Umbilical hernia in the newborn: what is it? How to manage it?

During the diaper change, or during a bath , it can happen that mums and dads notice a small nodule next to the navel (the umbilical hernia) which could become more visible in particular circumstances, for example when the baby cries or coughs , or is making an effort.

Many new parents are frightened at the sight of the nodule, but the umbilical hernia shouldn’t be alarming. In this interview , Dr. Fabrizio Ciralli, head of Neonatology and Neonatal Pathology at Humanitas San Pio X answers all the doubts of new parents.

How to recognize an umbilical hernia in the newborn?

Umbilical hernia affects up to 20% of newborns, with the incidence increasing in premature babies. It manifests itself with protrusion at the level of the umbilical scar which can be little or very voluminous. It can enlarge and increase in volume in case of intra-abdominal pressure (crying, defecation). It is a situation that shouldn’t cause concern , especially if pressing on the hernia with your finger reduces it. Hernia in the newborn requires only to be monitored by the pediatrician during periodic check-ups in the clinic , and to wait a few months for it to resolve spontaneously.

Does it appear in predefined times? Can it resolve spontaneously?

It appears in the first months of life , but in most cases it resolves spontaneously without any intervention.

What causes an umbilical hernia?

The cause is the incomplete closure (diastasis) of the walls of the two muscle bands which then resolves spontaneously. In prematurity, the appearance of umbilical hernia is almost physiological.

Could it be dangerous for the newborn?

No, there is no danger even when the hernia wall overstretches due to increased abdominal pressure

What symptoms / problems can it give?

An umbilical hernia in a newborn is not a problem. The particular signs are only swelling and translucent skin at the site of the hernia, but neither a cause for concern nor can they cause future problems

Are there any special precautions to be taken?

Once upon a time, grandmothers advised putting a 2 euro coin (or 100 lire in the past) on the newborn’s navel and bandaging the belly because the pressure would help resolve the hernia. In reality, it is not needed and it is not useful, although even today grandmothers continue to recommend it to new mothers. The only valid advice is to wait for a spontaneous resolution and periodic pediatric checks

How is it treated? Is surgery necessary?

The child with this type of hernia is almost never treated, even if it is very large. Only in the case of genetic syndromes does the approach to umbilical hernia require a multidisciplinary approach due to the presence of other problems.