Umbilical HerniaWhat is an umbilical hernia?An umbilical hernia is an opening or weakness in the muscle under the umbilicus or belly button. It is caused by incomplete closure of the umbilical ring, the place where the umbilical cord is attached, after birth. Approximately 20% of full term newborns will have this problem. Umbilical hernias are much more common in premature infants. What does an umbilical hernia look like?When your baby cries, stools, or bears down his belly button will push out. As soon as the baby relaxes, the belly button will sink back into the abdomen. Some babies have a large enough hernia to allow the belly button to always pouch out. Usually only fat or fluid from the abdomen pushes out, but occasionally loops of bowel may also be present. Does my baby need surgery for this type of hernia?About 80 % of umbilical hernias will close on their own by the time the child is 5-6 years old. Because of this fact surgical correction is usually avoided until the child reaches this age. If the hernia has not closed by the 5 or 6 years of age, surgical correction is recommended. The surgeon may recommend closure at an earlier age if the hernia does not easily reduce or if the hernia becomes painful. Earlier correction is also sometimes offered if the child will be having a general anesthetic for another procedure. How is the hernia repaired?A general anesthetic is used. A small incision is made in the belly button. The hernia sac and muscle layers are sutured closed with dissolvable suture. The outer skin is then closed with skin glue and/or special tapes. Sometimes a small pressure dressing is applied for 24 hours. How do we care for the incision?If there is a pressure dressing or gauze bandage over the incision, it may be removed the day after surgery. You may keep a bandage over the incision for about 5-7 days to protect it from rubbing on diapers or pants. Keep the incision dry for 24 hours, then the child may shower or sponge bathe. Be sure to gently pat the incision dry after bathing, avoid rubbing. Do not soak the incision in water for one week. Once the child resumes normal bathing, the skin glue or tapes will begin to peel away. What restrictions will my child have after the surgery?Your child can return to normal activity or school the next day, but should avoid vigorous physical activity (gym class, tree climbing) for 2-4 weeks. Your child should also avoid lifting anything greater than 10 pounds for one month after surgery. Will my child have pain?Most children do not have severe pain after an umbilical hernia repair. Most often over-the-counter pain relievers (ie. Children's Tylenol or Children's Advil) are adequate for pain control. Often we will provide you with a prescription for Tylenol with Codeine for more severe pain. Do NOT mix a dose or regular Tylenol for Children and a dose of Tylenol with Codeine - this may be too much Tylenol and could be harmful. Remember that codeine may make your child drowsy, nauseated, or constipated. Have your child take the codeine with food and encourage them to drink plenty of liquids. Teenagers should not drive or operate heavy machinery while taking codeine. When should I call to speak with a nurse?If your child has:
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This information is provided by the University of Michigan Department of Surgery, Section of Pediatric Surgery and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider or our offices. |
