How to treat an umbilical hernia in a newborn?

Anatomical features of the peritoneum in infants

After birth, the baby's umbilical cord is cut. It is fixed with a clothespin, and when it dries, it falls off. The result is a retracted scar or navel. If a crust does not form on its surface, which should fall off in a timely manner, a pathology has occurred that requires consultation with a doctor.

It happens that due to muscle weakness, a newborn’s navel begins to protrude, whereas normally it is sunken. It’s okay if the baby’s umbilical ring is enlarged after birth. This happens often, and over time the protrusion disappears.

Causes of a protruding navel

Congenital umbilical hernia

A pathological condition leading to expansion of the umbilical ring can occur in several cases. First of all, this is a hereditary weakness of connective tissue, obesity and low tone of the abdominal muscles. In men, the impetus for development can be injury to the muscular system during heavy physical activity, and in women, late or multiple pregnancies and difficult childbirth. Statistics also indicate that a number of patients have genetic disorders of the anterior abdominal wall.

A hernia can be congenital, diagnosed in newborns or children in the first year of life, as well as acquired - this type is more suitable for adults. Depending on the type, all formations are divided into reducible and irreducible. The first case involves protrusions that disappear after the patient assumes a horizontal position. In the second case, it is no longer possible to straighten the bulge due to the onset of the adhesive process with an advanced form of the formation.

Disruption of normal bowel function leads to frequent constipation, which can cause a hernia.

In children, the cause of a hernia is most often a defect in the development of the muscles of the umbilical ring due to intoxication of the mother’s body or infectious diseases she has suffered, as well as high intra-abdominal pressure due to frequent crying and screaming.

In order for the navel to come out in adults, it is necessary to combine genetically predisposing root causes with producing factors:

• disruption of the normal functioning of the gastrointestinal tract;
• difficulty urinating due to diseases of the genitourinary system;
• prolonged severe cough;
• development of abdominal cancer.

Why do babies have a protruding belly button?

Frequent urination in a child under one year old - possible causes

A protruding navel may not bother the baby in any way, but it can also cause unpleasant symptoms that can only be removed through surgery.

Natural causes

It happens that the umbilical cord is cut high, leaving it too long, because of this the navel remains convex. Then it is considered that this is a characteristic of the child. However, even in this case, it can cause inconvenience if the navel rubs against the diaper or clothes, which leads to irritation and redness of the skin.

Hernia

The most common explanation for a baby's belly button protruding is a hernia. Usually it is congenital and becomes noticeable in the second month of the baby’s life. Normally, after cutting the umbilical cord, the umbilical ring tightens and contracts. If this does not happen, or it does not close completely, a protrusion is formed. It is especially noticeable when the child cries or coughs. Any tension in the abdominal muscles indicates a hernia. Moreover, in the normal state, when the baby is lying down, he is calm, she may not give herself away.

The formation of a hernia is associated with muscle immaturity and delayed development of the child in the womb. Usually it can be removed by pressing, but setting it yourself is not recommended. Any deviations should be observed by a doctor, and action must be taken based on his prescriptions and advice.

Surgeon's baby

Note! There is no need to think that the baby’s crying and coughing provoke the formation of a hernia. They can only intensify its manifestation and are incapable of becoming the root cause of the disease.

Umbilical fistula

It happens that during fetal development the vitelline and urinary ducts remain open or close, but not completely. Then a small hole remains in the navel, which goes to the internal organs. If the child’s urine and feces are released through it, they speak of a complete fistula, which must be treated urgently and only surgically.

The ducts often do not have time to close in premature babies. In healthy babies born at term, they should close completely. It happens that a fistula becomes an acquired pathology, this can happen under the influence of the following factors:

• Pinched hernia;
• Intestinal injuries;
• Incorrect actions of medical personnel when cutting the umbilical cord.

What is an umbilical hernia and why does it appear?

Umbilical hernia is one of the most common diagnoses in newborns: it occurs in approximately 20% of infants (and in children born prematurely, this figure is even higher) and is more common in girls than in boys. Visually, it looks like a navel protruding forward. It appears due to delayed closure of the umbilical ring, which is facilitated by a variety of factors, ranging from genetic predisposition to rickets. As a result, the free space is occupied by intestinal loops, parts of the peritoneum or omentum, which create a “bulge.” It can form already in the prenatal period, but because the baby screams and cries after birth, it, contrary to popular belief, will not appear by itself.

A protruding navel is not always noticeable to parents right from birth. It can begin to bulge in the first few months of a baby’s life, and even after he is six months old. At the same time, when the baby lies on his back, his stomach looks normal.

How to determine the presence of pathologies

Feces for carbohydrates in an infant - interpretation of the analysis, normal values

A child's navel sticks out most often in the presence of a hernia; less often, a fistula is observed in newborns.

An umbilical hernia can be recognized by the following signs:

• The protrusion increases if the baby pushes. It is more visible when the child is standing;
• There may be part of the intestine in the hernial sac, then during palpation you can feel rumbling. With a large hernia, movement of the intestinal loops is noticeable;
• The abdominal muscles separate.

Hernia

Only a surgeon can accurately diagnose the pathology after examination.

If a child has a fistula, the following symptoms are observed:

• Inflammation of the umbilical ring;
• There is a visible wound in the navel, which goes deep into the abdomen. It persists even when the baby is 4 weeks old, gets wet, and the crust does not form;
• The baby's tummy smells unpleasant;
• Bloody, purulent discharge is observed. Yellowish fluid accumulates in the navel, and the baby's bowel movements may be noticeable;
• The belly button sticks out when the baby starts to cry or cough.

Signs are determined by the severity of the disease. If your baby has a fever, he urgently needs medical attention.

Diagnostic methods

As noted earlier, an umbilical hernia is usually visible upon examination. An experienced pediatrician will detect it and refer the patient to a surgeon to clarify the diagnosis. However, one examination is not always enough, because the protrusion may be invisible due to its small size or have other reasons for its appearance. There are pathologies with similar symptoms, for example, tumor-like neoplasms.

To exclude or confirm the diagnosis, the following studies are additionally performed:

• general blood analysis;
• ultrasound;
• herniography (x-ray examination of the hernial sac);
• X-ray of the stomach and duodenum.

Additional instrumental diagnostics are needed when the results of the examination determine how to treat the child, as well as when making a decision about surgery. In addition, it is necessary to find out if there is any other pathology of the digestive tract.

Ultrasound of the anterior abdominal wall for a hernia defect

The main symptom of the disease does not immediately become noticeable. At first, the shape of the abdomen does not change. The omentum, located on the peritoneum, is capable of holding the internal organs in an anatomically correct position for a certain period.

If in newborns the protrusion becomes visible almost immediately. If an adult’s belly button protrudes, only a specialist can determine the cause after a full history has been collected and appropriate research has been carried out. Surgeons treat hernias. Diagnosis is carried out by assessing clinical symptoms, as well as making differential connections with other pathologies.

Visual examination and palpation alone are most often not enough for an accurate diagnosis. Therefore, the patient must be prescribed:

• Ultrasound of hernia;
• fibrogastroduodenoscopy;
• herniography;
• tomography and radiography of the abdominal cavity.

Norms for blood biochemistry results

This is because the symptoms of the disease are similar to those of some benign tumors and congenital anomalies of the umbilical ring area.

If the doctor believes that surgical intervention may be required, or he suspects the presence of an inflammatory process, additional tests are prescribed:

• clinical and biochemical blood tests;
• urine and stool analysis;
• fluorography with ECG;
• test for RW and hepatitis.

Why are fistula and hernia dangerous?

Pathologies associated with navel protrusion can lead to serious and dangerous complications.

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A fistula can cause:

• Severe abdominal pain;
• Peritonitis;
• Intestinal obstruction;
• Nausea, vomiting;
• General intoxication of the body.

A hernia can cause:

• Bloating, constipation;
• Incarceration, which often results in intestinal obstruction;
• Formation of adhesions;
• Inflammation of the skin in the area of ​​the protrusion.

Note! If your baby has a protruding belly button, he or she should be monitored regularly by a doctor. When a doctor insists on hospitalizing a baby, you should not contradict him, so as not to harm the baby’s health.

Why is an umbilical hernia dangerous and what are the complications?

When an umbilical hernia is strangulated, the child may experience the following symptoms:

• vomit;
• nausea;
• blood in stool;
• inability to reduce the hernia with pressure while lying on your back.

In the presence of an umbilical hernia, nausea and vomiting are common symptoms in a child.
A complication in the form of a rupture of the hernial sac, in which its contents come out, is extremely rare. Strangulation and rupture of the hernia are life-threatening, so you must immediately contact a surgeon.

When to see a doctor

You should call a doctor or ambulance immediately if you notice the following symptoms:

• The child has a fever;
• The baby experiences severe pain, groans, strains, cries;
• The protrusion has increased in size and turned red or blue. Any change in skin tone in the navel area should alert you;
• The baby has been suffering from digestive problems for a long time, which he cannot cope with on his own;
• The appearance of discharge if there is a wound in the umbilical area. This is especially true for a fistula, in which bowel movements may come out in an unnatural way. Pus and blood on the surface of the skin are also direct indications for calling a doctor.

Methods of treating pathologies

The hernia usually goes away on its own. For some children, it disappears by the age of one, while others say goodbye to it closer to the age of five. If it does not cause any inconvenience to the child, he is cheerful, cheerful and active, you should not notice her. However, regular visits to the surgeon remain mandatory. Doctors usually recommend strengthening the abdominal muscles.

What to do if a newborn’s belly button sticks out, what activities are acceptable at home:

• Placing the baby on the stomach before eating;
• Abdominal massage;
• Gymnastics.

Gymnastics for babies

The technique of performing massage and exercises is shown by a surgeon or pediatrician. It is advised, for example, to place the baby on his back and alternately bend his legs, lifting him towards his stomach.

Note! Proper nutrition will help to avoid increased gas formation and constipation, which means it will not allow an increase in intra-abdominal pressure, which increases protrusion.

If the hernia becomes pinched, the baby experiences painful attacks and surgery is required. According to indications, it is carried out until the age of five. In any case, it is better to plan it before school.

Complete fistula can also be treated surgically. There are no conservative methods for this pathology. If the ducts are not completely open, drug therapy is prescribed; parents must constantly monitor the navel, disinfect, and dry the wound. Any treatment must be carried out under the supervision of a doctor. You cannot be guided by the advice of friends and rely on traditional medicine when it comes to your child’s health.

Umbilical hernia in children

Umbilical hernia is a common diagnosis given to children in the first year of life.

Most often, a hernia occurs due to a defect in the anterior abdominal wall, weakness of the umbilical ring. The provoking factor is a prolonged increase in intra-abdominal pressure as a result of severe coughing, constipation, and prolonged crying. Diseases such as rickets and malnutrition, which reduce muscle tone, create favorable conditions for the formation of an umbilical hernia. The most common hernia occurs in premature babies. An umbilical hernia usually involves loops of the baby's intestines or omentum.

Many parents believe that the navel was incorrectly bandaged in the maternity hospital; in fact, this is more often a manifestation of the immaturity of many of the child’s tissues or a genetic predisposition, or uncomfortable external influences on the fetus during intrauterine development. These factors, influencing the fetal placenta, entail inhibition of development. Inhibition is reflected, in particular, in the difficult growth of collagen fibers, which causes improper formation of navel ring structures. In other words, there are a large number of factors that make it difficult for the umbilical ring to close normally. During this process, under the area of ​​the overgrown navel, free space is preserved, previously occupied by blood vessels. Some doctors do not even pay parents attention to small umbilical hernias, being confident from experience that they will close on their own over time. Although it happens that a small umbilical hernia does not go away on its own. How should young parents behave if the surgeon has diagnosed an “umbilical hernia”?

First of all, don't start worrying right away. After all, as already mentioned, during the development of a child, a hernia can close on its own, most often this happens before the age of three. Sometimes during the observation process, when the surgeon sees that the hernia is closing slowly, he can postpone this period to 5 years. And only when the doctor is completely sure that the hernia will not close on its own, then he gives a referral for surgery.

Secondly, you need to know that you can help your baby do without surgery. To do this, you need to strengthen the child’s muscles, especially the anterior abdominal wall. Considering that up to 6 months, that is, until the child sits down, it is difficult to do special exercises, massage can and should be done. Of course, it is better if a specialist does this. When the child grows up, you can start doing the same exercises that adults do when they want to strengthen their abdominal muscles.

A physical therapy (physical therapy) doctor will show you this clearly. And you, the parents, will constantly be involved with the child.

The same diagnosis - umbilical hernia, does not mean that everyone has the same hernia. Each child has his own, special one. And only a specialist - a surgeon - can tell you specifically about your hernia. For example, there are hernias in which the hernial orifice is small (this is a purely anatomical concept), but the visible part of the hernia, that is, the navel itself, is huge. In such cases, the surgeon sometimes gives directions for surgery before 3 years. The fact is that if this is not done, the skin of the navel can stretch very much and you will have to do not an ordinary operation to eliminate a hernia, but a more complex one - a plastic one. Such an operation will be aimed at eliminating a cosmetic defect when the navel is so large that it literally dangles on the stomach. It's better not to let it come to this.

There is one more very important point. Do not confuse an umbilical hernia with an inguinal hernia. These are completely different diseases with similar names. There are different hernias - inguinal, umbilical, femoral. And in different children the same hernias occur differently, in their own way.

In any case, this problem should be solved wisely and consistently. You must follow all the instructions of your doctor and not self-medicate. Only through joint efforts will an umbilical hernia in your baby become a thing of the past.

Author: pediatric surgeon, urologist-andrologist Protsenko V.A.

Inappropriate advice

There is a method that claims to help get rid of bulging but actually has no scientific evidence. It is often advised to apply a coin to the convex navel. Such actions can harm the baby by promoting the spread of bacteria and causing inflammation.

If a newborn's navel protrudes, you should also not put cabbage leaves and other vegetables on it; this will not have any effect.

Even more often, it is recommended to cover the navel with a band-aid. But the skin underneath will not breathe, it will begin to sweat, and irritation will appear, which will definitely bring discomfort to the baby.

If a baby's belly button protrudes, the child should be seen by a doctor. The doctor will tell you why this happened and whether treatment is required. You cannot act on your own if the baby is in pain, his temperature rises, and his navel swells and becomes inflamed.