Hernia in children Dr Trisha Macnair At least one in 50 boys develops an inguinal hernia, while umbilical hernias are even more common in babies of both sexes.

In this article

What is a hernia? Symptoms

Causes and risk factors Treatment and recovery

A hernia simply means a protrusion of body tissues through a weakness or hole in other body tissues. It most often refers to a part of the intestines protruding through the muscular wall of the abdomen (although other types of hernia are sometimes seen elsewhere in the body). The most common are inguinal hernias and, especially in small children, umbilical hernias.

A hernia usually causes a visible lump or swelling, which appears intermittently as the herniating tissue slips back into place and then protrudes again (umbilical hernias are more constant).

Crying, straining, coughing or anything else that increases pressure within the abdomen can make the hernia more obvious, as this forces out the contents.

Hernias are usually painless. However, if the contents become trapped, the blood supply to the tissues may become restricted causing pain. This pain may be intermittent, but if the hernia is stuck permanently - known as an irreducible, strangulated or incarcerated hernia - the pain becomes constant and there's a risk of damage to the trapped intestines or surrounding tissues. In this case the child may vomit and appear unwell.

An inguinal hernia results when a structure called the inguinal canal doesn't close properly after birth. This is the tube through which the testes descend from inside the abdomen into the groin during development in the womb. If the inguinal canal remains open, other abdominal contents can also pass down it.

At least one in 50 boys develops an inguinal hernia. It's much less common in girls, because of how it forms.

Inherited factors may be important, especially in umbilical hernias (where the weakness in the abdominal wall is around the umbilicus, and present from birth), and other family members are often affected.

If you think your child may have a hernia, get a medical opinion, especially if the swelling is tense or painful. The doctor may ask the child to do something such as cough to make the hernia more obvious, and can usually make a diagnosis simply by examination.

Umbilical hernias may need no treatment and often improve with time as the muscles of the abdomen develop. If they persist after the age of five, you may want to review the problem.

Surgery is almost always required for an inguinal hernia, to close the defect. This must be done urgently with a strangulated hernia.

This article was last medically reviewed by Dr Trisha Macnair in February 2009.