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My baby has a hernia

Hernias are caused by an opening in the muscle of the abdominal wall , allowing the intestines (bowel) to move in and out. They can occur around the belly button (umbilical hernia) or in the groin area (inguinal hernia). They are common in babies, especially premature babies. Umbilical hernias rarely require treatment but inguinal hernias need to be operated on.
 

What is an umbilical hernia?

An umbilical hernia is a bulge at your child’s belly button. This arises when the opening for the umbilical cord doesn’t close completely after birth. This hole allows intestines (bowel) to move in and out causing a small bulge. The hernia may be larger in size if the baby cries, coughs, or strains and may disappear completely if they are lying down.

 

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Is an operation required for an umbilical hernia?

Most children will not require an operation and often the hernia will resolve itself in the first couple of years of life. However, if the hernia is particularly large or if the hernia is still present when the child reaches age 3 or 4 they may require an operation to repair it.

What do I do if I notice an umbilical hernia?

If your child is under 3 and you notice an umbilical hernia, no action may be required. If they are feeding well, opening their bowels and have no pain over the lump, you can just monitor it at home.

If your child is over 3 and you notice an umbilical hernia, but they are well, feeding well, with no pain over the hernia, arrange an appointment to see your GP. They will refer you to see the Paediatric Surgical team in clinic.

When should I worry:

If there are any changes to the colour of the skin over the hernia, or it becomes painful, your child is vomiting and not feeding well, seek urgent medical attention in a child of any age. In this case the bowel may have been stuck in the hernia which may require an urgent operation. This is extremely rare. Take a look at the red, amber and green sections below.

What is an Inguinal Hernia?

An inguinal hernia is a small bulge in the groin area. They are very common in children, particularly in premature babies. In children this occurs when there is a small opening in the muscle wall in the groin which allows intestine (bowel) to bulge out causing a lump in the groin. The hernia may increase in size as your baby strains or cries. A hernia can occur on either side of the body or sometimes on both sides and your child will require an operation to fix it. In a girl sometimes the ovary can bulge out instead of the bowel.

 

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Why is an operation required?

Often the bowel can move in and out quite easily through this opening but sometimes the bowel can get stuck. If the bowel becomes trapped it may not receive an adequate blood supply and your child will become unwell. We therefore like to operate to prevent this complication from occurring.

What do I do if I notice an inguinal hernia?

If you notice a new lump in your child’s groin, you will need to seek medical assistance. If your child is happy, feeding well, pooing normally and the lump doesn’t appear to be painful you can make an appointment with your GP. They will refer you to see a paediatric surgeon.

However, if the lump is painful, discoloured, your child’s abdomen is big and swollen, they are vomiting or unwell, you should attend the Emergency Department urgently. For more information about things to look out for, take a look at the red, amber and green sections below.

Umbilical hernia

If your baby / child has a swelling at the belly button which can't be pushed back in and any of the following:

  • Swelling is sore
  • Swelling is red
  • A full / swollen tummy
  • Vomiting – particularly green
  • Unsettled / pain

Inguinal hernia

The lump in the groin is present all the time (won't go away with some gentle pressure) and your baby has any of the following:

  • The swelling is sore or red or both
  • A full / swollen tummy
  • Vomiting – particularly green
  • Your baby is unusually unsettled or seems to be in pain

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

Umbilical hernia

your child has a swelling at the belly button and any of the following:

  • Age 4 years or over
  • Mild discomfort over the lump

Inguinal hernia

Your baby has any of the following but the lump is not sore to touch and still comes and goes freely:

  • Lump getting bigger over time
  • Irritability
  • Feeding difficulties
  • Difficulty opening bowels
  • Sleep disturbance

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

Umbilical hernia

If your baby / child has a lump at the belly button that comes and goes but none of these features are present:

  • No pain or discomfort over the swelling.
  • No changes to the skin colour over the lump.
  • Feeding well, no vomiting and growing well

The swelling may change in size with coughing or crying

Inguinal hernia

You notice a new swelling or lump in the groin but:

  • It comes and goes (particularly noticeable if the baby is crying or straining but disappears when settled)
  • Baby is feeding well
  • Baby is settled
  • The lump is not sore to touch
  • The lump is not red

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance

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