Umbilical hernia in children and adolescents: main symptoms and methods of treating the disease

A hernia is a protrusion of an organ or part of it. The navel is a retracted scar that is formed as a result of the umbilical cord falling off after the birth of the baby. An umbilical hernia is so called because it forms in the navel area. According to statistics, this problem can now be found in every fifth child.

This disease in itself does not harm the health of the baby, but sometimes parts of the abdominal cavity, omentum or intestinal loops get trapped inside this protrusion. If the hernia constantly increases, then this creates a reason for surgical intervention. But how to identify and cure this disease? What are the causes of umbilical hernia in children, symptoms of the disease? Let's talk.

Why does a hernia appear?

The main and most common cause of an umbilical hernia in a child is weak muscle tissue in the navel area.

Secondary factors provoking the appearance of protrusion:

Premature birth.
Insufficient weight gain at birth.
Heredity. If parents had this disease, then there is a high probability that their children will have the same problem with the navel.
Loud crying, constipation, severe coughing and frequent bloating can also cause a hernia.
Some diseases in which the tone of the abdominal muscles decreases.
If the child went ahead of schedule. This also occasionally contributes to protrusion of the navel, since the muscles are not yet strong enough.
Girls have belly button problems more often than boys.

Some people believe that bulging is caused by improper cutting of the umbilical cord at birth. But this is not true, because the applied staples cannot expand the navel ring in any way.

How was an umbilical hernia treated before?

Previously, umbilical hernia in newborns was treated as follows: a copper coin was placed in its place and glued with a plaster. Naturally, the intestinal loops that fell out were set back by the midwife. Now they have abandoned this method, considering it unhygienic and incorrect.

Why you can’t adjust it yourself:

You can accidentally damage the intestinal tissue (only a doctor can adjust it);
Poor reduction can cause entrapment and tissue necrosis;
Various coins are not sterile, and can cause inflammation of the newly healed navel, and it will begin to fester again.

Although in some countries and distant villages they continue to use such old-fashioned methods, so its existence is known.

If a hernia is pinched, you must immediately consult a doctor, otherwise tissue necrosis may occur.

Symptoms of the disease and behavior of the newborn

An umbilical hernia in young children is visible even to the naked eye. The main indicator is a protrusion in the navel area, similar to a small ball. If this ball is pressed into the umbilical ring, it is easily set, but then just as easily pops back out. If the expansion of the ring is small, then the hernia in the form of a ball can only be noticed when the child strains the abdominal muscles, for example, during strong crying, laughing or coughing.

Also, signs of an umbilical hernia may manifest themselves in the baby’s excessive restlessness, which is not typical for his peers. Of course, it is hardly possible to find a baby who does not suffer from colic and bloating. But children with an umbilical hernia suffer more from them, and they also react more sharply to changing weather conditions.

If the baby suddenly has vomiting, pain in the navel, or the color, size or density of the navel has changed, then these are all symptoms of an umbilical hernia. This may also indicate strangulation, which is considered a dangerous complication of a hernia and requires immediate surgical intervention.

Kinds

In medical practice, umbilical hernia in children is classified into the following types: congenital and acquired.

Congenital

99% of babies are diagnosed with a congenital hernia. A congenital hernia can be detected already in the first month after the birth of a child. When the baby is born, the midwife must cut and tie the umbilical cord, causing the umbilical ring to shrink.

There are cases when in newborns the umbilical ring does not close at all or not completely, then a protrusion of the hernia occurs.

Among umbilical hernias, the following types are distinguished:

an embryonic hernia appears if the intrauterine development of the abdominal wall is disrupted;
umbilical cord hernia, formed when a section of intestine exits into the umbilical cord without breaking the weak peritoneal layer;
late umbilical hernia, which manifests itself in the late period of intrauterine development.

Acquired

An acquired hernia occurs when the aponeurosis ruptures . The main causes of the hernia process are as follows:

screaming and strong crying;
colic;
constipation in a child;
flatulence (accumulation of gases in the intestines).

If a baby has malnutrition or rickets, it can also cause a hernia, since these diseases reduce muscle tone.

Treatment of umbilical hernia

How to cure an umbilical hernia? There are several treatment methods for this disease depending on its stage. Sometimes an umbilical hernia can be cured on your own at home, but there are complications when only surgery will help the child. Treatment is determined by a pediatrician and an experienced surgeon after a joint consultation and examination of the baby.

How to treat an umbilical hernia at home? There are three effective methods that help avoid surgical intervention when working regularly with the child and monitoring the parents.

Gymnastics and tummy massage

Every time before feeding (10–15 minutes), you need to lay the baby on his tummy on a hard surface covered with a diaper. When he actively moves his arms, legs and whole body, he not only reduces the muscle tone of the neck and upper limbs, but also reduces intra-abdominal pressure and promotes the release of gases.

If you do this exercise at least 2-3 times a day, you can significantly reduce the protrusion and strengthen the anterior wall of the abdominal cavity. This procedure serves as an excellent prevention of colic, torticollis and umbilical hernia.

As early as two months, you can start massaging your baby’s tummy. To do this, you need to go to a children's clinic and take a course in baby massage from an instructor. And then do this procedure for your baby at home. Choose a time for the session when the baby is fed and in a good mood. If his tummy hurts, he wants to eat or sleep, then it is better to postpone the massage for a while.

Fixation patch

Take a hypoallergenic patch so as not to cause irritation on delicate skin. Apply the patch so that a small fold of skin forms in the navel area. Several courses of this procedure together with massage can give excellent results and lead to the disappearance of the hernia forever.

How to apply a regular patch for an umbilical hernia:

Clean and dry the skin around the navel well.
Secure the end of the patch to the right of the navel.
Pull the skin around the navel to form a fold that will close the umbilical ring and push the protrusion inward.
Seal the fold with a plaster, attaching its second end to the left of the navel.
After each bath, repeat this procedure again until the bulging ball in the navel ring completely disappears.

For convenience, you can use special medical patches that help cure a child’s hernia in a month.

Folk recipes

Our ancestors treated umbilical protrusion in a one-month-old baby using a copper coin, a hard oatmeal cake, or a folded piece of gauze, which was previously moistened with juice from fresh cabbage. These objects were used to fix the protruding navel so that it would not come back out and tie it up. This treatment most often gave a positive result if the hernia was small.

Surgery for umbilical hernia in children

If all of the above treatment methods are ineffective, the child may undergo surgery at age 5. It is believed that a large hernia can seriously harm the baby. Girls should not delay the operation, because during pregnancy and childbirth the hernia can be pinched and lead to serious complications.

In boys, the hernia can be removed later, because it does not bother them, most often it only spoils the appearance of the abdomen. If the operation is performed in a timely manner, the hernia will not recur in the future and the scar will be invisible.

Surgical intervention

What to do if the diameter of the umbilical ring exceeds 2 cm? In this case, only timely surgery will help. Unfortunately, no traditional methods will give the desired result. Typically, surgery is recommended at the age of three, but not later than six.

Surgeries to remove an umbilical hernia in children are divided into two types:

Hernioplasty is recommended for patients with large hernias and strangulations. It is done by laparoscopy or with the installation of a special mesh. The latter is needed to correct a large protrusion; over time, it grows into the tissues of the child’s abdominal cavity and serves as a guarantee that the hernia will not reoccur. During laparoscopy, the doctor makes three small incisions, so the recovery period is very short. Typically, with this type of surgery, children return home after two to three days.
A classic operation in which the umbilical ring is sutured and a small hernia is easily reduced.
If a child has a strangulation or his condition has worsened (something is bothering him, he is constantly crying, there is bloating, nausea and vomiting), then doctors recommend urgent surgery. This type of surgery takes longer than regular surgery, and post-operative recovery takes much longer. After all, it is necessary to eliminate the infringement, restore blood circulation and cut off connective tissue clots. And only then the doctor can begin to correct the umbilical ring and stitch its edges to prevent the protrusion from appearing again.

If the doctor recommends surgery, then it is better not to refuse it. Treatment of a hernia should not be delayed.

Treatment options

Surgery is prohibited for children under 5 years of age

Strengthening the abdominal muscles is one of the main ways to prevent the development of the disease. It has a beneficial effect on reducing the size of the navel ring by reducing its elasticity.

Prevention of umbilical hernia development

There are a number of measures that will help prevent the appearance of a hernia in the umbilical ring and eliminate the causes that cause its occurrence.

Some important advice that pediatricians usually give:

Continue breastfeeding as long as possible to prevent problems with the baby's intestines.
Mom should eliminate all foods that can cause bloating, fermentation and flatulence in the baby, such as legumes, cabbage, sweets, nuts and smoked meats.
Sometimes there is not enough mother’s milk or the child has congenital lactose intolerance, then a high-quality formula is selected for the child.
Protect your baby from colds, do not let him cry too much, scream or cough for a long time, so as not to increase intra-abdominal pressure.

All these simple recommendations will help keep your baby healthy.

An umbilical hernia in a child is not such a rare occurrence, especially in a premature one. But it does not arise due to problems with the umbilical cord at the birth of the baby, but for other reasons, such as screaming, crying, weak tone of the abdominal muscles and others. This condition is often immediately visible, so parents can take proactive steps to correct the problem right away. If the disease is not treated, the child faces surgery and a long recovery.

Symptoms of umbilical hernia in children

A newborn's navel is immediately noticeable and protrudes forward. Only in some cases is this type of navel an anatomical feature. Parents should constantly monitor the condition of their baby's navel. The following main symptoms can be identified:

In the area of the umbilical ring, a rounded protrusion is noticeable, which is easily set back.
When the child is relaxed, the hernia is invisible, but it appears again with tension.
The child is restless and sensitive to weather changes.
A hernia does not cause pain, but sometimes leads to severe bloating.
When an umbilical hernia is accompanied by nausea, pain, and weakness, it is necessary to urgently consult a physician. All of these symptoms may indicate the accumulation of large amounts of feces in the intestines.

If the umbilical hernia is small, it may manifest itself when the baby cries a lot or is constipated. When the hernia is large, it is clearly visible, especially when the child strains. If the pathology worsens, urgent surgery is required.

Surgical treatment

Surgical removal of an umbilical hernia is extremely rarely prescribed for children under 5 years of age. This is due to the fact that this pathology can disappear thanks to preventive methods of influence.

There are the following cases in which surgery is indicated:

Surgical treatment if a complication occurs

by 5 years of age, self-healing had not occurred;
the diameter of the umbilical ring is more than 2 cm;
protrusion increases at the age of one year and older;
the pathology appeared at six months of age and later;
the presence of complications (damage or strangulation of the hernia);
the presence of a defect worries the child and causes him inconvenience.

If the hernia has complications, as well as a large hernia, then hernioplasty is performed. This method is divided into laparoscopy and treatment with the installation of a mesh implant. Laparoscopy is considered the most gentle method with the shortest rehabilitation period (2-3 days). The process involves making several small cuts using micro-equipment.

The method of installing a mesh implant is considered the most reliable, maximally eliminating the possibility of recurrence of hernia formation. After the hernia is reduced, the walls of the hernial orifice are fastened with a special material, which subsequently fuses with the tissues of the baby’s body. If the hernia is small and there are no associated complications, classical surgery is used. The process involves suturing the umbilical ring.