As parents, you instinctively notice even the smallest changes in your child—whether it’s an unusual cry, a swelling, or a lump that wasn’t there before. One condition that often creates worry, yet may be overlooked in the early stages, is a hernia. While hernias in children are common and usually treatable, timely identification plays a crucial role in preventing complications and easing parental anxiety.
A hernia occurs when an organ or tissue pushes through a weak area in the muscle wall, forming a visible bulge under the skin. In children and babies, hernias most commonly appear in the groin (inguinal hernia) or around the belly button (umbilical hernia).
According to Dr Amita Jain, who is a leading general and laparoscopic surgeon in Delhi, understanding the signs and behaviour of these hernias allows parents to seek medical care at the right time.
What Is a Hernia in Children?
In paediatric patients, hernias are usually present from birth and develop due to incomplete closure of natural openings in the abdominal wall. While many hernias remain harmless for a period of time, some can become trapped or strangulated, making early diagnosis extremely important, says Dr Amita Jain, who is an experienced hernia specialist and surgeon in Delhi.
Inguinal Hernia in Babies and Children
An inguinal hernia occurs when part of the intestine or abdominal tissue protrudes through a weak spot in the lower abdominal wall into the groin. It is one of the most common hernias seen in infants and children, especially in boys and premature babies. The hernia may appear on one side—most often the right—or on both sides in some cases.
Why Does It Happen?
Before birth, a passage known as the inguinal canal allows structures to move from the abdomen to the genital area. Normally, this canal closes before birth. If it remains partially open, abdominal contents can slip through, leading to an inguinal hernia. Almost all inguinal hernias in children are congenital and classified as indirect inguinal hernias. Direct inguinal hernias are extremely rare in children.
How to Identify an Inguinal Hernia
The most noticeable sign is a soft bulge in the groin area. In boys, this swelling may extend into the scrotum, while in girls it may be seen in the labial area. The bulge often becomes more prominent when the child cries, coughs, or strains and may disappear when the child is relaxed or asleep.
Some children may also experience mild discomfort, a feeling of pressure in the groin, swelling of the scrotum, or irritability—especially in infants who cannot express pain verbally.
When Is It an Emergency?
An inguinal hernia can become incarcerated or strangulated, meaning the intestine gets trapped and its blood supply is compromised. This is a medical emergency. Parents should seek immediate medical care if the child develops severe pain, redness or discolouration over the bulge, vomiting, fever, refusal to feed, or blood in the stool.
Umbilical Hernia in Babies and Children
An umbilical hernia appears as a bulge at or near the belly button. It occurs when the opening in the abdominal wall, through which the umbilical cord passed during pregnancy, does not close completely after birth. Umbilical hernias are more commonly seen in premature babies and infants with low birth weight.
Is It Dangerous?
In most cases, umbilical hernias are harmless and painless. They often become more noticeable when the baby cries, strains, or sits up and tend to flatten or disappear when the child is calm or lying down. Many umbilical hernias close on their own by the age of two to five years without any treatment.
Signs That Need Medical Attention
Although rare, an umbilical hernia can become incarcerated. If the bulge becomes hard, painful, red, or fixed in place, or if the child develops vomiting, fever, or abdominal swelling, immediate medical evaluation is essential.
What Is an Incarcerated or Strangulated Hernia?
An incarcerated hernia occurs when a portion of the intestine becomes trapped and cannot be pushed back into the abdomen. If this condition persists, it can progress to strangulation, where blood flow to the trapped tissue is cut off. This can cause serious damage to the intestine and nearby organs and is life-threatening. Sudden severe pain, persistent swelling, vomiting, fever, and skin changes over the hernia site are warning signs that require emergency surgery.
Other Less Common Hernias in Children
Apart from inguinal and umbilical hernias, a few less common types may be seen in children. These include hiatal hernias, where part of the stomach moves into the chest; incisional hernias, which develop at the site of a previous surgical incision; and epigastric hernias, which appear as small bulges between the belly button and the breastbone. Epigastric hernias do not resolve on their own and usually require surgical correction.
Treatment Options for Paediatric Hernias
Treatment depends on the type and severity of the hernia. Inguinal hernias almost always require surgical repair, as they do not close on their own and carry a higher risk of complications. Umbilical hernias are often monitored and may only need surgery if they persist beyond four to five years of age, cause discomfort, or show signs of incarceration.
Dr Amita Jain emphasises that laparoscopic surgery is a highly effective option for paediatric hernia repair. It offers smaller incisions, minimal scarring, faster recovery, and less postoperative discomfort, making it especially suitable for children.
Hernias in babies and children should never be ignored, even if they appear painless at first. Recognising early signs—such as a bulge in the groin or near the belly button—helps parents take timely action and avoid serious complications. With proper medical evaluation and treatment, most children recover completely and return to normal, healthy activity. Early care ensures not only physical safety for the child but also reassurance and peace of mind for parents.
Dr Amita Jain is one of India’s most distinguished and experienced female surgeons, known for her unmatched expertise in general and laparoscopic surgery. With over 29 years of surgical excellence, Dr Amita Jain has built a reputation for precision, compassionate care, and advanced surgical techniques.
Dr Amita Jain has successfully performed a wide range of complex general surgeries, including both open and minimally invasive procedures, with a strong focus on trauma care, onco-surgical techniques, and reconstructive surgeries. Her areas of specialisation include (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor of Surgery at the Army College of Medical Sciences and Base Hospital, Delhi Cantt. In 1994, she was commissioned asa Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior General and Laparoscopic Surgeon at Rainbow Children Hospitals (Malviya Nagar, Delhi), Artemis Lite: Multi-Speciality Care Hospital (New Friends Colony, New Delhi) and at Rosewalk – Luxury Maternity Hospital in Delhi (Panchsheel Park, Delhi)
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