My baby has an umbilical hernia, and now what?
Time to time parents receive news they don't like from their baby's doctors, and one of the most common is that the baby has an umbilical hernia, but ... what does that exactly mean?
Well, let's go one step back to the intrauterine life. During this period the fetus is connected to the mother's placenta through the umbilical cord; inside this structure there are two arteries and one vein intended to provide the fetus with all the oxygen and nutrients needed for a normal development while removing all waste substances.
To do that, umbilical vessels need to get inside the fetus' body and get connected with general circulation. The point where the umbilical cord access the fetus will be later the umbilicus and during fetal life that's not more than a little hole on the anterior abdominal wall allowing umbilical vessels to pass through towards the fetal abdominal cavity.
After birth umbilical vessels have no function; in fact they are cut by medical personnel during the birth process and the stump still attached to the baby's body suffer from atrophy and it's lost between 7 and 10 days after birth, leaving behind a scar known as umbilicus.
Everyone has an umbilicus which is normally a depression on the middle of the belly with no communication with the inner abdomen; however in some cases the hole on the abdominal wall remains open leading to an umbilical hernia development.
Children with umbilical hernia have the same scar that any other children have, but the deep layers (called fascia) didn't close leading to a communication between the abdominal cavity and subcutaneous tissue.
Usually the hole is detected during a physical examination since doctors are able to identify it with their fingers, however in some cases a part of inner tissue, especially omentum pass through the hole leading to the formation of a mass on the umbilical base; then the hernia is also visible.
This may happen up to 10% of newborns but there's nothing to concern about it; in fact unless a complication appears there's no indication for surgery until the 2nd year of life because during this period up to 50% of umbilical hernia will close without further help.
When that doesn't happen it will be necessary to perform a brief surgery (it last between 15 and 30 minutes) to close the hole (repair the umbilical hernia) to avoid problems later in life.
Pediatric surgeons perform the procedure under general anesthesia and the patient usually is discharged the same day to recover at home. One week later stitches are removed and the hernia is just a memory.
So, if your baby has an hernia you don't have to be worried about it; just observe it carefully and wait until the 2nd birthday to know if it will be necessary to perform a surgery or not; meanwhile you must be aware of alert signs indicating a potential complication; if they occur you must find medical advice immediately.
Local signs indicating umbilical hernia complications are umbilical pain (associated or not to vomiting), redness on the umbilical area or sudden increase of the hernia size associated to pain. In case one of the above occurs, don't waste time and find medical advice immediately because probably it will be necessary an emergency surgery to avoid further complications.