The umbilical opening is provided for the exit of blood vessels which connect baby to mother during growth in the uterus. After birth these blood vessels shrink faster than the surrounding ring in the infant's abdominal wall. A hernia forms when intestine or fat from inside the abdominal cavity pushes through the defect next to the shrunken vessels. Most umbilical hernias will shrink and close spontaneously. Surgical repair is seldom performed in small infants and rarely recommended for children under three years of age.
Spontaneous closure becomes unlikely after five years of age and surgical closure is then advised.
Even very large bulges will disappear when the child relaxes and the herniated bowel falls back inside the abdomen. Should the bowel become trapped, swollen, and tender, however, emergency evaluation is important to avoid bowel injury and possible perforation. Appropriate surgical repair will then be performed. The office visit When your child sees us, he or she will be seen by either the pediatric surgery nurse practitioner or the surgery resident. They will perform a history and physical examination on your child, answer any questions you may have and complete all necessary paperwork.