Umbilical hernia is a quite common condition in neonates and infants. It represents an incomplete closure of the umbilical ring which leaves a gap through which the content of the abdomen can protrude (e.g. intestine).
It is present most commonly in preterm neonates with low birth weight, in various genetic syndromes and in the black race.
The hernia looks like a lump at the site of umbilicus that can grow bigger when crying or coughing, i.e. when there’s an increase of the intra-abdominal pressure.
In most of the cases, this gap is small (<1cm) and closes spontaneously by the age of 2-4 years. When the gap is bigger (>1.5-2cm), spontaneous closure it less likely and a surgical intervention may be required after 2 years of age.
Umbilical hernia is usually painless in childhood, does not cause any symptoms and is easily retractable which means that its content can easily be pushed back in the abdomen by applying a bit of pressure on top. Very rarely, the intestine can be captured within the hernia and get constricted (strangled). This is an urgent condition that needs immediate medical care (usually surgical). The child will usually cry vigorously and the lump will be red, sore, hard and unretractable.
In conclusion, we could say that a umbilical hernia in kids resolves spontaneously by the age of 2 years in most of the cases. Surgical intervention is needed only when the gap is big, the hernia is still growing bigger after first tear of life or does not resolve by 4 years of age and, finally, when constriction is clinically suspected.
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