Umbilical hernia: babies, adults and when repair is needed

The NHS defines an umbilical hernia as a bulge in the tummy caused by part of the bowel, or surrounding fat, pushing through a weakness in the muscles. It forms under or near the belly button, where the muscles around the umbilical cord did not close fully after birth, or where the abdominal wall has weakened later in life.

Umbilical hernias are common in babies and young children. The NHS says the usual only symptom is a soft swelling or lump coming out of the belly button, ranging from around the size of a pea to about 2cm across. Complications are very rare in children.

Children do not usually need treatment, says the NHS, as the hernia usually disappears by around age 5. Treatment is usually only needed if the hernia is very big or does not disappear. See a GP if you think your child has an umbilical hernia, so it can be examined.

In adults the NHS says umbilical hernias are usually painless but can sometimes cause discomfort when coughing or straining. They are described as small (around 1cm), medium (1cm to 4cm) or large (bigger than 4cm).

The NHS lists three causes in adults: living with obesity, having multiple pregnancies, and having a condition that causes fluid to build up inside the tummy (ascites), such as liver disease. See a GP about a lump that is painful, hard or does not move, or one that is getting bigger or does not go away.

The NHS describes umbilical hernia repair as usually done under general anaesthetic. Cuts are made in the skin near the hernia, the hernia is gently pushed back into place, and the gap in the muscles is closed by stitching the muscles together. For larger hernias, surgical mesh may also be attached to the muscles to help hold them in place. The skin is closed with stitches or clips and covered with a dressing. The operation lasts between 30 and 60 minutes.

Surgery is usually recommended for adults because the hernia is unlikely to improve by itself. The NHS adds that people who are unwell from a condition such as liver disease may not be fit enough for surgery, which is a decision for the surgical and anaesthetic team.

Full recovery usually takes up to 4 to 6 weeks, and the NHS suggests staying off work for usually at least 1 to 2 weeks, or up to 6 weeks if the job involves heavy lifting. Risks are small and include infection, blood clots, lasting pain and the hernia coming back. The surgeon can give specific information about risks and benefits for your situation.

The NHS general hernia page also advises helping to prevent some types of hernia by keeping to a healthy weight, staying active and stopping smoking.

The most serious complication is a strangulated hernia, where the blood supply to the bowel is blocked. The NHS calls this a medical emergency that can lead to sepsis and gangrene, and says surgery is needed as soon as possible. Call 999 if you have an umbilical hernia and:

• you have very bad tummy pain that does not go away

• you feel sick, are being sick, or cannot keep any food down

• the hernia is more swollen than usual and the skin around it has changed colour

• you cannot pass wind or poo