Umbilical hernias in babies are usually benign and often resolve on their own — but there are specific cases when treatment (surgical repair) is indicated.
When to Treat an Umbilical Hernia in Babies:
Indications for Surgery:
- Hernia persists beyond age 4–5 years
- Most hernias close spontaneously by 1–2 years of age.
- If it’s still present by age 4 or 5, surgical repair is usually recommended.
- Hernia is larger than 1.5–2 cm
- Large defects are less likely to close spontaneously.
- Incarceration or strangulation
- Rare, but urgent. Signs include:
- Painful, tender, discolored swelling at the umbilicus
- Vomiting
- Inability to reduce the hernia
- Requires emergency surgery.
- Rare, but urgent. Signs include:
- Associated symptoms or complications
- Recurrent pain, skin issues, or parental concern in borderline cases may prompt earlier referral.
- Cosmetic or psychosocial concerns in older children
- Especially if the hernia is prominent or noticeable under clothing.
When Not to Treat (yet):
- Asymptomatic small umbilical hernias in infants under 2 years.
- Easily reducible hernias in toddlers.
- No signs of complications.
Key Point:
Most umbilical hernias in infants close spontaneously by age 2–3. Surgical referral is generally made after age 4–5, or earlier if there are red flags.