Has your baby been diagnosed with a congenital Hernia? Has the doctor suggested surgery, and are you worried about how it will affect your little one’s health? If you nodded along, then reading our post could be a good idea.
Hernia (especially inguinal) is a common disorder affecting around 1-3% of full-term babies and 30% of premature babies in India. Here, we look at hernia in babies, how it affects them and what you can to do to help your little one overcome it.
What Is A Hernia?
Hernia refers to the soft bulge that’s seen under the baby’s skin (where a hernia occurs). A hernia occurs when a portion of the intestine protrudes through an opening in the abdominal cavity. When the opening is too narrow, only liquid from the abdominal cavity flows down and collects around the testicles in the scrotum. The liquid is hydrocele. There are different types of hernias; each requiring a different type of care. The most common of these are inguinal and umbilical hernia (1).
[ Read: Causes Of Kidney Reflux In Babies ]
1. Inguinal Hernia:Sponsored
A hernia that develops in the groin is called inguinal hernia. As the fetus develops, testicles move down from the abdomen (from one of the ovaries or fallopian tube in the case of girls) into the scrotum through an opening called the inguinal canal. The canal closes by birth. When the opening does not close completely, a loop of the intestine may move through the inguinal canal causing an inguinal hernia. The problem also occurs among girls- sometimes extending up to one of the outer labia around the vagina. Inguinal hernias in babies are common among baby boys with undescended testicles, children with cystic fibroids, babies born prematurely, and those with a family history of a hernia. It also occurs more often in the right groin rather than the left, but can occur on both sides as well (2).
2. Umbilical Hernia:
An umbilical hernia occurs when a part of the intestine protrudes through an opening around the belly button (the umbilical portion). These are common and usually harmless and often close before the child’s first or second birthday. When it does not close on its own and when the hernia does not disappear by age 4, the child needs surgical intervention. An umbilical hernia in babies is fairly common among African-American children (especially girls) and is more likely to affect premature babies (3).
[ Read: Sandifer’s Syndrome In Babies ]
Symptoms Of Hernia In Babies:
If you notice a slight bulge in the groin or around the belly when your child cries or coughs, and if the bulge does not disappear, your child may have a hernia. When liquid accumulates around the scrotum (hydrocele), it may appear enlarged and bluish. In some cases, the child may become constipated and irritated. And sometimes, the swollen area may appear red, and the child cries continuously. Take your child to the doctor immediately if any of these symptoms appear. The symptoms of an inguinal hernia in babies are slightly different from symptoms of an umbilical hernia:
Symptoms of Inguinal Hernia:
- A bulge that appears under the skin when the child’s crying, coughing or straining. The swelling usually occurs between the belly and the inner thigh. Sometimes, the swelling may extend up to the scrotum (or the labia in the case of girls).
- The swelling can also be noticed if the child suddenly becomes cranky or refuses feed.
- Symptoms often vary according to the type of hernia. For example, in the case of a reducible hernia, the swelling may occur only when the child strains or creates pressure around the belly. It may retract back when the child’s resting.
- In the case of incarcerated hernia, the bulge can be prominently seen at all times- it does not retract when you apply gentle pressure and often causes pain.
- Doctors often examine the area between the belly and inner thigh and in the scrotum (in the case of boys) to feel for signs of hernia.
[ Read: Symptoms Of Appendicitis In Babies ]
Symptoms of Umbilical Hernia:
- Umbilical hernia is often painless and observed only when the child coughs or cries. Among older children, it can be seen when the child sits or stands upright.
- The hernia is usually seen when the umbilical cord falls off, but sometimes, symptoms aren’t visible early on.
- A bulge is often seen under the skin near the belly. On physical examination, the doctor may try and push back the bulge to recommend further course of action.
- In some cases, children may experience vomiting and pain.
Treating Hernia In Infants:
Just as symptoms for inguinal and umbilical hernia vary, so does the treatment differ. For example, doctors may ask you to wait for a year or two until the umbilical cavity fills on its own in the case of an umbilical hernia.
Inguinal Hernia Treatment In Babies:
- Whether reducible or incarcerated, inguinal hernia does not go away, and it needs treatment. Even when it seems to have gone, the swelling may appear again when the child cries, coughs or strains during a bowel movement.
- If the doctor can push the bulge, he may recommend a surgery within a few weeks so as to close the opening and prevent the hernia from returning.
- But, if the bulge cannot be pushed back, the doctor may recommend an immediate surgical intervention. This is an emergency because tissues (in the intestine) are trapped and not getting enough oxygen to survive (4).
Umbilical Hernia Treatment In Babies:
- Most umbilical hernias close without surgical intervention.
- The doctor may advise surgery if the hernia does not close after the first two years or if it is painful.
- He may also suggest surgery if the hernia is bigger than 1.5 centimeters in diameter or if it blocks the intestines.
What Happens During Surgery:
The surgery starts with the doctor administering anesthesia to your child. He then makes an incision in the lower abdomen and pushes any bulging tissue back before sewing the sac that protruded through the opening. For girls, the doctor shuts the hole, while, for boys, he leaves the hole that goes into the abdomen and the scrotum. He does so because the hole carries blood vessels for the testicles- the hole is not the problem, but the sac is. The entire procedure takes about 35 to 40 minutes, and the child will be in the recovery room for about an hour. You can take your child home the same day (except for premature babies who may have to stay overnight). As for post surgery care, you’ll be advised to keep the operated area clean and dry until it is healed.
Do you know of someone who had baby hernia and have a different experience to narrate? Share your experience with us here. Leave a comment below.
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