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Umbilical Hernias: Not Just An Outtie Belly Button

If you’ve worried that your baby’s belly button looks a little funny and sticks out, it may be an umbilical hernia. Most belly buttons that people think are “out-ties” are in actuality hernias.

What is an umbilical hernia?

Technically, the umbilicus (belly button) is what’s left from where mom and baby were connected by the umbilical cord when mom was pregnant. So when baby is delivered and the cord is cut, there is a little stump left. When the remaining cord falls off, if there is a remaining out pouching or bulge at the belly button then there is a hernia.

What causes umbilical hernias?

The abdominal wall has muscles that run vertically. Usually when a baby has an umbilical hernia, the muscles haven’t quite come together all the way and there is a little “defect” or gap. Other “defects” or problems with the abdominal wall can cause hernias, but those causes in babies are rare (and certainly something your pediatrician will talk to you about).

How do you treat umbilical hernias?

The vast majority of umbilical hernias resolve on their own. The muscles grow together and the gap closes up on its own. This process can take months to years. In the meantime, do nothing. Resist the urge to put anything on it or tape it down (this is a terrible, potentially dangerous, wives tale passed on from well-meaning grandparents). If your child is among the few that don’t resolve (if it was a huge hernia), the ultimate treatment is surgical closure. The surgery is for umbilical hernias that don’t resolve is usually a quick few stitches to close it up. In rare situations, the defect may be so big that the surgeon may have to use a mesh or device to help close the gap.

How worried should I be?

Umbilical hernias are something I see multiple times a day. They are really common and most of them resolve on their own. Generally speaking, they are no big deal. On a worry scale of 1-10 (where 1 means don’t worry and 10 means freak out), umbilical hernias are a 1.

Thanks to my patient’s mom who let me take a pic of her baby’s belly to show you a great pic of an umbilical hernia.

Quick Tip: How To Stop Your Child From Picking His Or Her Belly Button

Many toddlers pick at or play with their belly buttons. I have seen some pretty infected, inflamed, and irritated belly buttons over the years. The simple solution is to make the belly button inaccessible. Put the child back in onesies (yes, you can buy 3T and 4T onesies online) for a while. I know it can be hot (especially certain times of the year in some locations), but it’s better than infected belly buttons. Have the child wear the onesie under his/her shirt. After a while (can be weeks to months), you’ll break the habit and you can stop the extra layer.

Umbilical Cord Care

How do I care for the umbilical cord?

Caring for your baby’s umbilical cord is quite easy. You don’t have to do anything. It used to be that parents were told to dab rubbing alcohol on it. The new recommendations are to put nothing on it and let it dry up and fall off on its own. If the cord starts to get goopy or smelly, you can use alcohol, you won’t hurt anything. It just isn’t necessary otherwise.

When should it fall off?

Most cords fall off between 1 and 3 weeks; average is around 2 weeks. If the cord is knocked off prematurely, it can bleed and a new scab will form. If it is delayed in falling off by more than 1 month, you need to call your doctor. There are a few rare medical conditions that can cause delayed cord falling off and your doctor needs to evaluate.

The cord is bleeding, should I worry?

Often times a cord will get knocked by clothing or diapers and start to bleed. Usually the bleeding is very minimal and will stop with a little pressure. This is quite common and not worrisome. Usually, a new scab will form and heal appropriately. If there is profuse bleeding (dripping blood or more), your child needs to be seen by the pediatrician.

When should I worry?

If the skin on your baby’s belly around the umbilical cord is red, warm, or tender, your child must be seen. Consider that the umbilical cord is a direct connection to the inside of your baby’s body. If there are any signs of infection (e.g., red skin, warm, tenderness) on the outside then you may have a more involved infection on the inside, or the skin may be infected. If that happens, your baby needs to be seen by the pediatrician immediately.