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Identifying and Caring for Hernias in Children

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Most people associate hernias with lifting heavy items. But babies, toddlers, young children and teens can develop hernias too. Most of the time, hernias in little ones are present at birth, but may not be noticed until later in life.

Our experts are here to walk you through the basics, including types of hernias, how to identify a hernia in children and how to best care for them.

Types of Hernias

Inguinal hernias: About 80% of hernias in children are inguinal hernias. They’re located in the lower part of the abdomen, near the groin. In boys, the protruding piece of intestine may enter the scrotum, which can cause swelling and pain. In girls, the swelling is usually in the labia or the groin. The most common areas for hernias to appear are in the abdomen, groin and belly button.

There are two types of inguinal hernias:

  1. Direct inguinal hernia: This occurs when a weak spot develops in the lower abdominal muscles and tissues can push through the weak spot.
  2. Indirect inguinal hernia: This occurs when the inguinal canal (a small passage through the lower abdominal wall) fails to close before birth. These hernias are more common in children who were born prematurely.

Umbilical hernias: Umbilical hernias are common in newborns and babies younger than 6 months old. They happen when the opening in the abdominal wall, where the umbilical cord exits the abdominal wall, doesn’t close. Your baby's belly button may look enlarged and swollen. Umbilical hernias usually heal on their own by the time your baby is one year old.

Epigastric hernias: These hernias occur mostly in boys; there is a protrusion through the abdominal muscles between the chest and the belly button, causing a lump in that area. Surgery is required to fix this type of hernia.

Hiatal hernias: A hiatal hernia happens when the upper part of the stomach bulges through a weak opening in the diaphragm where the esophagus meets the stomach. While these hernias are common, they’re often small and don't cause issues. However, your child may have heartburn, chest pain and indigestion. Diet modifications and medications can bring relief, but sometimes these hernias require surgery.

Incisional hernias: The incisional hernia occurs after abdominal surgery. The intestines may protrude through the abdomen around a surgical incision. Your child will need another surgery to fix this hernia.

Sports hernias: Teens can develop sports hernias, an injury of the inguinal area caused by repetitive twisting and turning. This type of hernia occurs mainly in young people who play ice hockey, soccer and tennis. They can be difficult to diagnose because they may not exhibit the classic signs of a hernia. The main symptom is groin pain that may radiate into the scrotum. The pain can last for months, but the telltale bulge of tissue never appears.

Hernia Symptoms in Children and Babies

Children can be too young to describe their hernia symptoms, so it’s important for parents to be vigilant and know how to identify the signs of a hernia.

Symptoms of a hernia in a child or baby may include:

  • A lump or swelling near the groin or belly button
  • Pain or tenderness around the groin or lower belly
  • Unexplained crying or fussiness
  • A visible bulge that gets bigger during straining, crying or coughing

In most cases, hernias are not cause for alarm. However, they can lead to serious health complications. That’s why it’s important to talk to your child’s pediatrician right away if they have symptoms of a hernia.

Surgery might be necessary for umbilical hernias that fail to close by school age, and it’s always needed for inguinal hernias because they won’t close on their own.

Hernia Treatment for Children and Babies

Because inguinal hernias and some umbilical hernias need surgery, it’s important to know what the process would be like. During the procedure, the surgeon pushes the protruding tissue back into place and closes the opening with stitches. There are two surgical techniques for hernia repair in children:

  • Open surgery: Traditional surgery is used for umbilical hernias and requires a small incision under or through the belly button; for inguinal hernias, a small incision is made in the groin, typically along a natural skin crease
  • Laparoscopic surgery: This is minimally invasive surgery that uses several tiny incisions in the abdomen and groin

Risk Factors for Hernias in Little Ones

Factors that can increase a child’s risk of developing a hernia include:

  • Birth weight: Hernias are more common in premature, underweight babies
  • Gender: Inguinal hernias are more common in boys
  • Genetics: Hernias are more common if there is a family history
  • Medical conditions: Undescended testicles, cystic fibrosis, a need for peritoneal dialysis or shunt and other genetic syndromes, such Beckwith-Weidemann syndrome and trisomy 13, 18 or 21, increase the risk of a hernia
  • Race: Umbilical hernias are more common in children of African descent

Expert Hernia Repair by Those Who Care

If you’re concerned your little one may have a hernia, reach out to their pediatrician to talk about the benefits and risks of hernia surgery. Visit us here to learn more or request an appointment.

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