Hernias in the Newborn

The bowel (intestine) is held inside the abdomen (belly) by a wall of muscle. A hernia occurs when a section of bowel pushes out through a weakness in the muscle. In many cases, this is due to the baby straining (such as during crying, feeding, or a bowel movement). The hernia looks like a bulge under the skin. It can move back into the abdomen through the weak spot in the muscle. So you may not see the bulge all the time.

Which Babies Get Hernias?

Any baby can have a hernia, but they’re most common in:

• Preemies, because the abdominal muscle isn’t fully developed yet.

• Boys, because it’s easy for a hernia to form in the space where the testicles descend.

• Babies with lung disease, because they often strain to breathe.

Two Types of Hernias 

• An inguinal hernia occurs when a section of bowel extends into the groin area (the crease between the baby’s leg and abdomen). For boys, it could also extend into the scrotum. Surgery is usually needed to treat this type of hernia.

• An umbilical hernia occurs when a section of bowel extends into a weak area around the bellybutton. This type of hernia often heals on its own.

What’s the Problem?

In many cases, hernias aren’t dangerous. As long as the hernia can move back into the abdomen, it’s usually not a problem. But if the bowel becomes strangulated (stuck in the weak spot), the problem becomes more serious. The abdominal muscle squeezes the bowel, causing swelling. Blood flow to that part of the bowel may be reduced, and that portion of the bowel could rupture or die. In boys, blood supply to a testicle could be reduced, leading to damage or death of the testicle.

Is Treatment Needed?

Not always. An inguinal hernia often requires treatment, but an umbilical hernia might heal by itself. This can take 1 to 2 years. The doctor will keep an eye on it during this time to make sure the hernia doesn’t become strangulated. If a hernia is strangulated, it must be treated right away with surgery. In some cases the doctor may want to operate before the baby goes home from the hospital, even if the hernia isn’t strangulated yet.

What Are the Long-Term Effects?

Once a hernia goes away or is treated, many babies have no lasting problems. However, if a hernia is strangulated and blood supply is cut off, this could cause damage to the bowel or testicles. Talk to the doctor about how your baby is likely to progress.