Umbilical Hernia (Belly Button Sticking Out)
The short answer
An umbilical hernia is a soft bulge near the belly button caused by a small gap in the abdominal muscles where the umbilical cord was attached. They are very common, occurring in about 20% of babies, and the vast majority close on their own by age 4-5 without any treatment. They are almost never dangerous in children.
By Age
What to expect by age
Umbilical hernias are often first noticed in the early weeks as the umbilical stump heals. The bulge typically becomes more prominent when your baby cries, strains, or coughs, and may flatten when they are calm or lying down. This is completely normal. The hernia does not cause your baby pain, even when it is bulging. Do not tape a coin over it or try to push it in, as these folk remedies do not help and can cause skin irritation.
The hernia may appear unchanged or may be slowly getting smaller. The size of the hernia can vary, from less than 1 cm to several centimeters. Larger hernias may take longer to close but still usually resolve. Your pediatrician will check the hernia at routine well-child visits to monitor its progress.
Most umbilical hernias close by age 1-2, and nearly all close by age 4-5. As your child becomes more active, the hernia may still be visible during periods of straining or abdominal pressure. Continued monitoring is the standard approach; surgery is generally not considered until after age 4-5 unless the hernia is very large or causing problems.
If the hernia has not closed by age 4-5, or if it is larger than about 1.5-2 cm, your doctor may recommend surgical repair. The surgery is a straightforward outpatient procedure with an excellent success rate. Hernias that persist past age 5 are unlikely to close on their own.
What Should You Do?
When to take action
- A soft bulge at the belly button that becomes more prominent with crying, coughing, or straining and reduces when your baby is relaxed
- The hernia is soft and can be gently pushed back in (reducible)
- Your baby does not appear to be in pain when the hernia bulges
- The hernia is gradually getting smaller over months to years
- The skin over the hernia looks normal in color, without redness or discoloration
- The hernia seems to be getting larger rather than smaller over time
- Your child is approaching age 4-5 and the hernia has not closed
- You have questions about whether or when surgical repair might be needed
- The hernia becomes hard, swollen, discolored, or very tender and cannot be gently pushed back in, as this may indicate an incarcerated or strangulated hernia requiring emergency surgery (this is very rare in children)
- Your baby is vomiting and the hernia area appears firm and painful, which could indicate trapped intestine
Sources
Related Resources
Related Medical Concerns
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
I'm Worried About Lazy Eye (Amblyopia)
Amblyopia (lazy eye) is the most common cause of vision loss in children, affecting about 2-3% of kids. It occurs when one eye develops weaker vision because the brain favors the other eye. The tricky part is that amblyopia often has no obvious outward signs - the eye usually looks normal. Early detection through routine vision screening is critical because treatment is most effective in the first few years of life.
Anaphylaxis Signs in Baby
Anaphylaxis is a severe, potentially life-threatening allergic reaction that affects multiple body systems. In babies, it can be caused by food (most commonly), insect stings, or medications. Signs include widespread hives, facial or throat swelling, difficulty breathing, persistent vomiting, and becoming limp or unresponsive. Anaphylaxis is a medical emergency. If you suspect anaphylaxis, use an epinephrine auto-injector if available and call 911 immediately. Early recognition and rapid treatment lead to excellent outcomes in the vast majority of cases.
My Baby Has Unequal Pupils
Slight differences in pupil size (anisocoria) can be normal and affect up to 20% of people, including babies. However, if the difference is large, came on suddenly, or is accompanied by other symptoms like drooping eyelid, vision changes, or neurological symptoms, it needs immediate medical evaluation to rule out serious causes.
My Baby Stops Breathing Briefly (Apnea)
Brief pauses in breathing lasting under 10 seconds are very common in newborns and are called periodic breathing. This is a normal pattern where the baby breathes rapidly, then pauses briefly, then resumes. However, true apnea (pauses lasting 20 seconds or longer, or shorter pauses accompanied by color changes or heart rate drops) is a medical concern that should be evaluated promptly.
Baby Allergic Reaction to Food
Food allergic reactions in babies range from mild (hives, rash around the mouth, minor vomiting) to severe (difficulty breathing, widespread swelling, multiple body systems affected). Most reactions are mild and appear within minutes to 2 hours after eating the food. The most common food allergens in babies are milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. Current AAP guidelines recommend introducing allergenic foods around 6 months, as early introduction can actually help prevent allergies in many cases.