Treatment of the umbilical hernia of the newborn

What is going on in my baby’s body?

A pair of abdominal muscles run along the abdomen from the ribs to the pelvis. These muscles are the same ones that you can see on a bodybuilder’s stomach. The muscles are parallel and connected from top to bottom by their thick surrounding tissue.

Newborns have these muscles, but the connective tissue is not fully bound. This makes sense because the umbilical cord exits through the space between these muscles. If your baby were in the womb and these muscles were attached, this would have interrupted the blood flow between mother and child. Both the muscles and the associated tissue adhere above and below the navel, but remain tied directly to the umbilical cord until after birth.

Once your baby is born and the umbilical cord is severed, the muscles can become safe. If the muscles are not attached after the stump has fallen, the intestine can protrude through this hole and the navel looks like an “outie”, also known as an umbilical hernia. The actual hernia consists of a sack that protrudes through this opening between muscle and tissue in the abdominal wall. This opening is called the umbilical ring.

Some babies have small hernias and others have large hernias. Every time a baby cries, a hernia occurs because the pressure created by crying causes the intestine to be pushed out by the umbilical ring. The hernia can also appear quite noticeable when a baby tries it. Sometimes hernias can get stuck.

Umbilical hernias occur in over 10% of normal Caucasian babies and an even higher number of African American babies. They are more common in premature babies than in full-time babies.

What can I do?

You really don’t have to do anything to help an umbilical hernia. It’s an ancient myth that you can tie a coin to a string and wrap the device around a baby’s waist to push back the navel. Given the reason umbilical hernias actually exist, it’s easy to see why this doesn’t work.

When should my doctor be called?

Hernias appear – sometimes in remarkable numbers – but need to be flattened slightly: light pressure should allow a parent to push the hernia back. When a baby cries, it is difficult to insert the hernia. But when a baby is calm, it should be easy.

Hernias should be examined by a doctor if they cannot be easily pushed back or if the area around them becomes red and hot. Sometimes they remain trapped – the intestine gets stuck in the muscle and cannot be pushed back because they are swollen. In this case, they can be strangled. This is the case when the blood supply to the adherent part of the intestine is impaired and this part of the intestine lacks important nutrients, including oxygen. This can cause vomiting and remarkable pain.

Enclosed and strangled hernias are medical emergencies. Strangulated hernias should be operated on immediately, because if the part of the intestine that is deprived of oxygen dies, this part of the intestine must be removed before life-threatening consequences occur. Enclosed hernias may not require urgent surgery, but should be examined immediately by doctors (often surgeons) to avoid strangulation.

What tests should be done and what do the results mean?

The only test is to put light pressure on the hernia to see if it can be pushed back (medically this is called reduced). You or your doctor can do this test. If a hernia can be slightly reduced, this is normal. If this is not possible, he can be arrested or strangled.

In the case of a strangled or trapped hernia, an ultrasound can help determine if blood is still flowing to the part of the intestine that is in the hernia.

What are the treatments?

It’s time to treat a normal, reducible hernia. At the age of two, 95% of all umbilical hernias close on their own. If a hernia has not been closed in kindergarten, you can have it closed surgically for cosmetic reasons.

Leave a Reply