Umbilical Hernias

Dr. Greene’s Answer:

I used to scoff at “navel gazing,” or contemplating one’s navel. It wasn’t until I was studying fetal development in medical school that my own belly button became a source of wonder. It finally sunk in that my being was formed inside my mother’s body, and that she had supplied all of “the stuff” of my developing body through that most intimate of connections, the umbilical cord. My belly button became a permanent monument of my connection to, and my growth away from, my mom. As the cord was cut, and the belly button formed, a new life was launched.

The umbilical cord is a strong, flexible pipeline. It carries a mother’s lifeblood to her child, and anything that might harm the child is removed by her mother. This conduit enters the baby between the two rectus abdominus muscles of the abdominal wall. These two muscles (which we later try to keep firm with sit-ups) are connected by a white line of tough fibrous tissue called the linea alba. The umbilical ring is a small hole (about 1/2 inch in diameter) through which the umbilical cord passes into the belly. Usually, after the umbilical cord is cut and the stump begins to wither and fall off, the umbilical ring closes and the linea alba becomes a smooth, unbroken band.

If the umbilical ring is still open, the child has an umbilical hernia. The belly button “pooches” out, and gets bigger if the baby is crying or straining. Sometimes it looks almost like a balloon. When the baby is relaxed, this balloon can be gently pushed back into the belly — only to reemerge a few minutes later.

Umbilical hernias are quite common. They are found in about 10 percent of all babies, and as many as 90 per cent in some ethnic groups. They are also much more common in girls and in premature babies. Often, the hernia isn’t noticed when the child is very young, since the hernia may not pop out until the baby begins tightening the abdominal muscles and building up pressure in the belly. When sticking out, the hernia might be as small as a cherry or as large as a lime.

The word hernia conjures up thoughts of surgery, and appropriately so since many types of hernia are best treated with surgery. Umbilical hernias are an exception to this and are not a cause for alarm. In the not too distant past, the most popular treatment for umbilical hernias was to push in the pouch and tape a coin over the belly button to prevent it from pooching out again. Most of the time this worked and the umbilical hernia disappeared by the time the baby was a year old. Umbilical bands or straps were a variation on this theme.

We now know that not using a coin, band, or strap works just as well — and avoids skin irritation. Over 85 per cent of umbilical hernias will disappear by age one even if you do nothing at all. Predictably, the smaller the hernia (not the smaller the balloon, but the smaller the opening in the belly wall), the more likely the hernia is to close by itself. Still, even large hernias (6 cm opening) have been known to close spontaneously by 5 years of age. Those that first appear after 6 months of age are less likely to correct themselves.

There are a wide variety of opinions about when, if ever, surgery is useful. I would consider surgery if the ring is still bigger than 2 cm across at one year, if the defect grows after one year, or if it is still present at kindergarten (when further spontaneous closure becomes very unlikely). The only time umbilical hernias need urgent repair is in the rare event they become incarcerated (unable to be pushed back into the abdomen when a child is relaxed). Otherwise, there is no rush.

The surgery itself is simple and safe. The incision is tiny, and a couple of stitches usually suffice to close the remaining hole in the linea alba. Voila! An innie!

Karen, you can put your mind at ease. When I see an umbilical hernia I see a fading reminder of the physical joining you and your daughter shared. The in-again, out-again balloon reflects the struggle we all have between the deep desire to be one with others and the powerful urge to become a unique, separate human being. Early on, it is the connection that allows us to grow toward separation. Later in life, it is a strong separate self that allows us to experience the deepest union. As your daughter’s umbilical ring closes, you will enjoy her in ways you only dreamed about when you were carrying her inside.

July 30, 2008

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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  1. Jeevan

    Hello! My son is now 3 and half months old, he stayed in hospital about 2 weeks after birth. Now he is healthy and active but there is a little wet in his umbilical cord anytime, it makes me worried, I think there might be a small hole in umbilical cord, what might be the possible solutions except surgery? pls reply with the best solutions. Thank you.

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  2. Sabrina

    My son is 3 months old and he’s been having a umbilical hernia since he was one month it just keeps getting bigger when he’s cries or tries to poop

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  3. Ashley Garcia

    How many times dose an one year old baby go an number two? Cause I’m worried about my son.

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    • Hi Ashley,
      Thanks for writing in! This article by Dr. Greene might help – http://www.drgreene.com/qa-articles/stool-regularity/

      It says, “By 8 weeks old, the average drops to 1 per day. Most formula-fed babies will not go less often than daily, but many breast-fed kids will poop even less often than this. I know many babies who only go every three days. If a happy formula-fed baby goes 4 days, or a breast-fed baby goes 7 days without a stool, I recommend that he or she be checked once by a pediatrician (sooner if the child seems to be in pain). Still, it can be completely normal to go only once every eight days — as long as the stool is soft when it comes out.”

      Hope that helps!
      Alexandra (caring helper at drgreene.com, not a doctor)

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  4. Ni-quan Dawes

    Hello doc my baby boy is 8 weeks old an has an hernia from about 3 weeks into life, am very worried if it will go in because it has got bigger he cries an strains alot that time it as if if will burst,it go down when I push it back an stays calm until he strains cough cries or sneez, i just want to know since it looks bigger is there still a chance for it to close???? I try to feel the hole n honestly it feels small to me like it just fits the top of my finger and my finger is small that made me feel good but what do u think is it possible that it’s closing even though it pulp out very large when he cries????

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    • Tina

      Did you ever get an answer? I’m facing the exact same thing right now with my 10 week old son.

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  5. Alexsia

    My daughter is 2 and a half, i noticed her belly button is starting to open up… nd that it has a bad smell, is this bad or why doed this happen ?

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  6. wondering

    my son’s navel was normal but now he has straining a lot and his navel sticks out big at times it go back in will the straining subdue n will his navel go back normal???

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    • Wondering,

      This would be good to bring up with your child’s pediatrician.

      Best, @MsGreene
      Note: I reply to a lot of the comments on DrGreene.com, I am the co-founder of DrGreene.com and Dr. Greene’s business partner, but I am a not doctor. Please keep that in mind when reading my comments and replies.

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  7. Maria

    Hello dr it’s my sisters baby she is 2 weeks old and her belly botton is sticking out like a tounge. She is in Kashmir no dr available ATM plz help us is it normal thanks

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  8. Nontokozo

    my 9 weeks baby have some noise on his hernia like wind and after that he cries as if he feels some pain should i worry?

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  9. Martie

    Thanx Dr Green.

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  10. Jason N Lee

    My wife has been worried also with this same issue. After going through your article and explaining to my wife, we are very much happy and at ease. Thank you very much for such a helpful information for all specially for new parents like us. This is our 1st child a cute daughter of 6 weeks. Keep up the good work. Salute !!!

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    • Thanks so much for your kind words. We always appreciate feedback from readers, but it’s particularly rewarding to hear positive responses.

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  11. gladys

    Dr Gleen, my daughter is one year three months and her navel its big i went to see the doctor and i was asked to wait for three years. do i still wait or a coin can work?

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    • Gladys,

      Once kids have passed one year large navels often won’t get better on their own with or without a coin, but is pretty easy for a doctor to fix.

      Hope that helps,
      @MsGreene

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  12. Victoria

    Thank you Dr Greene
    that really put my mind at ease. I was so worried that my little angel, now 2 weeks old will end up hating me or blaming me for not taking care of her properly. As a mom you already deal with so much stress and I am always worried that I’m doing the wrong thing. At least I can stop stressing about this.

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    • Nemes

      Thanks doctor, your answee open up our mind as far as my wife was fairing for our little angel. But now we are happy for her.

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  13. Lyndle

    Hi my name is Lyndle I am 30 years old . My navel popped during pregnancy and has never gone back in. 3 years after the birth of my baby girl and still my navel is out.out should I worry. Please help

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  14. izaak hills

    Hello I’m 15 but my belly button have still shot up
    What should I do?

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  15. Tara

    Thank you for this-my daughter has a rather large umbilical hernia and our Ped told me the same things but I feel much better hearing it from you because I feel our Ped is overly lax about everything (I plan on switching soon)..I asked them to wait until after the cord stopped pulsing to clamp and cut and they ended up waiting until after the Placenta was delivred to clamp and did so very loosely and up high and then cut further down later..do you think this may have caused the hernia? My other 2 kids didn’t have anything close..

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  16. agnes

    My daughter is now 18 years old, but she still has this big navel. I dont know what to do. Please help me doc.

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  17. Mary Chifunda

    Am grateful for this message. It has helped me know that my two months old is not at risk.

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  18. Stacey Spencer

    Thank you Dr. Greene! My baby is three weeks old and I am a first time mom. This post gave me relief as well as insight to my unique daughter.

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  19. haneeya kamran

    Thanks dr that was very helpful. I have this same problem with my two months old daughter and after reading your article I am relaxed.

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  20. Lettia

    You should have called your doctor then…..

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  21. Heather

    Dr. Greene, that was a very informative response, beautifully written. Thank you for putting my mind at ease!

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  22. Faith Nthoba

    Thank you Dr. Greene. I don’t need to research further. Your answer was
    helpful and thank you for the emotional touch. It will help mothers to
    tell their kids so they can embrace their umblical hernias in case they
    cannot bafford surgery. Keep up your good work.

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  23. Dee

    Thank you this really does as a women get deeper peace of mind. I’m caring for my grand child via text and crying as he cries, sometimes you need a deeper meaning to feel the ease! As a new parent and trying to make sure as i get older I’m not Giving wive tales… Coin ida what i did to ease pressure per holistic Dr…. Thank you again!

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  24. msbrown

    That was an ignorant way to criticize a doctor. If the info isn’t helpful to you, don’t use it. Keep your nasty comments in your personal diary.

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    • Alan Greene

      Thanks msbrown :)

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  25. Alan Greene

    Worried Parent, thanks for your feedback. Our site is set up with hundreds of medical articles (like this one over here on umbilical hernias http://www.drgreene.com/articles/umbilical-hernia/) that sound like more of what you are looking for. The articles tagged ‘qa-articles’ in the url, though, are less ‘medical’ than conversations between me and individuals, with more of a personal perspective. You are welcome to ‘listen in’. In the navigation menu above you can choose the types that suit you best.

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