Hernia in Babies and Children: Should You Be Worried?

Noticing a small lump or swelling on your baby can be worrying. You may find yourself wondering if it’s something serious, especially when it becomes more noticeable whenever your child cries or strains. In many cases, though, this kind of swelling is simply a hernia, a condition that’s actually quite common in infants and young children.

A hernia develops when tissue, such as part of the intestine, pushes through a weak spot in the abdominal wall. This can happen near the belly button (umbilical hernia) or in the groin area (inguinal hernia). While the sight of a bulge can be unsettling, the good news is that most hernias in babies are harmless and easily managed. Many even close on their own as your child grows, while others can be repaired quickly with a minor procedure.

Types of Hernias in Children

Hernias in children are usually congenital, meaning they are present from birth rather than caused by lifestyle factors. Understanding the different types can help you recognise what you’re seeing and know when to seek medical advice.

• Umbilical hernia
  If you notice a soft bump near your baby’s belly button that seems to appear when they cry or strain, it could be an umbilical hernia. This happens when the abdominal wall does not fully close after birth, leaving a small opening for tissue to slip through. In most cases, the gap seals naturally by the time your child reaches three to five years old.
• Inguinal hernia
  An inguinal hernia appears in the groin area and is more common in boys. It develops when a passage called the processus vaginalis, which normally closes before birth, remains open. This allows a section of intestine (or occasionally, in girls, an ovary) to slip into the groin or scrotum.
• Diaphragmatic hernia
  This is a more serious but rarer condition, where an opening in the diaphragm allows abdominal organs to move into the chest cavity. This can affect lung growth and breathing and requires prompt medical attention.
• Epigastric hernia
  Located between the breastbone and the navel, an epigastric hernia develops when fatty tissue pushes through a weak spot in the upper abdominal wall.

Risk Factors

Several factors can increase a child’s likelihood of developing a hernia. While most of these factors are beyond parental control, being aware of them helps ensure early detection and management.

• Premature birth or low birth weight
• Family history of hernias
• Male gender (especially for inguinal hernias)
• Chronic coughing or constipation that increases abdominal pressure
• Genetic or connective tissue disorders

Common Signs and Symptoms

Wondering how to tell if your child might have a hernia? The symptoms are often subtle at first. You might notice:

• A soft bulge in the groin, belly button or upper abdomen that appears when your child cries, coughs or strains
• The lump becoming smaller or disappearing when your child is calm or lying down
• Fussiness, crying or discomfort in babies
• In more severe cases, vomiting, swelling that turns firm or discoloured, or refusal to feed

Diagnosing Hernias

Doctors can often diagnose a hernia through a simple physical examination. During the check-up, they may gently feel the area while your baby is relaxed and again when they cry or strain, as the swelling often becomes more visible then.

Sometimes, an ultrasound may be recommended to confirm the diagnosis and identify the type of hernia. If a diaphragmatic hernia is suspected, imaging such as X-rays or prenatal scans may be needed to assess how the abdominal organs are positioned.

Treatment Options for Children

It’s natural to feel anxious when surgery is mentioned, but hernia repair in children is typically a straightforward and safe procedure. The aim is to close the opening and prevent future complications.

• Laparoscopic Surgery
  This minimally invasive option involves a few tiny incisions through which a camera and fine instruments are inserted. The surgeon views the inside of the abdomen on a screen and carefully repairs the hernia. Because the cuts are small, recovery tends to be quicker and discomfort minimal.
• Open Surgery
  For inguinal, epigastric, and diaphragmatic hernias, surgery is generally advised, as these types do not close on their own and may cause complications if left untreated. During the procedure, which is performed under general anaesthesia, the surgeon carefully moves the displaced tissue back into place and strengthens the surrounding muscle wall to reduce the risk of the hernia returning.

Potential Complications if Left Untreated

Most hernias in children are not emergencies, but some can become serious if they are ignored. Understanding the potential risks can help you spot warning signs early.

• Incarceration: This happens when the herniated tissue gets trapped and cannot be pushed back into the abdomen. It may cause discomfort or swelling that does not go away, even when your child is calm.
• Strangulation: If the trapped tissue loses its blood supply, it can become damaged. Strangulation is a serious situation that requires immediate medical attention to prevent lasting harm.
• Bowel Obstruction: A hernia can sometimes block a portion of the intestine, leading to abdominal pain, vomiting, and swelling. This can make your child unusually fussy or reluctant to eat.
• Tissue Death (Necrosis): In severe cases, if blood flow is restricted for too long, the affected tissue may die. This can result in infection or sepsis, which is a medical emergency.

Although the term “hernia” may sound alarming, remember that most are easily treatable with excellent outcomes. If you’re concerned about a possible hernia in your baby or child, call us at 6262 1226 to schedule an assessment. Early intervention and proper management can make all the difference.