An umbilical hernia is one of the most common findings in the neonatal physical examination — a soft, fleshy protrusion at the navel that may be barely noticeable or may be dramatically prominent, particularly when the baby cries. For most parents, the key information they need is simple: the vast majority of umbilical hernias close on their own, without any intervention, by the time the child is two to three years old.
Healthbooq supports parents with evidence-based guidance on common newborn health findings, including those that are benign and self-resolving and those that require monitoring.
What an Umbilical Hernia Is
During fetal development, the intestines develop outside the abdomen and return through the umbilical opening; after birth, the umbilical ring (the opening through which the cord passed) normally closes progressively. An umbilical hernia occurs when this closure is incomplete and a gap persists, allowing a small amount of abdominal contents (usually a fold of the peritoneal lining or a small amount of bowel) to protrude through the ring under the skin of the navel.
The hernia appears as a soft bulge at the navel, which is typically more prominent when the baby cries, strains, or is upright (when intra-abdominal pressure is increased) and reduces or disappears when the baby is relaxed and lying down. The bulge is soft, easily reducible (it can be gently pushed back), and painless. Umbilical hernias are most common in premature babies (the umbilical ring has had less time to close before birth) and in babies of Black African or Caribbean heritage, in whom they are particularly common.
Natural History
The great majority of umbilical hernias close spontaneously as the umbilical ring strengthens and closes with age. Approximately eighty to ninety per cent of umbilical hernias close without intervention by two to three years of age. Smaller hernias (ring diameter less than one centimetre) close more rapidly and reliably than larger ones.
No treatment is needed during this waiting period. Various folk remedies — taping coins or devices to the navel, binding the abdomen — are not recommended, are not effective, and can cause skin damage.
When Surgical Treatment Is Considered
Surgical repair (umbilicoplasty) is typically considered for hernias that have not closed by three to five years of age, for very large hernias (umbilical ring diameter greater than two centimetres at age two), and for hernias that cause symptoms. The operation is a straightforward day-case procedure under general anaesthetic.
When to Seek Urgent Medical Attention
Although umbilical hernias are generally benign, incarceration — the entrapment of bowel within the hernia sac with the contents unable to be pushed back — is a rare but serious complication. Signs of incarceration include: the hernia becoming suddenly hard, tender, or irreducible (cannot be pushed back); the baby showing signs of significant distress; vomiting; and abdominal distension. These features require emergency medical assessment (call 999 or go to A&E).
In practice, incarceration of umbilical hernias in infants is uncommon — far less common than with inguinal hernias — but parents should know the signs.
Key Takeaways
An umbilical hernia — a soft protrusion at the navel caused by abdominal contents pushing through the gap where the umbilical cord was attached — is very common in newborns, particularly in premature babies and babies of Black African or Caribbean heritage. The vast majority of umbilical hernias close spontaneously by two to three years of age without any treatment. Umbilical hernias are not painful and do not require binding or other home treatments. Surgical repair is considered for hernias that have not closed by three to five years, are very large, or cause symptoms.
