Hernia in Babies

A hernia is a lump that develops under the skin, in the tummy or groin region in variable sizes. A hernia mostly appears in the abdominal region but can also be found in the areas like the upper thighs, belly button, and groin. Generally, the muscles across the tummy area and the pelvic region form a wall that holds the organs like gut and intestines within its boundaries.

What Is Hernia in Babies?

Babies have a small opening in their abdominal tissues that allows the umbilical cord to pass through. It connects the mother to the baby when the baby is inside the womb; at birth or later, as the baby matures, this opening in the muscles closes. In some cases, where the muscles do not meet and complete their growth, a small gap is created in the region. If a loop of intestines or tissues squeezes in through this opening, it results in a hernia.

Types of Hernia in Babies and Young Children

A hernia is a condition where fatty tissue or an organ pushes through a gap in the surrounding muscular wall. Often, babies are born with certain small openings inside their body, but these usually close at some point. If the opening does not close, the nearby connective tissues squeeze in through these openings, they result in a hernia. The two most common kinds of hernia that occurs in babies and young children are:

Umbilical Hernia

This kind of hernia occurs around the belly button; sometimes, babies are born with an opening in the abdominal muscles circling the belly button. The abdominal membrane or small intestines may protrude from this weak spot, causing a soft bulge known as an umbilical hernia. Its size ranges anywhere between 2 centimetres and more than 6 centimetres. Usually, an umbilical hernia in newborn babies doesn’t cause any discomfort and can be pushed back in easily by the doctor. Most umbilical hernias tend to disappear on their own as the gap in the muscular wall gets closed by the age of two.

Inguinal Hernia

The primary cause of an inguinal hernia in infants depends on the gender of the baby. The protrusion of a portion of the intestine or membrane from the abdomen is the cause of an inguinal hernia. In boys, this hernia may extend beyond the groin and into the scrotum – the gland that holds testicles. For girls, this bulge goes from the ovary or fallopian tube through an opening into the groin and may extend up to the outer labia around the vagina. 

What Are the Causes of Hernia in Babies?

Causes of Umbilical Hernia

At birth, babies are born with a ring of muscular tissues surrounding the umbilical cord. This ring usually gets closed before birth. In cases where it does not close, such an opening becomes the weak spot which results in an umbilical hernia.

Causes of Inguinal Hernia

Its primary cause is the formation of a sac which is left open in the inguinal ring during fetal life. This sac should close on its own at birth. But if it doesn’t, the sac allows abdominal muscles to squeeze through the ring into the groin. In the case of boys, the organ trapped may be a loop of the bowel, while in the case of girls; it may be a part of the intestine or ovary.

Signs and Symptoms of a Hernia in a Child

During infancy and childhood, the tissues generally protrude only when one applies physical pressure or strains oneself. These situations include instances of crying, coughing, or sneezing. In these cases, the visible bulge usually retracts or disappears on its own. A hernia in this state is harmless and can be reduced.

Umbilical Hernia

Umbilical hernias mostly disappear on their own as the child matures; except in some cases where it may have become trapped. The symptoms include fever, constipation, severe abdominal pain, vomiting, redness, discolouration, and a bulging or rounded abdomen.

Inguinal Hernia

In an inguinal hernia, the lump does not disappear, but instead gets caught in the opening and stays bulged out the whole time. As a sign, the baby doesn’t stop crying as the lump becomes hard and painful for the baby. Another symptom in babies is that the groin area suddenly begins to swell. In the case of a reducible hernia, the bulge appears when the baby exercises strain but disappears otherwise. In case of a strangulated or incarcerated hernia, the child may be in pain, become fussy, vomit, and cry uncontrollably.

Diagnosis of a Hernia

The diagnosis of a hernia is a simple procedure for the doctor. During the checkup, he examines the child’s belly, the area between the abdomen and inner thigh, both the sides of the groin and the scrotum for the boys. He checks whether or not the bulge enlarges when the child coughs, cries or strains, and decides whether a surgery is required. He will see if the hernia can be pushed in and if it is trapped or incarcerated. He may perform an X-ray and ultrasound on the belly to check for complications and may prescribe a blood test to check for infections.

Treatment for Hernia in Babies

The need for surgical removal of hernia in babies depends on the severity of the case; for some, the hernia may be simply pushed in, while for some, surgery is required. The surgery lasts for an hour and is done under the effect of general anaesthesia.

Umbilical Hernia

For an umbilical hernia, surgery is only performed to prevent any further complications. Before opting for surgery, the doctor checks matters like whether the hernia is painful, doesn’t shrink after a year, doesn’t disappear till the child turns 3 or 4 years old, or gets trapped. The surgery consists of an incision that is made at the belly button or at the location of the bulge, where the intestinal tissue is pushed back through the stomach wall, and the opening is then closed with stitches.

Inguinal Hernia

Infants having inguinal hernia hold a higher risk of strangulation than older children. Hence, surgery for an inguinal hernia in babies should not be delayed. The procedure involves the surgeon making a small incision of 2 to 3 cm in the skin fold of the groin, and pushing the intestine back to its proper position. The muscle wall is then stitched to prevent another hernia.

Risks and Complications

A hernia can occur without any specific reason. The pressure applied to the abdomen makes the hernia visible, and it may go away when the pressure is released.

An inguinal hernia is majorly found in premature infants. It occurs in 1 to 2 per cent of children and mostly affects boys than girls. An umbilical hernia is more common and affects about 10 per cent of children. This kind of hernia is more common in girls and premature babies.

An inguinal hernia may involve some complications and will need to be followed closely. The bowel may get trapped and turn into an incarcerated or strangulated hernia. This part of the intestine, if unable to be pushed back through the stomach wall, may lack adequate blood supply. In such cases, doctors recommend immediate surgery to repair the hernia before the situation worsens.

Recovery After Baby’s Hernia Surgery

Generally, the surgery for umbilical hernia repair in a child is done within an hour; most babies can be taken home within a few hours of the umbilical surgery. Once the child is home, he needs to stay indoors and avoid day-care or school for some days, to get adequate rest. He can also be prescribed pain medications for a few days. Recovery from a hernia surgery takes 2 to 3 days until the child feels normal. He should be given a sponge bath for 2 days after surgery until the stitches heal. The child may feel some twinges or a pulling effect at the groin area while moving.

Are There Any Home Remedies for Treating Hernia in Babies?

When the baby is suffering from a hernia, apart from the medical treatments, you can help your child with certain remedies. Some of the home remedies for treating an umbilical hernia are mentioned below:

• Water: Provide your baby with adequate amounts of water after every feed. Water is known to keep the system clean and can reduce the problem of an umbilical hernia. It improves blood circulation and can reduce the strain during bowel movements.
• Aloe Vera: You may extract aloe vera juice and add it to the food prepared for your child if he is above 6 months of age. If he is younger, you may give him a few teaspoons of the extracted juice after consulting your doctor.
• Coconut Oil & Olive Oil: Coconut oil & olive oil are considered highly effective in reducing the occurrence of an umbilical hernia in babies. It is recommended that you regularly massage the child’s abdomen with coconut or olive oil 5 to 6 times per day.
• Berries: Berries are considered one of the best natural cures for an umbilical hernia, as they are rich in antioxidants and have a high content of fibre which improves the immune system.
• Green Vegetables: Fresh green vegetables such as broccoli, capsicum, cucumber, and spinach possess a high degree of fibre content, vitamins and, minerals that can help to guard against the condition of a hernia.

Hernias can be painful for your child even if they are not extremely dangerous. It is best to identify the symptoms early on and get it checked by a doctor.

Resources & References: Healthline, Stanford Children’s Hospital

Also Read: Hydronephrosis in Babies: Causes, Symptoms & Treatment