Inguinal Hernia in Newborns (Groin Hernia)
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, NIH guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect inguinal hernia in newborns (groin hernia), here is what the evidence says.
The short answer
An inguinal hernia appears as a bulge in the groin or scrotum (in boys) that comes and goes, becoming more prominent when the baby cries or strains. Unlike umbilical hernias, inguinal hernias do not resolve on their own and require surgical repair to prevent complications. The surgery is safe and highly successful.
Key takeaways
- An inguinal hernia appears as a bulge in the groin or scrotum (in boys) that comes and goes, becoming more prominent when the baby cries or strains. Unlike umbilical hernias, inguinal hernias do not resolve on their own and require surgical repair to prevent complications. The surgery is safe and highly successful.
- Usually normal when: There is no "normal" inguinal hernia. All inguinal hernias in babies need medical evaluation and surgical repair.
- Call your doctor if: A groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, NIH guidelines, an inguinal hernia appears as a bulge in the groin or scrotum (in boys) that comes and goes, becoming more prominent when the baby cries or strains. Unlike umbilical hernias, inguinal hernias do not resolve on their own and require surgical repair to prevent complications. The surgery is safe and highly successful. At 0-1 month, inguinal hernias occur when a loop of intestine slips through an opening in the abdominal wall into the groin area (or scrotum in boys). They are more common in premature babies and in boys. You may notice a bulge in one or both sides of the groin that appears when your baby cries, strains, or is active, and disappears when calm. Unlike umbilical hernias, inguinal hernias always require surgical repair because of the risk of incarceration (trapped intestine). Surgery is typically scheduled soon after diagnosis. It is generally considered normal when there is no "normal" inguinal hernia. All inguinal hernias in babies need medical evaluation and surgical repair. However, you should contact your pediatrician promptly if a groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery.
Normal vs. Concerning
By Age
What to expect by age
0-1 month
Inguinal hernias occur when a loop of intestine slips through an opening in the abdominal wall into the groin area (or scrotum in boys). They are more common in premature babies and in boys. You may notice a bulge in one or both sides of the groin that appears when your baby cries, strains, or is active, and disappears when calm. Unlike umbilical hernias, inguinal hernias always require surgical repair because of the risk of incarceration (trapped intestine). Surgery is typically scheduled soon after diagnosis.
1-3 months
If an inguinal hernia is diagnosed, surgery is usually performed promptly, especially in young infants where the risk of incarceration is higher. The surgery (herniorrhaphy) is a straightforward outpatient procedure with an excellent success rate. Recovery is typically quick, with most babies returning to normal activities within a few days.
3-6 months
Inguinal hernias can present at any age. If you notice a new bulge in the groin area, contact your pediatrician promptly. After surgical repair, recurrence is uncommon. Your doctor may also check the other side, as bilateral hernias can occur.
6-12 months
Inguinal hernias can still first appear at this age. Any new groin bulge that comes and goes should be evaluated. After surgical repair, follow-up care is minimal and the prognosis is excellent.
What to Tell Your Pediatrician
- Describe when you first noticed inguinal hernia in newborns (groin hernia) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice a bulge in the groin area or scrotum that comes and goes.
- Mention if one side of the groin or scrotum appears larger than the other.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- There is no "normal" inguinal hernia. All inguinal hernias in babies need medical evaluation and surgical repair.
- You notice a bulge in the groin area or scrotum that comes and goes
- One side of the groin or scrotum appears larger than the other
- A groin bulge appears during crying or straining and goes away at rest
- A groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery
- Your baby is vomiting, extremely irritable, or refusing to eat along with a firm groin bulge
What You Can Do at Home
- Keep track of when you notice inguinal hernia in newborns (groin hernia) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that there is no "normal" inguinal hernia. All inguinal hernias in babies need medical evaluation and surgical repair — this is generally within the range of normal.
- At 0-1 month, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if a groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery.
Related Conditions
Umbilical Hernia (Belly Button Sticking Out)
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.
My Baby's Belly Button Bulges When Crying
This is almost always an umbilical hernia, which is very common (occurring in about 1 in 5 babies) and usually harmless. It happens when a small opening in the abdominal muscles near the belly button doesn't close completely after birth. The bulge you see is intestine pushing through when baby cries, strains, or coughs. Most umbilical hernias close on their own by age 2-5 without any treatment.
My Baby Has a Swollen Scrotum
A hydrocele is a collection of fluid around the testicle that causes the scrotum to swell. It's common in newborn boys and usually harmless. Most hydroceles disappear on their own by age 1. Your pediatrician will examine your baby to distinguish it from an inguinal hernia, which requires surgery. If the hydrocele persists or is very large, surgery may be recommended.
Related Resources
Frequently asked questions
Is inguinal hernia in newborns (groin hernia) normal?
When should I call the doctor about inguinal hernia in newborns (groin hernia)?
When is inguinal hernia in newborns (groin hernia) normal?
What causes inguinal hernia in newborns (groin hernia)?
What should I mention to my pediatrician about inguinal hernia in newborns (groin hernia)?
Is inguinal hernia in newborns (groin hernia) normal at 0-1 month?
Is inguinal hernia in newborns (groin hernia) normal at 1-3 months?
Should I go to the ER for inguinal hernia in newborns (groin hernia)?
Does inguinal hernia in newborns (groin hernia) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Inguinal Hernia in Newborns (Groin Hernia).
Things to mention
- Describe when you first noticed inguinal hernia in newborns (groin hernia) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if you notice a bulge in the groin area or scrotum that comes and goes.
- Mention if one side of the groin or scrotum appears larger than the other.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- You notice a bulge in the groin area or scrotum that comes and goes
- One side of the groin or scrotum appears larger than the other
- A groin bulge appears during crying or straining and goes away at rest
Urgent signs to report immediately
- A groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery
- Your baby is vomiting, extremely irritable, or refusing to eat along with a firm groin bulge
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of inguinal hernia in newborns (groin hernia) are normal. Talk to your pediatrician if a groin hernia becomes hard, swollen, red, or tender and cannot be gently pushed back in, which could indicate incarcerated hernia requiring emergency surgery.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Medical Concerns
Umbilical Hernia (Belly Button Sticking Out)
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.
My Baby's Belly Button Bulges When Crying
This is almost always an umbilical hernia, which is very common (occurring in about 1 in 5 babies) and usually harmless. It happens when a small opening in the abdominal muscles near the belly button doesn't close completely after birth. The bulge you see is intestine pushing through when baby cries, strains, or coughs. Most umbilical hernias close on their own by age 2-5 without any treatment.
My Baby Has a Swollen Scrotum
A hydrocele is a collection of fluid around the testicle that causes the scrotum to swell. It's common in newborn boys and usually harmless. Most hydroceles disappear on their own by age 1. Your pediatrician will examine your baby to distinguish it from an inguinal hernia, which requires surgery. If the hydrocele persists or is very large, surgery may be recommended.
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.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.