was 9 months of age, the hernia was gone. I'm glad we didn't try surgery on such a little baby. I would have felt terrible putting him through that when it just went away on its own. "

— Jeannette, age 27

" Sierra, my little girl, developed a large umbilical hernia around her first birthday. It was really horrible to look at and scared her sometimes. Plus, she'd fiddle with it and scratch it in her sleep. We waited a little while to see if it would get better, but before her second birthday, we decided to have it surgically repaired. It was really hard to do it, but I'm glad we did. She looks perfect and we don't have to worry about it anymore. "

— Loni, age 33

"My son, Johnny, had an umbilical hernia that we noticed shortly after his umbilical cord stump fell off. It was disconcerting to see it, but we decided that if the doctor wasn't too worried about it yet, we wouldn't be either. It didn't change much over the next 2 years, but then finally went away. Since it didn't bother any of us very much, it wasn't hard to try the "wait and see" approach. "

— Paco, age 41

"My daughter was born with really big bulging skin around her belly button. It was awful-looking. It scared me to even touch it. My wife and I decided there was no way we could wait 4 to 5 years to see if it would go away. Once she got a little bigger and stronger, we asked if she could have surgery. She had it and looks great now. I'm glad that's over and she looks like a normal baby again. "

— Dustin, age 22

3. Your Feelings

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose surgery

Reasons to wait and see if the hernia closes on its own

The way the hernia looks bothers me.

I don't mind the way the hernia looks.

More important
Equally important
More important

I want to take care of the problem now.

I don't mind waiting to see if surgery is really needed.

More important
Equally important
More important

It's okay if my child is given general anesthesia.

I don't want my child to have general anesthesia.

More important
Equally important
More important

I know that surgery has risks, but I think the benefits are worth it.

I don't want my child to have surgery.

More important
Equally important
More important

I'm worried about the risks of having a hernia.

I'm not worried about the risks of having a hernia.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

4. Your Decision

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Surgery

Learning toward waiting

Leaning toward
Undecided
Leaning toward

5. Quiz Yourself

Check the facts

1. Do most umbilical hernias close on their own?

  • Yes
  • No
  • I'm not sure
You're right. There's a good chance that your child's umbilical hernia will close on its own. Most of the time, a hernia that starts before 6 months of age will go away by 1 year of age.

2. Are there any risks to having an umbilical hernia?

  • Yes
  • No
  • I'm not sure
You're right. There are some rare risks, such as the hernia breaking open or parts of the intestine getting trapped in the hernia sac.

3. Are there some kinds of hernias that require surgery?

  • Yes
  • No
  • I'm not sure
You are right. Your child may need surgery if the hernia is very large or if a hernia of any size has not gone away by age 5.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

Credits and references
Credits
AuthorCaroline Rea, RN, BS, MS
EditorSusan Van Houten, RN, BSN, MBA
Associate EditorPat Truman, MATC
Primary Medical ReviewerMichael J. Sexton, MD - Pediatrics
Specialist Medical ReviewerBrad W. Warner, MD - Pediatric Surgery
References
Citations
  1. Stoll BJ, Kliegman RM (2006). The umbilicus. In RE Behrman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 775. Philadelphia: Saunders.
  2. Papagrigoriadis S, et al. (1998). Incarceration of umbilical hernias in children: A rare but important complication. Pediatric Surgery International, 14(3): 231–232.
  3. Marion RW (2001). Umbilical hernia section of Umbilical anomalies. In RA Hoekelman et al., eds., Primary Pediatric Care, 4th ed., p. 1891. St. Louis: Mosby.

Last Updated:January 23, 2008

Author:Caroline Rea, RN, BS, MS

Medical Review:Michael J. Sexton, MD - Pediatrics & Brad W. Warner, MD - Pediatric Surgery

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