Medical Conditions

My Baby Has an Omphalocele

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published CDC, NIH, Children's Hospital guidelines

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If your baby has been diagnosed with or you suspect has an omphalocele, here is what the evidence says.

The short answer

An omphalocele is a birth defect where abdominal organs (intestines, liver, or other organs) protrude into the base of the umbilical cord, covered by a thin membrane. It differs from gastroschisis in that the organs are covered by a protective sac and the defect is located at the umbilicus. Omphalocele is associated with chromosomal abnormalities and cardiac defects in up to 50% of cases, so thorough genetic testing and cardiac evaluation are recommended. Small omphaloceles are repaired surgically soon after birth, while giant omphaloceles may require staged repair.

Key takeaways

  • An omphalocele is a birth defect where abdominal organs (intestines, liver, or other organs) protrude into the base of the umbilical cord, covered by a thin membrane. It differs from gastroschisis in that the organs are covered by a protective sac and the defect is located at the umbilicus. Omphalocele is associated with chromosomal abnormalities and cardiac defects in up to 50% of cases, so thorough genetic testing and cardiac evaluation are recommended. Small omphaloceles are repaired surgically soon after birth, while giant omphaloceles may require staged repair.
  • Usually normal when: The omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon
  • Call your doctor if: Your baby has bilious (green) vomiting, which could indicate a bowel obstruction
  • Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

Parents everywhere have the same worry. You are doing the right thing by looking into it.

What Parents Should Know

According to CDC, NIH, Children's Hospital guidelines, an omphalocele is a birth defect where abdominal organs (intestines, liver, or other organs) protrude into the base of the umbilical cord, covered by a thin membrane. It differs from gastroschisis in that the organs are covered by a protective sac and the defect is located at the umbilicus. Omphalocele is associated with chromosomal abnormalities and cardiac defects in up to 50% of cases, so thorough genetic testing and cardiac evaluation are recommended. Small omphaloceles are repaired surgically soon after birth, while giant omphaloceles may require staged repair. At Prenatal, omphalocele is typically detected on prenatal ultrasound during the anatomy scan at 18-20 weeks. Because of the strong association with chromosomal abnormalities (such as trisomy 13, 18, or 21) and Beckwith-Wiedemann syndrome, amniocentesis or other genetic testing is usually recommended. A fetal echocardiogram is performed to evaluate for associated cardiac defects. Delivery is planned at a facility with NICU and pediatric surgery capabilities. Cesarean section may be recommended for giant omphaloceles to avoid rupturing the sac. It is generally considered normal when the omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon. However, you should contact your pediatrician promptly if your baby has bilious (green) vomiting, which could indicate a bowel obstruction.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
The omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon
Your baby has bilious (green) vomiting, which could indicate a bowel obstruction
Your baby has had successful surgical closure and is recovering in the NICU
Your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever
Genetic testing and cardiac evaluation have been completed and results have been discussed with your team
Your baby develops breathing difficulty, especially if associated heart defects are present
Your baby is feeding well and growing after discharge
The omphalocele membrane ruptures or appears to be breaking down, exposing organs

When to Seek Immediate Care

  • Your baby has bilious (green) vomiting, which could indicate a bowel obstruction
  • Your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever
  • Your baby develops breathing difficulty, especially if associated heart defects are present
  • The omphalocele membrane ruptures or appears to be breaking down, exposing organs
  • Your baby has a distended abdomen with vomiting and stops passing stool

By Age

What to expect by age

Prenatal

Omphalocele is typically detected on prenatal ultrasound during the anatomy scan at 18-20 weeks. Because of the strong association with chromosomal abnormalities (such as trisomy 13, 18, or 21) and Beckwith-Wiedemann syndrome, amniocentesis or other genetic testing is usually recommended. A fetal echocardiogram is performed to evaluate for associated cardiac defects. Delivery is planned at a facility with NICU and pediatric surgery capabilities. Cesarean section may be recommended for giant omphaloceles to avoid rupturing the sac.

0-1 week

After birth, the omphalocele sac is kept moist and protected. The baby is evaluated for associated anomalies, including heart defects, kidney problems, and genetic conditions. For small omphaloceles, primary surgical closure (pushing the organs back in and closing the abdominal wall) may be performed within the first days of life. For giant omphaloceles (containing liver), staged repair is often needed. One approach is "paint and wait" - applying topical agents to the sac to allow skin to grow over it gradually.

1-4 weeks

If primary closure was done, recovery follows a similar timeline to gastroschisis - the bowel gradually starts functioning and feeds are introduced slowly. For babies with the paint-and-wait approach, the sac is treated daily and monitored closely. Any associated conditions such as cardiac defects may require their own management or surgical intervention during this period. Your baby will remain in the NICU for close monitoring.

1-12 months

Babies with small omphaloceles and no major associated conditions often do well after repair. Those with giant omphaloceles or significant associated anomalies may need additional surgeries and longer hospital stays. A ventral hernia (weakness at the repair site) is possible and may need future repair. Your baby will be followed by pediatric surgery, cardiology (if heart defects are present), genetics, and pediatrics. Growth and feeding are monitored closely.

1 year+

Long-term outcomes depend largely on the size of the omphalocele and associated conditions. Isolated small omphaloceles have excellent outcomes. Children with associated chromosomal conditions will need ongoing developmental support. Those with Beckwith-Wiedemann syndrome require monitoring for overgrowth and tumor risk. Many children go on to lead healthy lives. Abdominal wall repair may continue to be refined as the child grows.

What to Tell Your Pediatrician

  • Describe when you first noticed has an omphalocele and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have questions about genetic testing results or what they mean for your baby.
  • Mention if your baby seems to have feeding difficulties or is not gaining weight well after discharge.
  • 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

Probably normal when...
  • The omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon
  • Your baby has had successful surgical closure and is recovering in the NICU
  • Genetic testing and cardiac evaluation have been completed and results have been discussed with your team
  • Your baby is feeding well and growing after discharge
Mention at your next visit when...
  • You have questions about genetic testing results or what they mean for your baby
  • Your baby seems to have feeding difficulties or is not gaining weight well after discharge
  • You notice a bulge at the surgical repair site, which may indicate a ventral hernia
  • You are concerned about your baby meeting developmental milestones
Act now when...
  • Your baby has bilious (green) vomiting, which could indicate a bowel obstruction
  • Your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever
  • Your baby develops breathing difficulty, especially if associated heart defects are present
  • The omphalocele membrane ruptures or appears to be breaking down, exposing organs
  • Your baby has a distended abdomen with vomiting and stops passing stool

What You Can Do at Home

  • Keep track of when you notice has an omphalocele — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that the omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon — this is generally within the range of normal.
  • At Prenatal, 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 your baby has bilious (green) vomiting, which could indicate a bowel obstruction.

My Baby Has Gastroschisis

Gastroschisis is a birth defect where the baby's intestines (and sometimes other organs) extend outside the body through a hole in the abdominal wall, usually to the right of the umbilical cord. Unlike omphalocele, there is no protective membrane covering the organs. It is typically detected on prenatal ultrasound around 18-20 weeks. Surgical repair is performed within hours of birth, and the majority of babies do very well after treatment.

20-Week Anatomy Scan Unexpected Findings

The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is has an omphalocele normal?
An omphalocele is a birth defect where abdominal organs (intestines, liver, or other organs) protrude into the base of the umbilical cord, covered by a thin membrane. It differs from gastroschisis in that the organs are covered by a protective sac and the defect is located at the umbilicus. Omphalocele is associated with chromosomal abnormalities and cardiac defects in up to 50% of cases, so thorough genetic testing and cardiac evaluation are recommended. Small omphaloceles are repaired surgically soon after birth, while giant omphaloceles may require staged repair.
When should I call the doctor about has an omphalocele?
Your baby has bilious (green) vomiting, which could indicate a bowel obstruction Your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever Your baby develops breathing difficulty, especially if associated heart defects are present
When is has an omphalocele normal?
The omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon Your baby has had successful surgical closure and is recovering in the NICU Genetic testing and cardiac evaluation have been completed and results have been discussed with your team
What causes has an omphalocele?
An omphalocele is a birth defect where abdominal organs (intestines, liver, or other organs) protrude into the base of the umbilical cord, covered by a thin membrane. It differs from gastroschisis in that the organs are covered by a protective sac and the defect is located at the umbilicus. Omphalocele is associated with chromosomal abnormalities and cardiac defects in up to 50% of cases, so thorough genetic testing and cardiac evaluation are recommended. Small omphaloceles are repaired surgically soon after birth, while giant omphaloceles may require staged repair. Common explanations include: The omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon. Your baby has had successful surgical closure and is recovering in the NICU.
What should I mention to my pediatrician about has an omphalocele?
You should mention has an omphalocele at your next visit if: You have questions about genetic testing results or what they mean for your baby. Your baby seems to have feeding difficulties or is not gaining weight well after discharge. You notice a bulge at the surgical repair site, which may indicate a ventral hernia.
Is has an omphalocele normal at Prenatal?
Omphalocele is typically detected on prenatal ultrasound during the anatomy scan at 18-20 weeks. Because of the strong association with chromosomal abnormalities (such as trisomy 13, 18, or 21) and Beckwith-Wiedemann syndrome, amniocentesis or other genetic testing is usually recommended. A fetal echocardiogram is performed to evaluate for associated cardiac defects. Delivery is planned at a facility with NICU and pediatric surgery capabilities. Cesarean section may be recommended for giant omphaloceles to avoid rupturing the sac.
Is has an omphalocele normal at 0-1 week?
After birth, the omphalocele sac is kept moist and protected. The baby is evaluated for associated anomalies, including heart defects, kidney problems, and genetic conditions. For small omphaloceles, primary surgical closure (pushing the organs back in and closing the abdominal wall) may be performed within the first days of life. For giant omphaloceles (containing liver), staged repair is often needed. One approach is "paint and wait" - applying topical agents to the sac to allow skin to grow over it gradually.
Should I go to the ER for has an omphalocele?
Seek emergency care if your baby has bilious (green) vomiting, which could indicate a bowel obstruction, or if your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever. When in doubt, call your pediatrician's after-hours line for guidance.
Does has an omphalocele go away on its own?
In many cases, has an omphalocele resolves on its own, especially when the omphalocele was diagnosed prenatally and you are being monitored by a maternal-fetal medicine specialist and pediatric surgeon. By 1 year+, long-term outcomes depend largely on the size of the omphalocele and associated conditions. Isolated small omphaloceles have excellent outcomes. Children with associated chromosomal conditions will need ongoing developmental support. Those with Beckwith-Wiedemann syndrome require monitoring for overgrowth and tumor risk. Many children go on to lead healthy lives. Abdominal wall repair may continue to be refined as the child grows.
CDCNIHCHILDREN'S HOSPITAL

References

  1. [1]Centers for Disease Control and Prevention. Facts about Omphalocele. Birth Defects, 2024. CDC
  2. [2]National Institutes of Health. Omphalocele. Genetic and Rare Diseases Information Center (GARD), 2024. NIH
  3. [3]Cincinnati Children's Hospital. Omphalocele: Diagnosis and Treatment. Children's Hospital

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss My Baby Has an Omphalocele.

Things to mention

  • Describe when you first noticed has an omphalocele and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you have questions about genetic testing results or what they mean for your baby.
  • Mention if your baby seems to have feeding difficulties or is not gaining weight well after discharge.
  • 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 have questions about genetic testing results or what they mean for your baby
  • Your baby seems to have feeding difficulties or is not gaining weight well after discharge
  • You notice a bulge at the surgical repair site, which may indicate a ventral hernia

Urgent signs to report immediately

  • Your baby has bilious (green) vomiting, which could indicate a bowel obstruction
  • Your baby has signs of infection at the surgical site or the omphalocele sac: redness, warmth, drainage, or fever
  • Your baby develops breathing difficulty, especially if associated heart defects are present

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

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Bottom line

Most cases of has an omphalocele are normal. Talk to your pediatrician if your baby has bilious (green) vomiting, which could indicate a bowel obstruction.

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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Gastroschisis is a birth defect where the baby's intestines (and sometimes other organs) extend outside the body through a hole in the abdominal wall, usually to the right of the umbilical cord. Unlike omphalocele, there is no protective membrane covering the organs. It is typically detected on prenatal ultrasound around 18-20 weeks. Surgical repair is performed within hours of birth, and the majority of babies do very well after treatment.

20-Week Anatomy Scan Unexpected Findings

The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.

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