Q: Hello Doctor, thanks for being a source of medical education to most of us. Please, I would like to know if it is normal for a baby’s navel to get bigger. My boy is 7 weeks old and his Navel is getting bigger than it was after the normal birth treatment. My daughter presses it in my absence. Could it be the reason for it to get bigger almost by day? Again he stretches a lot…could that also be the reason? I’m just curious ma’am. Thanks for being there to lean on.

A: It does sound like your baby has an umbilical hernia. Don’t go shouting and screaming just yet! It’s probably not as horrible as it sounds. It looks all dramatic any time the baby cries and does appear to ‘swell up’ causing parents to panic. But, it usually closes up on its own by the time the baby turns 1 year though some may last slightly longer. If this persists up till the age of 3 years, please see your baby’s doctor.

Now, what’s a hernia? This is the protrusion of an organ or its covering through the wall of the cavity that usually contains it. There are different types of hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhoea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means 😀 The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen 😀

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which need to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counselling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long standing coughs, eating healthy to prevent straining at stool etc.

So, peeps, you can’t dodge this stuff. It’s healthy living and eating all the way 😀 Have a great evening.