Hernias in the Newborn
A wall of muscle holds the bowel (intestine) inside the belly. A hernia happens when a section of bowel pushes out through a weakness in the muscle. The hernia looks like a bulge under the skin. In baby boys, a bulge in the scrotum is the most common type of hernia. It happens because of a persistent canal between the scrotum and abdomen that normally closes when a fetus is developing. A hernia can move back into the abdomen through the passage. So you may not see the bulge all the time. You may see it most when your baby is straining. This can happen your baby is crying, feeding, or a having a bowel movement.
Why do 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
Inguinal hernia. This occurs when a section of bowel extends into the groin area. This is 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.
Umbilical hernia. This occurs when a section of bowel extends into a weak area around the bellybutton. This type of hernia often heals on its own.
When is it a 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 stuck in the weak spot (strangulated), 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 burst or die. In boys, blood supply to a testicle could be reduced, leading to damage or death of the testicle.
How is it treated?
An inguinal hernia often requires treatment, but an umbilical hernia might appear smaller over time as the child grows. This can take 1 to 2 years. Your child’s healthcare provider 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, most 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 with the healthcare provider about how your baby is likely to progress.
Signs of a strangulated hernia
Watch for the following signs to know if your baby’s hernia is strangulated. If you see any of these signs, alert your baby’s healthcare provider right away:
Crying that can’t be consoled, which can mean the baby is in pain
Crying or fussing when you touch the hernia
Hernia doesn’t move back into the abdomen
Redness or blue discoloration in the groin, scrotum, or bellybutton
Swollen, round belly, which can be a sign that food isn’t passing through the bowel
March 27, 2018
Assessment and Management of Inguinal Hernia in Infants. Wang, K. Pediatrics. 2012, is. 130, ed. 4, pp. 768-773., Care of the Umbilicus and Management of Umbilical Disorders, UpToDate
Adler, Liora C., MD,Sather, Rita, RN