My baby has a hernia

Hernias are caused by an opening in the muscle of the abdominal (tummy) wall which allows the intestines (bowel) to move in and out.

They can happen around the belly button (umbilical hernia) or in the groin area (inguinal hernia).

They are common in babies, especially premature babies.

Umbilical hernias rarely require treatment but inguinal hernias need an operation to fix them.

When should you worry?

If your baby has any of the following:
  • Lump (hernia) is painful
  • Lump (hernia) is red 
  • A swollen tummy
  • Green vomit (like the colour of spinach or green washing up liquid)
  • Pale, mottled or abnormally cold to touch
  • Extremely agitated (crying inconsolably despite distraction)
  • Floppy or very lethargic (difficult to wake)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your baby has any of the following:
  • Umbilical (belly button) hernia and age 4 years or over
  • Any swelling in the groin area
  • Mild discomfort over the lump
  • Irritability
  • Feeding problems
  • Difficulty pooing

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111

We recognise that during COVID, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest A&E

If your baby has an umbilical hernia with none of the features above in red or amber

  • Continues to feed well
  • Has plenty of wet and dirty nappies
  • Baby wakes up or cries regularly for feeds
  • Additional advice is also available to young families for coping with crying of well babies.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111

What is an umbilical hernia?

 

umbilical hernia.jpgAn umbilical hernia is a bulge at your child’s belly button. This happens when the opening for the umbilical cord doesn’t completely close after birth. This hole allows bowel to move in and out causing a small bulge. The hernia usually appears when your baby is 2 to 3 months old. It may look larger if your baby cries, coughs, or strains and may look smaller if they are lying down.

Is an operation needed for an umbilical hernia?

Most children will not need an operation. Often the hernia will get better by itself in the first couple of years of life. If the hernia is very large or if the hernia is still there when your child reaches age 4 they may need an operation to repair it. 

 
What do I do if I notice an umbilical hernia?

No action is needed if your child is under 4 and otherwise well. If your child is eating and drinking well, going to the toilet normally and has no pain you don't need to worry.

If your child is over 4, you can speak to your GP. They may refer you to the Paediatric Surgeons who will assess if an operation is needed. 

Surgery to repair an umbilical hernia is cosmetic and is done to change the size of a 'sticky out' belly button.

 
When should I worry?

Seek urgent medical help in a child of any age if their hernia becomes painful.

The bowel may have got stuck in the hernia which may need an urgent operation. This is extremely rare in children.

What is an inguinal hernia?

An inguinal hernia is a bulge in the groin area. inguinal_hernia.jpgThey are common in children, particularly in premature babies. They happen when there is a small opening in the muscle wall in the groin which allows bowel to bulge out causing a lump in the groin. In a girl sometimes the ovary can bulge out instead of the bowel. The bulge may look larger when your baby strains or cries. A hernia can happen on either side of the groin or sometimes on both sides. Your child will need an operation to fix an inguinal hernia.

Why is an operation needed?

An operation is needed to repair inguinal hernias soon after they are seen. Usually the bowel can move in and out easily through the opening but sometimes the bowel can get stuck. If the bowel gets stuck it may not get enough blood to keep it healthy and your child will become very unwell. 

What do I do if I notice an inguinal hernia?

If you notice a new lump in your child’s groin you need to seek medical advice. If your child is happy, feeding well, pooing normally and the lump doesn’t appear to be painful you can speak to your GP. They will refer you to see a Paediatric Surgeon for an operation to fix the hernia.

Children under 6 months old should be referred urgently and have their inguinal hernia fixed soon after it appears. It is safe for older children to wait longer before the hernia is fixed but they should still be referred to a Paediatric Surgeon when a hernia is seen.

If any of the following are present you should seek help urgently. An urgent operation may be needed.

  • The lump is painful
  • The hernia is out and your child is crying and does not settle when fed, cuddled or changed
  • Your child is vomiting and not pooing
  • Your child is unwell

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice about a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents/carers and young people more information about other organisations that might be able to also help them with healthy eating.

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses01274 221203

Wakefield School Nurses (0 to 19 service)0300 373 0944 (local rate number)

Leeds School Nurses - 0113 843 5683

Calderdale School Nurses030 3330 9974 (local rate number)

Kirklees School Nurses0300 304 5555 (local rate number)

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Please note, the online version of NHS 111 is only recommended for children over the age of five. If your child is under five years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance