Large Umbilical Hernia in Newborns
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 large umbilical hernia in newborns, here is what the evidence says.
The short answer
A large umbilical hernia in a newborn, while dramatic-looking, is still usually harmless. Even large hernias (over 2 cm) typically close on their own by age 4-5, though larger ones may take longer. Surgery is generally only considered if the hernia persists past age 4-5 or causes complications, which is rare in children.
Key takeaways
- A large umbilical hernia in a newborn, while dramatic-looking, is still usually harmless. Even large hernias (over 2 cm) typically close on their own by age 4-5, though larger ones may take longer. Surgery is generally only considered if the hernia persists past age 4-5 or causes complications, which is rare in children.
- Usually normal when: A soft bulge at the belly button that gets larger with crying or straining and reduces when baby relaxes
- Call your doctor if: The hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation)
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP, NIH guidelines, a large umbilical hernia in a newborn, while dramatic-looking, is still usually harmless. Even large hernias (over 2 cm) typically close on their own by age 4-5, though larger ones may take longer. Surgery is generally only considered if the hernia persists past age 4-5 or causes complications, which is rare in children. At 0-1 month, large umbilical hernias can appear quite alarming, with the belly button protruding significantly, especially when your baby cries or strains. The hernia is a soft bulge caused by intestine or fatty tissue pushing through a gap in the abdominal wall muscles near the belly button. Even large hernias are soft, painless, and can usually be gently pushed back in (reducible). Do not put tape, coins, or belly bands over the hernia, as these do not help and can irritate the skin. It is generally considered normal when a soft bulge at the belly button that gets larger with crying or straining and reduces when baby relaxes. However, you should contact your pediatrician promptly if the hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation).
Normal vs. Concerning
By Age
What to expect by age
0-1 month
Large umbilical hernias can appear quite alarming, with the belly button protruding significantly, especially when your baby cries or strains. The hernia is a soft bulge caused by intestine or fatty tissue pushing through a gap in the abdominal wall muscles near the belly button. Even large hernias are soft, painless, and can usually be gently pushed back in (reducible). Do not put tape, coins, or belly bands over the hernia, as these do not help and can irritate the skin.
1-3 months
Your pediatrician will measure and monitor the hernia at well-child visits. Larger hernias (greater than 1.5-2 cm at the fascial defect) may take longer to close spontaneously but still have a high likelihood of resolution. The hernia may appear to grow as your baby gains weight, but what matters is the size of the abdominal wall opening, not the external bulge.
3-6 months
Continue monitoring. Many large umbilical hernias begin to decrease in size during the first year. The abdominal wall muscles strengthen as your baby becomes more active. Your pediatrician may discuss a timeline for resolution and potential surgical referral if the hernia remains very large.
6-12 months
Large hernias may still be present but should be slowly decreasing. Surgical referral is typically not considered until age 4-5 unless the hernia is very large (over 2 cm fascial defect), is enlarging, or shows signs of complications. Complications such as incarceration (trapped intestine) are very rare in children with umbilical hernias.
What to Tell Your Pediatrician
- Describe when you first noticed large umbilical hernia in newborns and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if the hernia seems to be getting significantly larger over time.
- Mention if you have questions about whether surgery may be needed.
- 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
- A soft bulge at the belly button that gets larger with crying or straining and reduces when baby relaxes
- The hernia is soft, painless, and can be gently pushed back in
- Baby is feeding well and having normal bowel movements
- The skin over the hernia appears normal without redness or discoloration
- The hernia seems to be getting significantly larger over time
- You have questions about whether surgery may be needed
- The hernia is difficult to push back in but baby is comfortable
- The hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation)
- Baby is vomiting, extremely fussy, or refusing to eat with a firm, tender hernia
What You Can Do at Home
- Keep track of when you notice large umbilical hernia in newborns — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that a soft bulge at the belly button that gets larger with crying or straining and reduces when baby relaxes — 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 the hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation).
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.
Inguinal Hernia in Newborns (Groin Hernia)
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.
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.
Related Resources
Frequently asked questions
Is large umbilical hernia in newborns normal?
When should I call the doctor about large umbilical hernia in newborns?
When is large umbilical hernia in newborns normal?
What causes large umbilical hernia in newborns?
What should I mention to my pediatrician about large umbilical hernia in newborns?
Is large umbilical hernia in newborns normal at 0-1 month?
Is large umbilical hernia in newborns normal at 1-3 months?
Should I go to the ER for large umbilical hernia in newborns?
Does large umbilical hernia in newborns go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Large Umbilical Hernia in Newborns.
Things to mention
- Describe when you first noticed large umbilical hernia in newborns and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if the hernia seems to be getting significantly larger over time.
- Mention if you have questions about whether surgery may be needed.
- 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
- The hernia seems to be getting significantly larger over time
- You have questions about whether surgery may be needed
- The hernia is difficult to push back in but baby is comfortable
Urgent signs to report immediately
- The hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation)
- Baby is vomiting, extremely fussy, or refusing to eat with a firm, tender hernia
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 large umbilical hernia in newborns are normal. Talk to your pediatrician if the hernia becomes hard, swollen, discolored, or very tender and cannot be pushed back in (incarcerated hernia requiring emergency evaluation).
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.
Inguinal Hernia in Newborns (Groin Hernia)
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.
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'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.