Hernia in Children and Babies
Hernias are common in children, mainly inguinal and umbilical. Their management differs greatly: umbilical hernias usually close on their own, whereas inguinal hernias need early surgical repair.
Contents
Why do children get hernias?
Most childhood hernias are congenital — the child is born with an opening that did not close completely. They are not caused by crying or by how the baby is carried. Management differs from hernia in adults.
Inguinal hernia in children
How it happens: during fetal development the testis descends through the processus vaginalis, which normally closes before birth. If it stays open, bowel or an ovary can enter it (indirect inguinal hernia), or only fluid (hydrocele).
Who is at risk: about 1–5% of children, around 30% of very premature babies, boys far more than girls; the right side is more common and it can be bilateral.
Symptoms: a bulge in the groin, scrotum or labia that appears with crying or straining and disappears when calm or asleep.
Why not wait? The risk of incarceration in infants, especially in the first year, is much higher than in adults, and may damage the bowel, testis or ovary. Surgery is recommended soon after diagnosis.
The operation: herniotomy (sac ligation) without mesh, through a small skin-crease incision or laparoscopically (allowing inspection of the other side). Most children go home the same day (except small premature babies who may need breathing monitoring) and are back to normal within days.
Umbilical hernia in children
- Very common, especially in premature babies; grows with crying.
- Rarely incarcerates and closes spontaneously in most cases by age 4–5.
- Do not tape a coin on the navel.
- Surgery if: it persists after 4–5 years, the defect is large (>1.5–2 cm), or there is incarceration or recurrent pain.
See umbilical hernia.
Inguinal hernia vs hydrocele
| Inguinal hernia | Hydrocele |
|---|---|
| Contains bowel or ovary | Contains fluid only |
| Comes and goes with crying | Mostly constant |
| Needs early surgery | Many resolve by age 1–2 |
| Risk of incarceration | No incarceration risk |
Warning signs
Go to the emergency department if the bulge becomes hard, painful and will not go back, turns red or blue, or is accompanied by inconsolable crying, vomiting, abdominal distension or refusal to feed. See hernia complications.
Frequently asked questions
Is a hernia in a baby dangerous?
Does crying cause hernia in babies?
Is mesh used in children's hernia surgery?
Scientific references
⚠ This website is for health education and does not replace a medical examination. If you develop sudden severe pain at a hernia, vomiting, or the bulge changes colour, go to the emergency department immediately.