Umbilical hernia in a child: secrets of recovery. A complete review of umbilical hernia in children: symptoms, treatment, prevention Hernia on the abdomen in a baby

Umbilical hernia in children is a common pathology, affecting every fifth child. Premature babies suffer from this disease more often than full-term babies - about one in three.

Minor defects of the umbilical ring occur in almost all newborns. You should not immediately sound the alarm when you discover a protrusion above the navel. It is important not to make a diagnosis yourself, but if you suspect a hernia, consult a doctor. What kind of disease is this, how to recognize it in time, whether it is necessary to operate on a small patient - we will figure it out in this article.

What is an umbilical hernia and for what reasons does it occur in children?

The child, while in the mother's womb, is connected to her by the umbilical cord, through which he receives nutrients for formation and growth. After birth, the umbilical cord is tied up and cut off, and the umbilical cord is no longer needed.

Over time, the umbilical ring tightens thanks to the abdominal muscles. Since the umbilical ring in newborns is weak, it sometimes happens that it does not close completely, and this leads to an intestinal loop protruding through it.

An umbilical hernia is a condition in which abdominal organs protrude under the skin through the umbilical ring. Most often, the disease is diagnosed in newborns, but it is also observed in one-year-old children and at 6-8 years of age.

An umbilical hernia can be either congenital or acquired. The following causes of congenital hernia in children are known:

prematurity;
genetically determined weakness of the baby's abdominal muscles;
hereditary factor (pathology more often appears in children whose parents suffered from the same disease in childhood);
an infectious disease suffered by the mother during pregnancy or an unfavorable environmental situation.

Causes of acquired hernia:

Special plasters and bandage

As a complex treatment, together with massage and gymnastics, a special fixing patch and bandage are used. A patch that allows you to remove an umbilical hernia in a baby is used after the umbilical wound has healed. It is glued to the navel so that a fold is formed and worn for 10 days. The course is repeated several times with short breaks.

The main thing is that the patch is made of hypoallergenic and breathable material. Babies' skin is very sensitive and an allergic reaction may occur.

The bandage is worn to prevent strangulation of the hernia. When wearing this accessory, the walls of the abdominal cavity are strengthened and the umbilical ring is reduced, which leads to recovery.

In what cases is surgery required?

If the doctor insists on the need for surgery, you should not ignore his advice. In what case is a hernia operated on? This happens if:

umbilical ring size more than 2 cm;
a strangulated hernia appeared;
a hernia in a baby over 1 year old increases in size;
protrusion does not go away in a child until 4-5 years of age.

When the hernia is small, during surgery the doctor makes an incision above the navel and tightens the umbilical ring. The operation lasts no more than 20 minutes.

Often, instead of abdominal surgery, the surgeon resorts to laparoscopy. It is performed under general anesthesia, causes virtually no complications and leaves no scars.

For a large hernia, hernioplasty (hernia repair) is performed - the hernia is surgically removed. During the operation, the hernia is first reduced, then a synthetic mesh is placed on the hernial orifice according to the principle of a patch, which over time grows into the tissues of the body and prevents the recurrence of the protrusion.

How long does the recovery period after surgery last?

If the operation is carried out in a timely manner, that is, before the child goes to school (up to 7 years), rehabilitation lasts no more than 2 weeks. There are no complications. After removal of a hernia, the child must wear a postoperative bandage and adhere to a special diet - exclude foods that cause bloating from the diet. Doctors recommend limiting physical activity.

After surgery for strangulation or rupture of the hernial sac, rehabilitation is more difficult. Such patients are prescribed an additional course of antibiotics and physical therapy.

Why is an umbilical hernia dangerous and what are the complications?

When an umbilical hernia is strangulated, the child may experience the following symptoms:

vomit;
nausea;
blood in stool;
inability to reduce the hernia with pressure while lying on your back.

In the presence of an umbilical hernia, nausea and vomiting are common symptoms in a child.

A complication in the form of a rupture of the hernial sac, in which its contents come out, is extremely rare. Strangulation and rupture of the hernia are life-threatening, so you must immediately contact a surgeon.

Preventive measures

With proper care of the child and compliance with preventive measures, the chances of an umbilical hernia are reduced several times. We offer several tips to prevent this pathology:

Continue breastfeeding as long as possible to prevent constipation, bloating, and intestinal dysbiosis;
It is not advisable for a nursing mother to eat foods that cause bloating in the baby (cow's milk, legumes, grapes, cabbage, carbonated drinks, etc.);
It is worth including cereals, fruits and vegetables, and herbs in the diet of a nursing mother;
if breastfeeding is impossible for some reason, then the doctor must select the right mixture;
it is important to protect the baby from colds, and also to avoid prolonged crying and screaming, as they increase intra-abdominal pressure, which provokes the development of an umbilical hernia;
strengthen the abdominal muscles through gymnastics, massage and swimming.

An effective means of preventing umbilical hernia for babies with lactase deficiency is the correct selection of nutrition and additional intake of lactase. With dysbacteriosis, bloating and constipation often lead to the development of an umbilical hernia in infants. It is necessary to eliminate the symptoms of this disease to prevent the occurrence of an umbilical hernia.

The linea alba represents the fibrous structure on which the aponeuroses of the abdominal muscles converge. It runs down the middle of the abdominal wall from the xiphoid process of the sternum to the pubic symphysis.

Due to various congenital and acquired factors that lead to muscle weakening, a hernia may form in one of the areas of the linea alba. How to determine the presence of a disease? What treatments are available and what complications may occur? What should be done to prevent such a problem from occurring?

Causes of hernia of the white line of the abdomen in children

A hernia of the linea alba in a child appears when the midline is weakened. The elastic tendon plate may have congenital gaps due to underdeveloped structure. The two main factors that influence the development of the disease are weakness of the muscles of the anterior abdominal wall and increased intra-abdominal pressure.

In medicine, hernias of the white line of the abdomen are divided into three types:

In 80% of cases, pathology occurs in the upper abdomen. In this area the tendon is widest and softest. The anatomical structure of the body in children practically prevents the formation of an umbilical hernia. Below the navel, the tendon becomes narrow and strong, which also reduces the risk of developing a formation.

With an increase in intra-abdominal pressure, a small tubercle appears at the site of the divergence of the aponeurosis. Adipose tissue penetrates the gap and a lipoma forms. Quite often it is mistakenly associated with other diseases.

Gradually, the hernial opening enlarges, and part of the outer part of the abdominal cavity falls into it. This is how a hernial sac appears, into which the internal organs fall.

The main reasons for the development of the disease:

The reasons for the increase in intra-abdominal pressure, which provokes the occurrence of formation in children and newborns:

prolonged crying (the child seems to be tearing himself apart);
chronic constipation;
excessive physical activity;
excess weight;
chronic cough;
postoperative scars and scars on the abdomen;
hereditary predisposition.

How does it manifest?

The main symptom is a rounded lump on the child’s stomach; it is impossible not to notice. Over time, the protrusion increases in size. Weak muscles spread further, which causes further prolapse of the abdominal cavity and internal organs.

During physical activity, the hernia increases significantly, while in a lying position it decreases or completely collapses. When pressure is applied, children experience discomfort and pain. The hernial sac is soft and elastic to the touch.

The photo below shows examples of different types of disease and stages. Initially, the size of the cone may be the size of a walnut, but in the absence of the necessary treatment, the bulge increases.

Associated symptoms that should prompt you to go to the hospital:

vomiting and nausea;
heartburn;
prolonged constipation.

Diagnostic methods

At the slightest suspicion, you should contact your treating pediatrician. If necessary, he will refer you to specialized specialists. The diagnosis is complex, combining an oral conversation with the parents and the child (if the baby is talking) to collect an anamnesis and various diagnostic studies:

visual examination of the child;
auscultation (listening to the area of protrusion);
palpation of the abdominal cavity and hernia in particular;
laboratory tests (blood, urine, feces);
Ultrasound (provides information about the contents of the hernial sac);
radiography (shows the overall picture);
MRI or CT (if necessary).

In most cases, the doctor gets by with an examination, tests and ultrasound. Careful detailed scanning using MRI or CT is necessary in advanced situations or for various complications.

How to treat a hernia?

In any case, the pathology requires mandatory and competent treatment. Currently, the only treatment option is surgery. However, in some cases, therapy is practiced without surgery, although it does not guarantee a 100% result.

The treatment regimen is determined by a pediatric surgeon based on the results of examination, tests and hardware diagnostics. It should be noted that a hernia of the linea alba in children responds well to treatment, since the child’s body is resilient and recovers quickly.

Non-surgical methods

The treatment method without surgery is rather supportive and preventive in nature, helping the disease not to worsen.

Non-surgical therapy includes regular wearing of a special bandage, which resembles a wide and elastic Velcro belt. The bandage should support the abdominal cavity and prevent the hernia from growing.

The second stage is strengthening the abdominal muscles with the help of special therapeutic exercises (physical therapy). You only need to do the prescribed exercises. Unreasonable training will lead to worsening or strangulation of the hernia.

In addition, it is very important to take care of your baby’s diet and choose the right diet, which will be aimed at preventing constipation and increased gas formation.

Surgery

The surgical procedure is called hernioplasty. Usually a planned operation is prescribed, for which the child is carefully prepared. In case of injuries or additional complications, emergency surgery is performed.

Before the procedure, children must be examined by a therapist and cardiologist and undergo the necessary tests. The day before surgery you should not eat, you are only allowed to drink water. Then the baby is given an enema and given an injection, which stops the intestines. In addition, the child is given a sedative so that he gets enough sleep and is not afraid.

The procedure is carried out in two ways:

Classic hernioplasty. The surgeon makes an incision and assesses the condition of the internal organs. Puts them in place, sutured the hernial sac. If the pathology is small, the hole is closed with one’s own tissues. The aponeuroses overlap each other for better fixation. This method is dangerous due to possible relapses and suture divergence. If the hernia is large, the surgeon places a special mesh over the hernial opening, which securely closes it.
Laparoscopy. Modern minimally invasive technique. Only a few small incisions are needed to insert the laparoscope. The probe has cameras that show the condition of the abdominal cavity and give an overall picture. Advantages: low level of injury, short recovery time, absence of excessive bleeding. However, the operation has a number of contraindications.

Regardless of the type of surgery, children recover quickly. If there are no complications, babies are usually discharged after a few days. After 1 - 1.5 weeks, the sutures are removed. After discharge, it is very important to follow all doctor’s orders and recommendations.

What complications can a child experience?

Lack of medical care is dangerous due to serious complications:

Hernia injury. Swelling and inflammation of the hernial sac develops, which spreads to the entire abdominal cavity.
Lack of ability to straighten. An adhesive process develops between the skin, hernial sac, peritoneal wall and internal organs.
Pinching. Compression of the bag leads to disruption of normal blood circulation in this area. The organs in the hernia gradually die, necrosis and gangrene begin.

A hernia is a protrusion of an organ or part of it through anatomical canals under the skin, into the space between muscles or into internal cavities (for example, into the chest from the abdominal cavity). A hernia in a child should be diagnosed as early as possible, since this phenomenon can lead to life-threatening complications.

Why do hernias occur, what are they, how do they manifest themselves and why are they dangerous? This is important to know for parents who suspect such a pathology in their baby.

Any hernia has the following components:

hernial orifice - a hole in the abdominal wall or diaphragm;
hernial sac - a section of the peritoneum that has passed through the hernial orifice;
hernial contents - what is in the hernial sac.

Hernias are classified according to several criteria:

According to the time of formation. Congenital - the diagnosis is obvious already at birth, acquired - the pathology develops as the baby grows older.
By localization. A hernia in a child's abdomen (abdominal hernia). Its varieties are inguinal, umbilical, and hernia of the white line of the abdomen. In addition, a distinction is made between diaphragmatic and intervertebral localization of hernial formations.

Umbilical

A navel hernia in a child is the most common. A peri-umbilical hernia in children is a consequence of the release of an intestinal loop or part of the omentum through the dilated umbilical ring into the subcutaneous space.

Inguinal

A hernia in a child’s groin is formed when the closure of the inguinal canal is disrupted, which normally occurs at the age of 6-7 months after the testicles descend from the abdominal cavity into the scrotum. If the inguinal canal remains open, loops of intestine can fall through it under the skin or descend lower, down to the scrotum. In girls, the pathology is rare - with anomalies in the structure of the pelvic and groin organs.

Features of hernial protrusions in the groin:

According to localization, the hernia can be inguinal or inguinal-scrotal;
bilateral (less often) or unilateral formation;
according to the degree of severity - incomplete (does not extend beyond the inguinal ring) and complete (extends beyond it and spreads along the spermatic cord);
hydrocele and spermatic cord cyst are often observed as concomitant diseases.

Hernia of the white line of the abdomen

In a child, a hernia of the white line of the abdomen is often combined with an umbilical hernia. Supraumbilical hernia in children is a consequence of weakness and hypotension of the anterior abdominal wall. With an increase in intra-abdominal pressure, a defect in the abdominal aponeurosis is formed and separation of the abdominal muscles occurs. A white abdominal hernia forms in children, which can be located above or below the navel.

Intervertebral

A hernial bulge of this location is rarely observed at birth. It develops in children due to physical overload, after spinal injuries, or due to abnormalities in its structure. In this case, the cartilage located between the vertebral bodies is squeezed out. More often, such a hernia is localized in the lumbosacral region.

Why is a hernia dangerous?

Any hernia is dangerous due to the possibility of strangulation. As a rule, this leads to the development of peritonitis. Only emergency surgery can save a child's life.

Why is an umbilical hernia dangerous in children? Cases of strangulation of the hernial bulge of this localization are rare, but dynamic monitoring and consultation with a specialist are required if the baby’s condition worsens. If self-healing does not occur and parents reject surgical intervention, a large hernia may form in adulthood, especially in women after childbirth.

Large hernial protrusions are often strangulated, which leads to emergency surgery.

The danger of a hernia in the groin area, in addition to strangulation, lies in the pressure on the pelvic organs. Subsequently, the processes of spermatogenesis in boys and gestation in girls are disrupted. A herniated disc can cause compression of the nerve roots, which is accompanied by severe pain and limits movement. Sometimes there is difficulty urinating and defecating.

Symptoms

Signs of an umbilical hernia in children are more often observed from the neonatal period, while inguinal hernia can develop later. Upon examination, a swelling is detected under the skin around the navel or in the groin area.

This formation becomes obvious with an increase in intra-abdominal pressure of any etiology (crying, sneezing, coughing, straining during bowel movements, when the baby is in an upright position). Gentle palpation helps determine the size of the hernial formation.

By gently pressing your finger on the protrusion, it can be reduced. In the lying position and when the child calms down, the hernia disappears. With small hernias that are easily reduced, the child usually does not experience pain, but is characterized by increased excitability, weather dependence, a tendency to increased gas production and unstable stool.

Reasons

Abdominal hernia in children often begins to form even before birth.

This phenomenon occurs in the following pathological conditions:

abnormal course of intrauterine development;
intrauterine hypotrophy;

The following provoking factors play an important role in the formation of a hernia:

weakness of the abdominal muscles;
thinning and excessive elasticity of the peritoneum in some areas;
hereditary predisposition;
heavy weight of the baby;
surgery or abdominal trauma;
high intra-abdominal pressure (flatulence and stool disorders with a tendency to, frequent crying, child’s cough).

An umbilical hernial bulge in a one-year-old child may be the result of an overly expanded umbilical ring and severe muscle hypotonia. This is especially common if the child begins to walk and stand early. In this case, there is usually a defect or absence of a section of the peritoneum in the umbilical area, non-closure of the umbilical ring and the umbilical vein located in its upper part is noted.

Inguinal hernial bulge is more common in male infants. Among the reasons for its formation, a large role is played by hereditary predisposition, weakness of the peritoneal fascia, and prematurity.

How to understand that a child has a hernia?

A hernia in a child’s abdomen is in any case accompanied by the appearance of a protrusion in the navel, groin or along the midline of the abdomen, especially when crying and straining. The size of the formation can vary from a pea to a large plum. Touching the area of the protrusion is sometimes painful, but if it is small, it can be reduced.

Strangulated hernia

It is an absolute indication for surgical intervention. Moreover, within several hours, the bulge in the groin or abdominal wall cannot be reduced, which was previously easily done by the parents. Attempts to do this cause pain and increase the child’s anxiety.

Such phenomena indicate that the formation is compressed in the hernial canal. There is a threat of developing peritonitis due to necrosis of the strangulated intestinal loop. Therefore, a strangulated hernia is an emergency.

Danger signs are:

Significant increase in size of the hernial formation.
Redness and increased temperature of the skin over the hernial sac.
A sharp deterioration in the child’s condition (fever, stool retention, severe anxiety).

If the parents' attempts to correct the situation are unsuccessful within several hours, the child's condition is still poor, it is necessary to call an ambulance. Under no circumstances should you use painkillers or antipyretics, as this can lead to serious complications.

What to do?

Hernia of the white line of the abdomen in children, as well as hernial bulges of the abdomen of other localization, are an indication for the need to strengthen the abdominal wall. To do this, the baby must often be placed on the tummy before feeding; therapeutic exercises and a tonic massage are needed.

Parents should monitor the size and condition of the hernial bulge when bathing and swaddling the baby. At the slightest deterioration of the condition, urgent medical consultation is needed.

Removal of an inguinal hernia in a child can be performed routinely or for emergency reasons. If the hernial bulge is small, parents usually successfully correct it themselves; this does not cause concern to the child. In this case, the operation is planned after the baby reaches one year of age.

If the hernia often protrudes, its consistency gradually thickens, touching it becomes painful, and reduction is difficult, this is an indication for urgent medical consultation. With such dynamics of the disease, surgery should be performed at any age. Suspicion of infringement is a direct indication for emergency surgery.

An umbilical hernia rarely leads to health-threatening complications. Usually, as the child grows older, the size of the protrusion decreases, self-healing occurs, as the tone and strength of the muscles of the anterior abdominal wall increases.

Sometimes, to speed up this process, mothers practice tightly swaddling the baby's tummy or try to strengthen the abdominal wall with a bandage. These activities can lead to compression of internal organs and inflammation of the skin, so you should first consult a doctor. If sealing is necessary, only a hypoallergenic adhesive plaster can be used.

There are purely childhood diseases, and there are ailments that are most often found in adults. These include a hernia of the white line of the abdomen, but nevertheless, although rare, it still happens in children.

Definition and pathogenesis

In adults, the disease manifests itself between the ages of 20 and 30 years. On average, for every 10 hernias, one is formed at the level of the white line of the abdomen. Unlike inguinal and umbilical hernias, such a hernia in children occurs in less than 1% of cases.

The linea alba is a vertical muscle strip that begins at the xiphoid process of the sternum and ends at the symphysis pubis. The middle of this tendon layer passes through the navel and at its level has a width of 10–25 mm, and a little lower it narrows to 2–3 mm.

A hernia of the linea alba in a child occurs when the bundles of the tendon plate diverge at the level of the navel, and loops of intestine and omentum protrude through them. The wider the divergence of the fibers (up to 10–12 cm), the lower the risk of strangulation of the hernia. But generally the hernial orifice diverges to 5-6 cm.

A hernia of the white line of the abdomen in a child can occur due to genetic or acquired anatomical weakness of fibrous fibers. As a result, thinning, expansion, formation of slit-like openings and divergence of the rectus abdominis muscles occur. Also, the occurrence of a hernia may be due to underdevelopment of the wide tendon plate, consisting of collagen and elastic fibers.

Can provoke a white abdominal hernia obesity, abdominal trauma, postoperative scars. As well as an increase in intra-abdominal pressure that occurs with constipation, prolonged screaming, chronic bronchitis, whooping cough, etc.

Stages of hernia development

A hernia of the white line of the abdomen has three stages of development. IN first phase formation of a preperitoneal lipoma occurs. Sometimes the disease progresses into the so-called initial phase, and sometimes it reaches the final stage of formation.

The first phase is characterized by the protrusion of preperitoneal cells through the slit-like divergence of tendon fibers. This is exactly the picture that characterizes the formation of preperitoneal lipomas. Very often the disease stops at this stage and does not develop further.

But sometimes a lipoma can transform into a hernial sac, filled with part of the omentum and a small section of the small intestine. And the finally formed hernia has a hernial orifice and a hernial sac with contents. Inside the hernial sac you can often find the transverse colon, loops of the small intestine and even the walls of the stomach.

Last stage The development of a hernia of the white line of the abdomen is clearly visible to the naked eye. In addition, it is very easy to identify by palpation.

Basically, hernias of the white line are formed locally. But sometimes several hernias form, located one above the other. Hernias are supra-umbilical, peri-umbilical and sub-umbilical.

Signs of a white hernia

A hernia of the linea alba in a child is not a disease that can lurk for years. Its symptoms are usually visible to the naked eye. And the first sign of a hernia is painful protrusion along the linea alba.

If a child complains of increasing pain after eating, when playing sports, after defecation, etc., it makes sense to show him to a doctor. If the child constantly feels pain, most likely he has a temporary strangulated hernia.

Also, increased pain in the hernia may be due to tension in the omentum connected to the hernial sac, or increased pressure on the nerve endings of the parietal peritoneum. In most cases, a hernia of the linea alba in a child is accompanied by pain in the hypochondrium, scapula, and lower back.

With severe pinching, the child may feel nausea and sharp pain in the peritoneum. Also, his condition may worsen due to retention of feces and gases.

How to confirm the diagnosis and begin treatment for a hernia

Any mother should be wary if her child often has a stomach ache. If the pain intensifies, you should immediately consult a surgeon. He will first examine the little patient and then refer him for additional examination.

In addition to palpation, a hernia of the white line of the abdomen is diagnosed using Ultrasound and computed tomography abdominal organs. In addition, the doctor may prescribe x-rays of the stomach and duodenum, gastroscopy or herniorrhaphy. The last examination method involves injecting a contrast agent into the peritoneum to examine the hernia.

Once the diagnosis is confirmed, the child should be immediately scheduled for surgery. There is no other way to cure a hernia of the linea alba. When preparing for surgery, you need to exclude certain foods from your diet.

First of all, these are spicy and fatty dishes, including spices. The mother should ensure that the child who has been diagnosed with a hernia of the linea alba does not have butter, processed foods, various snacks (for example, chips, crackers), tomatoes, lemons, or chocolate on the menu. In addition, it is recommended to exclude vegetables and legumes from the diet, which cause bloating, colic and constipation. And in order to further reduce the load on the peritoneum, the child needs to be fed often, but in small portions.

When preparing a child for surgery, you need to feed him dishes made from brown rice, cereals, and vegetables - in particular carrots, cucumbers, and asparagus. You can also give fruits, fish, low-fat cheese, egg whites, cauliflower and lean veal. But we must remember that such a diet is not a treatment, but only relieves the stomach and intestines before surgery.

Surgery and recovery

Surgical intervention for a hernia of the linea alba in a child is called hernioplasty and is performed under general anesthesia. Depending on the degree of the disease, hernioplasty is performed using local (native) or artificial material (synthetic prostheses).

During the operation, the doctor is faced with the task of not only opening the hernial sac and removing its contents, most often this is a small part of the omentum, but also eliminating the discrepancy of the rectus abdominis muscles - diastasis. Only preventing further diastasis guarantees a complete cure for a hernia of the white line of the abdomen.

When hernioplasty using local (own) tissues, the defect of the aponeurosis (wide tendon tissue) is eliminated using a synthetic non-absorbable thread. This type of surgical intervention often leads to recurrence of the hernia, since the load on the sutures is quite large and they can erupt.

Therefore, most often the operation is performed using synthetic mesh frame, which covers the aponeurosis and evenly distributes the load on the seams. Since connective tissue grows through the allomaterial without difficulty, the likelihood of relapse is negligible.

The entire operation takes no more than an hour, and the next day, if there are no complications, the child can be discharged home. Although the doctor may leave him in the hospital for another two days. The stitches will be removed only after a week or a week and a half.

After surgery there occurs rehabilitation period, which is accompanied by a special diet and refusal of physical activity.

Both before and after surgery, you should not give your child spicy, fatty or fried foods. To make the digestion process easier for the stomach, you need to focus on liquid foods: porridge, purees, fermented milk products.

In order for the intestines to empty regularly, the child after surgery should eat liquid oatmeal, drink light vegetable and chicken broth, low-fat yogurt, kefir or yogurt. You can also give your child milk and fruit jelly.

To improve peristalsis, it is necessary to add fruit and vegetable purees and juices to the little patient’s diet. But you should not overuse fiber, as its excess can lead to flatulence and colic.

In addition, for a quick recovery, children after surgery should be given vitamins C and B, as well as calcium.

How to prevent a hernia from appearing

Prevention of hernia of the white line of the abdomen in infants are regular bowel movements and lack of excess weight. Since constipation and obesity increase the load on the abdominal cavity, care must be taken to ensure that the baby does not overeat and that his intestines work properly. In addition, the baby should not be allowed to burst into tears from screaming.

If the child is older - 5–10 years, you can prevent the formation of a hernia through moderate exercise. Strengthening the abdominal muscles helps to tighten the aponeurosis.

Even if a child is diagnosed with a hernia of the linea alba, this is not a reason to panic. This is not such a terrible disease, and the operation to eliminate it is quite ordinary and safe.

Educational video about where a hernia can appear

Hernia in children: types and symptoms, why it is dangerous

A hernia in children is a protrusion, prolapse of an organ under the skin, which occurs due to muscle weakness and for a number of other reasons. Most often, organ prolapse, usually the rectum, occurs in the abdominal cavity. Without appropriate treatment, this disease can cause serious consequences; it is worth knowing what to do if this condition appears in a child.

Hernia in children: what is it?

In children, hernias most often occur - protrusion of the small intestine in the abdominal cavity and other types of this disease. The most common umbilical hernia occurs in children, but other types may occur. It is much easier to get rid of such defects in children than in adults. The earlier the disease is detected and treatment started, the better. As you age, this condition can cause more negative health consequences.

You can often notice the occurrence of this pathology in children under one year of age, in some cases they say that it can disappear on its own. However, in any case, when it appears, the child should be under the supervision of a doctor.

The exact cause of protrusion in children is quite difficult; its appearance may be due to the structural features of the abdominal tissues; in this case, they speak of a congenital hernia. Other factors can affect the protrusion, these include strong child crying and screaming, severe constant cough. In any case, regardless of the cause, you need to start therapy as quickly as possible and straighten the protrusion of the organ.

Under no circumstances should you try to repair or cure a hernia by any other method, Dr. Komarovsky warns about the same. This disease requires medical supervision; self-medication can lead to worsening of the condition and serious problems.

Important! If this condition is not addressed in childhood, a hernia can cause much more problems in later life.

Why is it dangerous?

The main danger when such a condition occurs is the possibility of pinching of the protruding organ. If the organ is pinched by surrounding tissues, there is a possibility of complete disruption of its functioning. In the case of the intestines, this can lead to dire consequences.

Other possible complications that occur without timely treatment include inflammation and rupture of organs inside the hernia, and various strangulations inside the hernia. Over time, the defect may also become irreparable; getting rid of this condition will be extremely difficult.

Umbilical hernia in children - photo

Umbilical hernia in children is the most common type of this disease; most cases of pathology relate specifically to umbilical hernias. In this case, the defect occurs in the area of the umbilical ring; usually a section of the intestine, omentum and fat located in the peritoneum protrude.

Umbilical defects are usually congenital, caused by insufficient closure of the umbilical ring after birth. How to identify an umbilical hernia in children? Usually it is a small swelling in the area of the umbilical ring, which may increase in size. Pain and other unpleasant sensations are usually absent. However, it is worth noting that in some cases, protrusion of the navel does not occur if the defect is small.

Pinched protrusions in young children occur quite rarely, but this condition must be dealt with so that problems do not arise at an older age.

Important! It is worth noting that if one of the family members had this disease, there is a high probability of its occurrence in the child.

How to treat an umbilical hernia in a one-month-old baby

The younger the child and the earlier the defect is detected, the easier it is to treat this disease. A navel hernia in a child can be removed through treatment without surgery; a special medical bandage is usually used. A specialist will select a suitable model; you should not try to correct the defect yourself.

If the protrusion cannot be corrected by wearing a bandage, surgical intervention is resorted to. The operation lasts no more than half an hour, all manipulations are performed through a small incision, laparoscopy is possible. At the moment, it passes so easily that after a few days the patient can return to normal life.

Inguinal hernia

Another fairly common type of this defect. In this case, protrusion of the organ occurs in the lower abdomen through the inguinal canal. An inguinal hernia in boys usually contains part of a loop of intestine; in girls, it usually contains an ovary and a fallopian tube. It can appear in children under one year of age.

In boys, this condition occurs much more often; this is due to the peculiarities of the development of the male reproductive system. By the time of birth, this area usually closes, but if this does not happen, an inguinal defect will form.

How to understand that a child has a hernia

An inguinal bulge is usually a small swelling in the very lower abdomen, closer to the pubic area. There is no pain or inflammation; when pressed, the hernia seems to shrink, going back into the body. However, it is worth considering that with this type of disease there is a greater likelihood of pinching.

Pinching usually has the following symptoms: the swelling does not move back into place even when pressed; it feels quite dense to the touch. In this case, contractions appear in the abdominal area, nausea and vomiting may occur. If such symptoms occur, you should definitely consult a doctor.

Important! In girls, inguinal protrusion is treated exclusively by surgery.

In boys, depending on the characteristics of the course of the disease, manual reduction of the protruded organ may be prescribed. It all depends on the presence of complications, the size of the hernia and other factors.

Testicular hernia in a child

Inguinal-scrotal hernia also sometimes occurs in male children. In this case, the development of this disease is usually influenced by a congenital factor; the likelihood of a hernia depends on intrauterine development. This pathology is quite rare, but it is extremely dangerous, so if it is detected, treatment must be started.

The only treatment for this disease is surgery. This defect cannot be used using manual techniques. If swelling of the testicle is detected in a boy, you should consult a surgeon as soon as possible. It is worth noting that most often the right half of the scrotum is affected.

Hernia of the white line of the abdomen

Diaphragmatic hernias in children also sometimes occur, but much less frequently than umbilical hernias. The defect usually occurs in the space between the xiphoid process of the sternum and the navel. This disease has other names: paraumbilical hernia, paraumbilical hernia in children. Sometimes this variety is called supra-umbilical, but this name is not correct.

In this case, swelling and bulging of the organ is found in the space between the chest and the navel. This disease most often occurs in children aged two to five years, it is also caused by congenital and hereditary factors. On palpation, this defect resembles a slightly soft, non-inflamed, painless lipoma.

This defect cannot be corrected without surgery; usually they resort to removing the lipoma and reducing the protrusion of the organs. The operation lasts about twenty minutes and is quite easy. In this case, it is impossible to correct the defect manually.

Most often, hernias of any kind occur in children from one to seven years old; during this period you should be especially attentive to your child. Often, the formation of a protrusion is not immediately noticeable, therefore, in the presence of negative heredity and other factors that lead to this disease, special attention should be paid to the health of children.

An umbilical hernia is a subcutaneous protrusion in the area of the umbilical ring. Like any disease, hernias can be congenital or acquired. Acquired.

There are topics and problems that cause parents great concern for their child. One of these issues is abdominal hernia in children. This disease is a protrusion of the abdominal organs, which are located in the hernial sac. They protrude through a defect - an opening, which doctors call the hernial orifice.

Hernial orifices or protrusions begin to form only in those places that are weaker than others. These include the groin area, the area near the navel, and the white line of the abdomen.

Causes of the disease

Photo: umbilical hernia in a newborn

A hernia in a child can occur due to a genetic predisposition if, after birth, the abdominal walls do not develop correctly. Also, a hernia can be acquired due to anatomical weakness.

All this leads to tissue depletion and loss of their former elasticity. They are not able to cope with the loads exerted, so round or slit-like holes begin to form.

The most common cause of the development of abdominal hernia in children is underdevelopment of the tendon plate, which includes collagen fibers and tissues responsible for the elasticity of the peritoneum.

There are also frequent cases when the disease is provoked by increased intra-abdominal pressure. The following factors contribute to this:

Overweight child, in rare cases even obesity;
Abdominal injury. A hernia may begin to develop in places where the surgical suture was previously located;
Prolonged crying of the baby, chronic bronchitis or whooping cough.

Stages of development of hernial protrusion

Most often, a child experiences a hernia of the linea alba. There are three stages of its development:

The first stage is characterized by the protrusion of peritoneal cells through the opening, which is still small in size. A lipoma is formed located in front of the peritoneum. Basically, in children at this stage, the development of a hernia stops;
When the lipoma begins to form into a hernial sac, the second stage of the disease begins. The sac contains the omentum and small intestine. An already formed hernia forms a portal for exit. In complicated cases, the walls of the stomach are located inside the hernial sac;
The third stage of the disease is visible to the naked eye. It is easily detected by palpating the abdominal area. The hernial sac begins to fall out.

Features of the appearance of hernias in children

The peculiarities of the appearance of hernias in a child include the fact that they are local only in rare cases. Often several hernias form at once, which are located one after another. They can be near, under or above the navel.

In children, hernias are not large. Usually its parameters do not exceed two centimeters. In appearance, it looks like a small round-shaped swelling; you can view the photo for reference.

Symptoms of abdominal hernia in children

Signs of an abdominal hernia in children include pain, discomfort and the presence of a protrusion, which may disappear when lying down. If such symptoms occur, then you definitely need to visit an experienced doctor. Only he will confirm or refute the diagnosis and prescribe the necessary treatment.

Symptoms of a hernia vary depending on the location and degree of development. However, several important signs have been identified, which include:

Aching and nagging pain at the location of the hernia;
Poor functioning of the digestive system. Nausea accompanied by vomiting and frequent constipation are observed;
Problems with the urinary system. This is possible if the bladder gets into the hernial sac.

If such symptoms are observed, you should immediately consult a doctor!

Diagnostics. Preparing for treatment

Every mother should be wary if her child constantly has a stomach ache. When the pain does not go away, but only gets worse, you need to visit a doctor. Only he will be able to properly examine the little patient, and then, if necessary, refer him for examination.

In addition to palpation, an abdominal hernia can be diagnosed using ultrasound and computed tomography of the peritoneum. The doctor may also perform an X-ray of the gastrointestinal tract. During the final examination, a special substance will be injected into the peritoneum, which will allow a thorough examination of the hernia.

If the diagnosis has been confirmed, then it is necessary to immediately set up the child for surgery. If a hernia was detected in a baby, the date of surgical intervention will be postponed.

On average, most clinics undertake to operate on children over five years of age. However, it will be necessary to undergo a thorough examination by a doctor, who may postpone the treatment period or, conversely, shorten it.

To prepare your child for surgery, you will need to create a proper and balanced diet, excluding some foods from it. These include:

Spicy and fatty dishes, food with added herbs and spices;
Chocolate, lemonade, butter;
Snacks, semi-finished products.

You need to feed your baby five times a day in small portions to avoid problems with the digestive system.

Surgery to remove an abdominal hernia in children is called hernioplasty. The operation will be performed under general anesthesia, but with a lower dosage. Hernioplasty can be performed using two methods:

By stitching the peritoneal walls using your own tissues;
Carrying out an intervention using a specially designed mesh.

During the operation, the surgeon makes small incisions and then opens the hernial sac. He removes its contents, then works to eliminate the discrepancy of the rectus muscles. This allows you to avoid the progression of diastasis. Only this will guarantee a complete cure for the hernia.

When performing hernioplasty with native tissues, the aponeurosis defect is eliminated using a non-absorbable thread made of synthetic materials. This form of intervention can lead to relapse, because subsequently there is a large load on the sutures.

Therefore, surgery during which synthetic materials are used has become more widespread. The mesh frame covers the aponeurosis, which leads to an even distribution of the load on the peritoneum. At the same time, the possibility of relapse is minimal, since the tissue can quickly and easily grow through the allomaterial.

Features of surgical intervention (hernioplasty):

The operation lasts no more than an hour;
The next day the child can go home, complications are no longer observed. Only in some cases may the doctor leave the patient for a few more days for ongoing examination;
Sutures are removed after two weeks.

Rehabilitation period

After the operation, a rehabilitation period begins. During this time, it is necessary to adhere to proper nutrition and also avoid physical activity and heavy lifting. As before the operation, the child is advised to avoid fried, spicy and smoked foods. To facilitate the digestion of food, you should try to eat liquid foods: porridge and soups.

To restore the body after surgery, it is necessary to consume vitamin B and C complexes.

How to prevent a hernia?

To prevent a hernia from developing in infants, it is necessary to achieve constant and regular bowel movements and the absence of excess weight. It is worth taking care that the baby does not overeat or cry for a long time.

If the child is between five and ten years old, then the development of a hernial protrusion can be prevented through moderate exercise. Thanks to them, the abdominal walls are significantly strengthened.

Prices for hernia removal are quite reasonable. They vary in different clinics and depend on its prestige, the professionalism of doctors, the quality of the equipment and instruments used. On average, the cost of an operation to remove an abdominal hernia in a child is from 32,000 rubles. This price includes preliminary examinations.

Cost of surgical treatment of umbilical hernia

All about hernia of the linea alba in children

There are many factors that contribute to the occurrence and even progression of this pathological condition. A hereditary tendency leads to the occurrence of hernias; in fact, it is the most common cause of all ailments. The linea alba, which runs from the xiphoid process to the pubis, is the line of intersection of the aponeuroses of the rectus abdominis muscles. This is where hernias can form.

There are factors that increase intra-abdominal pressure and circumstances that weaken the anterior abdominal wall. The latter include weight loss, abdominal trauma, abdominal surgery and diseases that deplete children.

Factors that increase abdominal pressure:

Postoperative scars on the tummy;
Hereditary tendency;
Obesity;
Constant constipation;
Prolonged hacking cough or screaming;
Physical overexertion;
Ascites.

Long-term exposure to causes on the child’s small body leads to weakening of the aponeurosis and muscles of the abdominal wall.

Mechanism of hernia formation

The occurrence of a hernia is associated with the unfinished development of the aponeurosis, in which gap-like defects remain. These defects exist for the passage of nerves and blood vessels through them, connecting the preperitoneal fatty tissue with the subcutaneous tissue. A typical and characteristic place for the occurrence of a pathological condition called a hernia is considered to be the upper region of the white line; peri-umbilical (paraumbilical) and hypogastric localizations are very rarely found.

During an increase in intra-abdominal pressure, pre-abdominal fatty tissue falls out, which is later called preperitoneal lipoma. When this lipoma is compressed, acute pain occurs.

This pain syndrome can be confused with similar symptoms in conditions such as inflammation of the pancreas, gall bladder, peptic ulcer, peritonitis or other abdominal pathologies. Later, the peritoneum falls out and a hernial sac is formed, into which the internal organs emerge. This moment is the formation of a true hernia. Accordingly, there are three stages of development of a hernia of the white line of the abdomen:

preperitoneal lipoma;
initial stage;
formed hernia.

O.P. Krymov identifies types of hernia of the white line of the abdomen, depending on its location:

supra-umbilical (hernia epigastrica);
subumbilical (hernia paraumbilicalis);
peri-umbilical (hernia hypogastrica).

The latter type is very rare, because this is facilitated by the anatomical features of the white line itself, which narrows and thickens below the navel, so defects are less likely to form here. Very rarely, a child may develop not one, but several hernias of the white line of the abdomen. In this case, the pathology is called multiple hernias.

If the hernia is large, most often its contents will be the omentum, loops of the small intestine, and sometimes the wall of the transverse colon.

Most often, the hernia is asymptomatic, and is found by parents or doctors during a routine examination.

In the midline there will be a noticeable rounded protrusion, smooth and elastic to the touch, which increases during sneezing, coughing, or lifting weights; if you press on it, it can decrease. The protrusion may also decrease when lying down. As for the pain, it is mainly localized in the upper abdomen and intensifies with pressure, straining and after eating. Parents should also be wary of digestive disorders. This includes complaints of nausea, vomiting, heartburn, and constipation.

Research methods

examination and history taking of a small patient;
auscultation (listening), palpation (feeling) of the hernia;
general blood and urine analysis;
Ultrasound of the contents of the hernial sac;
gastroscopy;
X-ray examination of the abdominal organs;
herniography;
CT or MRI in difficult situations.

Ultrasound of the white line of the abdomen is considered a very safe and informative research method. It is used to clarify the nature and location of the hernia defect, and to clarify the contents of the hernial sac.

Abdominal palpation procedure to identify a hernia of the linea alba

Differential diagnosis should be carried out with the following diseases:

Peptic ulcer of the stomach/duodenum;
Gastritis;
Appendicitis;
Cholecystitis;
Pancreatitis;
Tumor metastasis to the omentum.

This requires detailed instrumental and laboratory diagnostics of the digestive system.

Possible complications

Strangulated hernia. The problem with this is poor circulation in the organs that are located in the hernial sac. The consequence will be intestinal gangrene. Moreover, the inflammatory process begins to intensify, quickly spreading to neighboring organs. And this will already indicate diffuse peritonitis.
Irreversible hernia. It is characterized by the fact that it is not possible to reduce the hernial contents. This is explained by the fusion of the organs of the hernial sac with each other.
Injury to the formation is dangerous due to subsequent damage and inflammation of the abdominal organs.

How to cure?

Any mother should immediately consult a surgeon. He will do everything necessary for further diagnosis and treatment of your child.

Doctor's note: Even with small hernias, it is imperative to see a surgeon, because there is a high risk of strangulation of the hernia.

Treatment of hernia of the white line of the abdomen only by surgery. This operation is called hernioplasty. It is planned and not very complicated. All surgical procedures are performed only under general anesthesia. Now surgeons use modern and child-safe means to ensure that young patients tolerate operations well.

Doctor's note: Traditional methods of treating hernias in children concern only umbilical hernias in the early stages of the disease. An abdominal bandage does not treat a hernia if it has already appeared.

Surgery as a method of treating hernia of the white line of the abdomen

Depending on the stage of the disease, local or artificial material is used. The surgeon must correct diastasis (separation of the rectus abdominis muscles). If local fabrics are used, the defect is eliminated using a synthetic thread. This method often leads to the reappearance of the hernia because the load on the sutures is quite large. Therefore, during surgery, synthetic mesh frames or prostheses are often used, which cover the aponeurosis and the load on the sutures becomes uniform. The likelihood of relapse when using these frames is almost zero.

The procedure lasts on average 25-40 minutes, it depends on the complexity and scope of the surgical procedure.

A few hours after the operation, children and their parents have the opportunity to return home. The stitches are removed after a week or a week and a half.

Postoperative period

After the surgical procedure, you must follow a restrictive regime for three days, and limit physical activity for 20 days.

Diet you need to follow:

You can’t eat fatty, fried, spicy foods;
liquid foods such as cereals, soups, vegetable or chicken broths, purees, and fermented milk products facilitate the baby’s digestion process;
to restore strength and improve peristalsis, you need to add juices, fruit and vegetable purees to your diet;
Flatulence and colic can occur with excessive fiber intake.

Prevention

Prevention in infants is to prevent constipation. The child should not overeat and scream. Adult children are recommended to play sports, this helps to tighten the aponeurosis.

To prevent relapses and reduce pressure on the abdominal wall, you can use a bandage.

In case of a hernia of the white line of the abdomen, timely diagnosis and treatment is considered very important and necessary, otherwise complications are inevitable. Surgical intervention will allow you to completely get rid of the disease.

Sources:

prematurity;

rickets (see also: what are the signs of rickets in children under one year old?);
intestinal colic;
lactase deficiency.

This is what a hernia may look like

At the first suspicion of pathology, parents should consult a doctor. Protrusion is treated quite easily.

Diagnostic methods

general blood test;
ultrasound;

Therapeutic gymnastics
Little children love fitball exercises.

Special plasters and bandage

a strangulated hernia appeared;

Often, instead of abdominal surgery, the surgeon resorts to laparoscopy. It is performed under general anesthesia, causes virtually no complications and leaves no scars.

vomit;
nausea;
blood in stool;

Preventive measures

Hernia in children: how to identify and treat?

Hernia in children: how to identify and treat?
Varieties
Umbilical
Inguinal
Hernia of the white line of the abdomen
Intervertebral
Why is a hernia dangerous?
Symptoms
Reasons
How to understand that a child has a hernia?
Strangulated hernia
What to do?
Symptoms and treatment of umbilical hernia in children without surgery and with surgical removal
What is an umbilical hernia and for what reasons does it occur in children?
Symptoms of an umbilical hernia in a child
Does a navel hernia bother your child?
Diagnostic methods
Features of treatment of umbilical hernia in children
Massage
Therapeutic gymnastics
Special plasters and bandage
In what cases is surgery required?
How long does the recovery period after surgery last?
Why is an umbilical hernia dangerous and what are the complications?
Preventive measures
Hernia in newborns and infants
How does a hernia form?
Types of hernias in infants
Diaphragmatic hernia
Abdominal hernia in children
Reasons
Symptoms
Diagnosis of abdominal hernia in a child
Complications
Treatment
What can you do
What does a doctor do
Prevention
Hernia on the abdomen of a child
Types of hernias in children and what is their danger
Hernia extending into the periumbilical space
Hernia developed due to diastasis of the abdominal muscles
Inguinal hernia in a child
All about hernia of the linea alba in children
Reasons
Mechanism of hernia formation
Symptoms
Research methods
Diseases with similar symptoms
Possible complications
How to cure?
Postoperative period
Prevention

A hernia in a child should be diagnosed as early as possible, since this phenomenon can lead to life-threatening complications.

Why do hernias occur, what are they, how do they manifest themselves and why are they dangerous? This is important to know for parents who suspect such a pathology in their baby.

Varieties

Any hernia has the following components:

hernial orifice - a hole in the abdominal wall or diaphragm;
hernial sac - a section of the peritoneum that has passed through the hernial orifice;
hernial contents - what is in the hernial sac.

Hernias are classified according to several criteria:

According to the time of formation. Congenital - the diagnosis is obvious already at birth, acquired - the pathology develops as the baby grows older.
By location. Hernia on the abdomen of a child (abdominal hernia). Its varieties are inguinal, umbilical, and hernia of the white line of the abdomen. In addition, a distinction is made between diaphragmatic and intervertebral localization of hernial formations.

Umbilical

Features of hernial protrusions in the groin:

According to localization, the hernia can be inguinal or inguinal-scrotal;
bilateral (less often) or unilateral formation;
according to the degree of severity - incomplete (does not extend beyond the inguinal ring) and complete (extends beyond it and spreads along the spermatic cord);
hydrocele and spermatic cord cyst are often observed as concomitant diseases.

Hernia of the white line of the abdomen

Intervertebral

Why is a hernia dangerous?

Any hernia is dangerous due to the possibility of strangulation. As a rule, this leads to the development of peritonitis. Only emergency surgery can save a child's life.

Why is an umbilical hernia dangerous in children? Cases of strangulation of the hernial bulge of this localization are rare, but dynamic monitoring and consultation with a specialist are required if the baby’s condition worsens. If self-healing does not occur and parents reject surgical intervention, a large hernia may form in adulthood, especially in women after childbirth.

Large hernial protrusions are often strangulated, which leads to emergency surgery.

Symptoms

Abdominal hernia in children often begins to form even before birth.

This phenomenon occurs in the following pathological conditions:

abnormal course of intrauterine development;
intrauterine hypotrophy;
Down syndrome.

The following provoking factors play an important role in the formation of a hernia:

weakness of the abdominal muscles;
thinning and excessive elasticity of the peritoneum in some areas;
hereditary predisposition;
rickets;
heavy weight of the baby;
surgery or abdominal trauma;
high intra-abdominal pressure (flatulence and stool disorders with a tendency to constipation, frequent crying, coughing of the child).

Inguinal hernial bulge is more common in male infants. Among the reasons for its formation, a large role is played by hereditary predisposition, weakness of the peritoneal fascia, and prematurity. Read more about nursing and development of premature babies →

How to understand that a child has a hernia?

Strangulated hernia

Danger signs are:

Significant increase in size of the hernial formation.
Redness and increased temperature of the skin over the hernial sac.
A sharp deterioration in the child’s condition (vomiting, fever, stool retention, severe anxiety).

What to do?

Parents should monitor the size and condition of the hernial bulge when bathing and swaddling the baby. At the slightest deterioration of the condition, urgent medical consultation is needed.

Elective herniotomy is resorted to at the age of 3-7 years, if spontaneous closure of the umbilical ring does not occur. In girls, surgery is performed to prevent complications during pregnancy.

If a child often complains of back pain, especially after a spinal injury, an MRI is necessary to clarify the diagnosis. If a spinal hernia is detected, the doctor will prescribe conservative treatment - NSAIDs, vascular and vitamin preparations, massage, exercise therapy, physiotherapy. If necessary, surgery is performed.

Hernia in children is a common pathology that can develop at any age. If warning signs appear, an urgent medical examination is necessary to select effective treatment. It is impossible to ignore the disease in order to avoid a threat to the health and life of the child.

Source: treatment of umbilical hernia in children without surgery and with surgical removal

Umbilical hernia in children is a common pathology, affecting every fifth child. Premature babies suffer from this disease more often than full-term ones - approximately every third.

What is an umbilical hernia and for what reasons does it occur in children?

An umbilical hernia can be either congenital or acquired. The following causes of congenital hernia in children are known:

prematurity;
genetically determined weakness of the baby's abdominal muscles;
hereditary factor (pathology more often appears in children whose parents suffered from the same disease in childhood);
an infectious disease suffered by the mother during pregnancy or an unfavorable environmental situation.

Causes of acquired hernia:

rickets;
intestinal colic;
low birth weight;
constipation, cough, severe crying, flatulence;
the beginning of walking, especially if the child began to take a vertical position at an early age, and the baby’s muscles are not yet strong enough;
lactase deficiency.

Sometimes bulging happens for no reason. A hernia in children can also occur in the first year of life (not only in newborns). At this age, complete closure of the umbilical ring occurs, but if the child is bothered by frequent constipation or flatulence, this process may proceed much more slowly.

When diagnosing rickets, doctors warn parents about the likelihood of an umbilical hernia. As a result of this disease, muscle tone weakens, which can lead to a bulge.

Symptoms of an umbilical hernia in a child

It is not difficult to determine whether a child has a hernia or not. It is visible upon visual inspection. The main characteristic feature is a protrusion above the navel, shaped like a ball (this is clearly visible in the photo). The size of the ball varies from 1 to 10 cm. If you lightly press on it, it will move into the peritoneum and then protrude again.

This is what a hernia may look like

With a slight increase in the umbilical ring, the hernia can only be noticed when the abdominal muscles tense when sneezing, coughing, crying or laughing. The color of the skin around the navel changes.

Only a surgeon can determine whether there is a hernia and what treatment needs to be applied. Sometimes the so-called “cutaneous navel” is mistaken for a hernia. Outwardly, it looks like a hernia, but it is not one - it is simply a physiological feature of a particular child.

Children with a hernia are more restless because the bloating and colic typical of babies are more painful. Babies with a hernia are weather dependent: they react to changing weather conditions with whims or, conversely, with lethargy and drowsiness.

Does a navel hernia bother your child?

It is important for parents to know that an umbilical hernia does not hurt and does not cause distress to children. Sometimes parts of the peritoneum and intestinal loops can get inside it, resulting in strangulation of the hernia.

Diagnostic methods

As noted earlier, an umbilical hernia is usually visible upon examination. An experienced pediatrician will detect it and refer the patient to a surgeon to clarify the diagnosis. However, one examination is not always enough, because the protrusion may be invisible due to its small size or have other reasons for its appearance. There are pathologies with similar symptoms, for example, tumor-like neoplasms.

To exclude or confirm the diagnosis, the following studies are additionally carried out:

general blood test;
ultrasound;
herniography (x-ray examination of the hernial sac);
X-ray of the stomach and duodenum.

Additional instrumental diagnostics are needed when the results of the examination determine how to treat the child, as well as when making a decision about surgery. In addition, it is necessary to find out if there is any other pathology of the digestive tract.

Features of treatment of umbilical hernia in children

The treatment method is chosen depending on the size of the hernia. It is often possible to manage with conservative methods without resorting to surgery. This is possible if the protrusion is small and does not increase in size and does not cause discomfort to the child. Usually a hernia is treated in simpler ways.

If the umbilical hernia is small, it is treated with conservative methods (massages, gymnastics and medications)

In some cases, the child is treated with medication. The drugs prescribed to the patient are designed to cure the hernia by strengthening the abdominal walls. By adding massage, gymnastics and wearing a bandage to this therapy, you can get good results. If the desired effect is not achieved by 4-5 years, doctors begin to think about surgery.

Massage is allowed for babies after the umbilical wound has healed, that is, a few weeks after birth. First, you can visit a specialist who will teach your mother how to do this correctly. Over time, mom herself will be able to understand the principle and master the massage technique and do it at home.

Before the procedure, it is necessary to straighten the protrusion and carefully cover it with a plaster. This is necessary to ensure that the hernia does not fall out during the massage. All actions during the massage should be soft, gentle, light. Do not press on the baby's tummy.

First, stroke around the navel clockwise, then counterclockwise. Afterwards, the oblique muscles are massaged to strengthen the walls of the abdominal cavity. Here the movements become more intense. Then again circular stroking. Next - light tingling in the navel area and stroking again.

The whole procedure lasts no more than 3-5 minutes. You need to repeat it several times a day and always before meals. Daily massage will give positive results.

Therapeutic gymnastics

For the little ones, use the following exercises:

Before each feeding, the baby is placed on his tummy for a few minutes;
turn the child over on the left side, then on the right side for a few seconds;
holding the baby facing you, tilt him back, holding his head so that he does not tip back;
from a supine position, lift the child by the arms, supporting him under the back (while the head and legs hang freely);
do rollovers from back to stomach;
Place the baby with his back on a large ball and roll, holding him by the legs.

Older children undergo a course of physical therapy, including physical and gymnastic exercises designed to strengthen the muscles of the abdominal wall. It is recommended to train at least 2-3 times a week. Physical therapy is a great way to remove a belly button mass.

Special plasters and bandage

Plaster and bandage for umbilical hernia

The main thing is that the patch is made of hypoallergenic and breathable material. Babies' skin is very sensitive and an allergic reaction may occur.

The bandage is worn to prevent strangulation of the hernia. When wearing this accessory, the walls of the abdominal cavity are strengthened and the umbilical ring is reduced, which leads to recovery.

In what cases is surgery required?

If the doctor insists on the need for surgery, you should not ignore his advice. In what case is a hernia operated on? This happens if:

umbilical ring size more than 2 cm;
a strangulated hernia appeared;
a hernia in a baby over 1 year old increases in size;
protrusion does not go away in a child until 4-5 years of age.

When the hernia is small, during surgery the doctor makes an incision above the navel and tightens the umbilical ring. The operation lasts no more than 20 minutes.

How long does the recovery period after surgery last?

After surgery for strangulation or rupture of the hernial sac, rehabilitation is more difficult. Such patients are prescribed an additional course of antibiotics and physical therapy.

Why is an umbilical hernia dangerous and what are the complications?

When an umbilical hernia is strangulated, the child may experience the following symptoms:

vomit;
nausea;
blood in stool;
inability to reduce the hernia with pressure while lying on your back.

In the presence of an umbilical hernia, nausea and vomiting are common symptoms in a child.

Preventive measures

With proper care of the child and compliance with preventive measures, the chances of an umbilical hernia are reduced several times. We offer several tips to prevent this pathology:

Continue breastfeeding as long as possible to prevent constipation, bloating, and intestinal dysbiosis;
It is not advisable for a nursing mother to eat foods that cause bloating in the baby (cow's milk, legumes, grapes, cabbage, carbonated drinks, etc.);
It is worth including cereals, fruits and vegetables, and herbs in the diet of a nursing mother;
if breastfeeding is impossible for some reason, then the doctor must select the right mixture;
it is important to protect the baby from colds, and also to avoid prolonged crying and screaming, as they increase intra-abdominal pressure, which provokes the development of an umbilical hernia;
strengthen the abdominal muscles through gymnastics, massage and swimming.

Umbilical hernia in children
What does it look like
Doctor Komarovsky
Hernia in a baby
Infantile hernia in a baby
Inguinal hernia

Umbilical hernia in children is a fairly common phenomenon, especially in the first year of life. Why it is dangerous, how to recognize such a pathology in a child and how to treat it, we will tell you in this article.

What is it

An umbilical hernia is a protrusion of internal organs outside the abdominal cavity through the umbilical opening. During pregnancy, the umbilical cord provides a close connection between the child and the mother, nourishes the baby, delivers oxygen and everything necessary for development. When the little one is born, and he has his own pulmonary breathing, the ability to take food through the mouth, then there is no longer a biological need for the umbilical cord.

It is cut off in the delivery room, tied or pinched at the cutting site with a special clothespin (at the discretion of the obstetrician). Ideally, the umbilical cord, part of which remains inside the baby’s tummy, should be overgrown with dense connective tissue within about 30 days. By the end of the newborn period, the navel should heal.

However, in practice, not everything is so rosy - quite often it happens that the cord does not heal completely, the formation of connective tissue occurs too slowly, and this becomes the cause of the development of a hernia. This pathology also has other reasons - from congenital malformations of the abdominal wall to the inept and illiterate actions of the obstetrician when cutting the umbilical cord. At a later age, the prerequisites for the appearance of a hernia are completely different - more traumatic.

The prevalence of the problem is extremely wide. According to statistics, every third premature baby suffers from a navel hernia to one degree or another.

Among children who were born on time, the problem is found in approximately 20% of toddlers. About 4% of children have a hernia until they are 6-7 years old.

Species

All umbilical hernias are usually divided into congenital and acquired. In the first case, doctors assume that the problem began long before the baby was born, even during intrauterine development. These are various umbilical cord pathologies and an incorrectly formed abdominal wall.

Acquired hernias are oblique and straight. Direct hernias are associated with changes in the fascia in the area of the umbilical space. This leads to the hernia exiting directly through the umbilical ring. With an oblique hernia, the path is a little longer - the hernial nodule itself appears not on the navel, but in the vicinity of it, more often between the place of thinning of the wall and the transverse fascia and the white line of the abdomen. And only after this the hernial sac appears in the umbilical ring.

Depending on the complexity of the pathology, hernias are divided into those that can be reduced and those that are not subject to mechanical action. Complex hernias often lead to strangulation of the hernial sac and acute pain.

Causes

Children who were born with a hernia, according to most modern doctors, suffered intrauterine suffering. The cause of a congenital hernia may be a violation of the formation of the peritoneum at the cellular level; this can occur with fetal hypoxia, or with some genetic diseases.

Newborns may be diagnosed with this condition because the umbilical ring heals too slowly after cutting the umbilical cord. As a result, an empty space is formed in the supra-umbilical area or directly below the navel, into which, when the abdominal muscles are tensed (for example, when crying heavily), a loop of intestine can come out.

In older children, a hernia may occur due to heavy lifting or weakness of the abdominal muscles. Very often, parents themselves provoke the appearance of hernias after 1 year by putting the child on his feet too early, placing him in various verticalizing devices such as jumpers and walkers. While the abdominal muscles are not ready for vertical load, the child must crawl, this is how he strengthens both the back and the tummy, and only then stand up. If the sequence of development provided by nature is violated, often after a year signs of a growing hernia appear.

In children 6-7 years of age and older, the appearance of a hernia can be affected by obesity, as well as scars that exist on the abdomen due to previous surgical operations. A strong, prolonged cough increases the chances of a child getting a hernia at any age. Increased physical activity, especially after a long period of lack of physical training, also triggers the starting mechanism for the formation of an abdominal hernia.

Symptoms and signs

Almost all babies have a belly button that sticks out. Some have more, some have less. In itself, a protruding and strongly protruding navel in a baby cannot be considered a hernia. Therefore, a hernia, as a well-defined pathology, has its own clinical symptoms, among which protruding navel is far from the main symptom.

Severe embryonic malformations of the peritoneum, which are accompanied by large hernial sacs, into which sometimes several internal organs (liver, intestines) emerge, are noticeable even during pregnancy. A specialist who will perform a routine ultrasound on the expectant mother will definitely pay attention to them. Such children are considered practically unviable. They rarely survive beyond 3 days in intensive care, although isolated positive outcomes are still known to medicine. Most often, a fetus with such a hernia has a serious genetic disease.

Hernias that a healthy baby acquires after birth, for example, during the newborn period, rarely bother him. They worry his relatives much more. The baby does not experience severe pain. The nodule itself is small in size - from 1 to 5 centimeters in diameter, and “shows up” only when the child screams, cries, or strains due to constipation or intestinal colic. When the child is calm, sleeping, relaxed, the bulge goes away and becomes invisible.

One of the initial symptoms of the development of a true abdominal hernia in a child can be considered some swelling in the area of the umbilical ring. At first, it’s easy to push it back with your finger, but then, as adhesions appear, repositioning becomes difficult, if not completely impossible. The presence of a hernia does not affect the child’s behavior in any way; it does not affect his sleep, appetite, or stool. Attempts to attribute colic, constipation and the child’s capriciousness to the presence of an umbilical hernia do not stand up to criticism. After all, 90% of all children - both with and without hernias - scream, are capricious and suffer from stomach pain, especially in rain or snow.

A symptom such as nausea, which is often attributed to an abdominal hernia in children of the first year of life, is no longer associated with this pathology, but with banal overfeeding of the child. The hernial sac in a child does not affect the functioning of the gastrointestinal tract unless it is pinched. This is always an emergency, but, fortunately, pinching occurs extremely rarely in childhood.

In most babies, from 1 month to 1 year, the hernia goes away on its own, as the abdominal muscles grow and strengthen. A hernia acquired at a later age (at 5,7,10 years) requires a more thorough examination and selection of a method of surgical treatment. For such children, mild nausea and a tendency to constipation are an indirect symptom of the development of a hernia. Surgery is considered the main way to cope with ailments in older age, since other methods are considered ineffective.

Danger

A hernia in the umbilical and periumbilical space is dangerous only because it can cause strangulation of internal organs that fall into the hernial sac. Most often this is an intestinal ring. As already mentioned, this risk in young children is considered minimal. But in older children it increases.

Signs of infringement are:

severe, sudden, acute, almost unbearable pain in the hernia area spreading to the entire tummy;
severe nausea, frequent vomiting;
the child has a feeling of fullness in the abdomen, the passage of gases is difficult or absent;
pronounced admixtures of blood may be noticeable in the stool;
the hernial sac looks inflated, tense, and changes its color to a darker one. If the child is placed in a horizontal position, the hernia does not “go away” as usual, but continues to remain outside.

Strangulation usually occurs in cases where the hernial orifice is narrow. Children with wide hernial orifices usually do not reach an acute condition. In any case, symptoms indicating that the hernial sac may be strangulated cannot be ignored. Parents should place the child on his side, call an ambulance and take the child to the surgical department of the nearest children's hospital.

It is strictly forbidden to give him a lot to drink, try to relieve pain with any painkillers, or apply a warm heating pad or cold to the stomach. And you certainly shouldn’t try to set the hernia back on your own. It might work out. More precisely, the parents will think that everything worked out. After all, visually the hernia will disappear, and the pain will subside. In fact, it can go into the intermuscular space, and when the pain returns after a while, the surgeon will be able to detect signs of peritonitis, necrosis of part of the intestine and other very undesirable problems.

Diagnostics

A pediatric surgeon can make a diagnosis. Parents should contact this specialist if they suspect a hernia. He will carefully examine the baby’s navel, palpate it, read the medical card, and ask many questions about the course of pregnancy and postpartum features of the healing of the umbilical wound.

If a child, due to his age, is able to cough at the doctor’s request, then such a test will also be included in the initial examination. An experienced surgeon will be able to determine the hernia and its approximate characteristics even by touch, but in order to make an accurate diagnosis and make a decision on treatment, several more studies will be needed. First, parents are given a referral for an abdominal ultrasound. Such diagnostics allows you to confirm the presence of a hernia, determine its size, and the exact location of its location. Then you may need radiography of the abdominal organs and irrigoscopy. To carry it out, a contrast solution is injected into the intestine with an enema, which allows you to see all parts of the intestine on the finished x-ray image and determine whether there are defects, perforations, adhesions and other complicating factors in the area of the hernia.

Sometimes a child is shown an endoscopic examination of endoscopy. You will definitely have to undergo traditional blood and urine tests for a general clinical examination.

Treatment

The main and most effective method of treatment is surgical intervention to remove the hernia. But when it comes to children, things are not so simple. Since the hernia can still regress on its own, children are usually not sent to the operating table unless absolutely necessary. Pinching of the hernial sac is considered an urgent need. According to established practice, the most often chosen tactic is waiting. If the child’s hernia has not retracted before the age of 5 years, then surgery may be performed.

In more than 95% of children at this age, hernias are successfully “reduced” on their own, but there are also difficult cases. It is clear that waiting should not be synonymous with inaction. In addition to regular visits to the surgeon for the purpose of intermediate monitoring of the condition of the hernia, parents will be given other recommendations that it is advisable to strictly follow.

Parents' actions

The best exercise, which is recommended for absolutely all babies starting from birth, is daily tummy time. It is better to do this 10-20 minutes before meals, so as not to provoke regurgitation. It should not be laid out on a soft sofa or parent’s bed, but on a hard, flat surface. This exercise not only allows the baby to quickly learn to hold his head, but also effectively strengthens the abdominal muscles, including the oblique muscles. It also promotes faster removal of gases from the intestines and reduces the intensity of intestinal colic.

The first placement on the tummy should not exceed 2-4 minutes, then the time is increased and the procedure is gradually increased to 15-20 minutes. For older children, a special massage that tones the abdominal muscles is recommended.

Massage. Massage does not require special medical skills; all parents, without exception, can master its technique. For infants, procedures can begin immediately after the umbilical wound has healed and dried, usually by 1 month. Massage movements should be carried out with the thumb, making circular movements around the navel in a clockwise direction.

For older children, you can complicate the massage by adding a massage of the oblique muscles of the abdomen, moving along their anatomical path from bottom to top (from the pubis to the ribs) with the index and middle fingers, as well as making horizontal movements in the supra-umbilical region. For children over one year of age, massage is performed using the same techniques, only light tapping movements with the tips of the fingers on the abdomen in the abdominal area are added to the manipulations.

Bandage. Special devices - bandages for umbilical hernias are used both as a means of conservative therapy and in the postoperative period. The bandage allows you to keep the abdominal muscles in the correct fixed position. Thanks to a slight constant pressure on the area of bulging of the hernial sac, a condition is reached in which the exit of the sac through the hernial orifice becomes impossible.

A children's bandage differs from an adult's; it is made of a soft elastic band that is worn on the naked body. Average sizes for children: 42-54 cm in length and 5 cm in width. You can start wearing the bandage immediately after the umbilical wound has healed. The device cannot be used if there is severe skin damage in the abdominal area (for example, atopic dermatitis, eczema, during illness with chickenpox, measles, when there is a rash on the abdomen). For small hernias, a bandage is considered the most effective method of conservative therapy. Its wearing must be coordinated with the surgeon observing the child.

Gymnastics. You can start doing gymnastics after the baby turns 1 month old. For the little ones, it must necessarily include turning over from tummy to side, from back to side. From 3 months you can do the same revolutions, but also in the opposite direction. In order for the baby to turn, you need to pull him by the right handle to the left side, then a rollover will occur on the left side. Another great exercise is tucking your legs towards your stomach. They should be brought in, held for about 30 seconds, then brought in and straightened alternately.

It is useful for children older than six months to exercise on a fitball. Crawling should be encouraged, since it is during this that the abdominal muscles develop the most anatomically correct way. Exercises with a crossbar while lying on your stomach are useful.

For children under 5 years of age with an established diagnosis of “abdominal umbilical hernia,” it makes sense to install a wall bars in the children’s room and teach them how to properly strengthen their abdominal muscles. To do this, use the exercises “Corner” (legs at right angles to the stomach in a hanging position on the crossbar) and “Pendulum” (swinging the body in a hanging position on the crossbar).

Treatment with folk and non-traditional remedies

Since doctors try to wait for developments until the age of 5, all kinds of clinics that offer unconventional treatment for a child’s problem for quite traditional national currency begin to feel most at ease. Parents who are trying with all their might to prevent surgery are ready to do anything. And now their baby is given a tummy massage by a specialist in the field of energy massage and charges considerable sums for it.

If you look closely, the tummy is massaged in the same way as any mother does at home, and, from this point of view, nothing new happens for the child. It’s good if the specialist does no harm, but sometimes the exact opposite happens. Traditional medicine and grandmother’s methods of ridding a baby of such an unpleasant “sore” are few and well known. It’s difficult to talk about their benefits, it’s a question of faith in a miracle, but it’s necessary to say about what can be potentially dangerous:

Piglet on the navel. The advice to tie or glue a five-ruble coin to a child’s umbilical ring with a bandage can come not only from the lips of a grandmother or a neighbor, but also from a local pediatrician, especially if this doctor himself is the grandmother’s age and studied at a medical university a very, very long time ago. Modern doctors have not found any benefit from placing a coin on the navel. If the hernia exists only in the understanding of the parents, then the piglet makes no sense at all, and if the hernia is real, then the piglet is powerless.

But what actually happens sometimes is the development of local inflammation in the navel area, infection of the navel with bacteria, prickly heat. In addition, the hernia itself does not bother the baby, but a coin glued to the delicate skin can cause many unpleasant moments.

Patch. There is nothing wrong with this method, and it does allow you to maintain the navel and hernial sac, if present, in a fixed, correct condition. There are two nuances, the observance of which will ensure successful treatment. Firstly, the plaster must be good (it is better to take products from manufacturers who make high-quality sterile plaster for use in surgical hospitals or a special children's hypoallergenic Porofix, Chicco).

Secondly, the patch should only be applied to the child by a surgeon. Independent attempts by proactive parents to manually repair a hernia can end very badly - with strangulation of the intestinal ring and the need for urgent surgery. It is correct to entrust the first application to the doctor, ask him to show and explain the process, so that later you can change the patch on the navel yourself without the risk of injuring the child. The navel sealed with a plaster should be shown to the doctor at least twice a month. If the hernia begins to increase in size, its presence under the patch becomes dangerous to the baby’s health.

Ointments and compresses. A very popular recipe for homemade ointment among connoisseurs of traditional medicine, which should be applied to the navel area at night, includes butter, propolis tincture and iodine. The navel is smeared with a mixture of oil and propolis, a compress is applied, and then the next morning an iodine mesh is made around the hernia. Official medicine is silent about how oil acts on a hernia, since there are no cases of healing with oil and propolis.

However, propolis, and even more so its alcohol tincture, can cause a serious allergic reaction in the baby, which will require the most traditional treatment. And frequent application of an iodine mesh leads to a very serious condition - an overdose of iodine, because children's skin, delicate and sensitive, absorbs it completely.

Decoctions and drinks. Traditional medicine is ready to offer a lot of recipes for making decoctions and tinctures from rhubarb, shepherd's purse and other herbs and roots against hernia. It is difficult to discuss such treatment seriously, since it is somehow strange in the 21st century to expect that a hernia will retract and resolve after drinking a herbal decoction for ten days.

If you want to give your child herbs, you can do so. But you should definitely agree on a set of herbs with your pediatrician, because many medicinal plants are quite strong allergens. Also, you should not expect a miracle from such “treatment”. It won't happen.

Surgical intervention

After 5 years, if the signs of the hernia have not disappeared, it exceeds 1.5 centimeters in size, if there is a tendency for the hernia sac to grow and enlarge, if there is a high risk of pinching due to the narrow hernia orifice, a decision is made to surgically remove the hernia. The operation is called “hernioplasty”. With such a surgical procedure, the excised sac is replaced either with a fragment of the body’s own tissue, or a mesh implant is inserted, which takes the load on itself and minimizes the likelihood of a hernia recurrence.

For this reason, the tension-free hernioplasty method, which uses special implanted meshes, is best suited for children. During the operation, the surgeon will not necessarily excise the hernia. If it is possible to reduce it and it is possible to fix it in its natural position in the right place, then there is no need to remove it at all.

A mesh implant can be installed either above or below the umbilical ring, depending on the size of the hernial orifice. The final stage of the operation is always suturing the hernial orifice. Quite often recently, for uncomplicated hernia, such operations are performed using laparoscopy. This minimizes the traumatic impact and helps you recover faster. Operations for excision and reduction of hernial sacs are also carried out using modern technologies, for example, laser.

Any type of anesthesia can be used for the operation and this is a great advantage in treating children. By the way, not all surgical hospitals practice this type of surgery for pediatric patients; there are doctors who are adherents of tension surgery. But in any case, parents should discuss this issue with their doctor in preparation for the intervention.

Postoperative period and rehabilitation

If the child had surgery using the tension method, without mesh implants, the recovery period will be longer. It can take from 1 month to six months. Physical activity will be contraindicated for the child. The risk of relapse with this intervention is significantly higher than with surgery using an implant. In the case of tension-free hernioplasty, rehabilitation is shorter. After 3-4 weeks, the child will be able to do his usual activities without restrictions, and will be able to attend sports clubs. And the probability of relapse after such an intervention is estimated at no more than 1%.

For children who have undergone surgery to remove an umbilical hernia, it is important to follow a proper diet that will not cause increased gas formation. You should temporarily exclude cabbage, peas, carbonated drinks, and kefir from your diet. In case of constipation, such children should be given a mild laxative approved for use by age. You should not do enemas and wait until the child goes to the toilet on his own.

In the first week after surgery, boys and girls should not be given solid or thick foods. It is advisable to cook porridge, jelly, compotes. You can gradually expand your diet only at the end of the first week. Wearing a children's bandage is encouraged, as well as massage and gymnastics, as mentioned above. Older children should definitely play sports.

For the prevention of umbilical hernia, for its treatment, if the diagnosis occurs, as well as as part of rehabilitation after surgical treatment, the child is recommended to go swimming. You can enroll a child as young as 1 month into the pool; now there are groups for the tiniest swimmers. Swimming helps to quickly strengthen all muscle groups, especially the abdominal and side muscles.
For the prevention of hernias in children during the neonatal period Some pediatricians do not recommend tight swaddling.
Dad's favorite pastime is “fly and fly” with throwing a child up, it tends to increase intra-abdominal pressure at the moment of throwing, which contributes to the appearance of a hernia in a child prone to such a pathology.
An abdominal hernia can only be treated surgically. Therefore, it is easier and simpler to prevent it by following all the doctor’s recommendations in a timely manner, strengthening the abdominal muscles from childhood.

You can also listen to useful advice from a professional doctor in the video below.

Umbilical hernia in children
What does it look like
Doctor Komarovsky