Tummy Time with an Umbilical Hernia (and 6 more Umbilical Hernia FAQ)

Maybe you’ve been told your baby has an umbilical hernia. You’re not alone. Umbilical hernias in babies are pretty common. They appear like skin-colored lumps that bulge out at the belly button. Families have many questions, of course. One that comes up a lot involves “tummy time.” Parents often ask if tummy time is okay if their infant has an umbilical hernia. I’ll cover that in this post, along with a few other common questions.

This post is for parents of babies that have already been diagnosed with an umbilical hernia. There are many other belly masses that are not hernias, and they are addressed differently. This is not about babies with an undiagnosed bump or mass in their belly.

I’ll answer other questions about umbilical hernias in babies later in this post, but let’s start with umbilical hernias and tummy time.

First, a quick review of “tummy time.” Tummy time refers to when babies are on their bellies. Because newborns should sleep on their backs (face up), they need a few daily minutes on their bellies when they’re awake. They need this time in order to develop neck, back, and trunk muscles.

Can babies with umbilical hernias still do tummy time?

Many babies with soft reducible umbilical hernias are able to do tummy time after their umbilical cord has fallen off. Usually, an umbilical hernia does not need to delay tummy time.

Overlying skin protects an umbilical hernia in babies. Since such hernias should be able to be reduced easily, tummy time usually won’t cause any problems. This is something parents can discuss with their baby’s doctor when the hernia is diagnosed.

What is an umbilical hernia in a baby?

An umbilical hernia in babies happens when the abdominal muscles don’t close completely after the umbilical cord falls off. There’s a small opening in the muscles. However, there is not an opening in the skin. If the muscle opening is big enough, sometimes the intestines squish through it and cause a bump or a bulge under the skin. And, sometimes they can slide back in if the baby changes position. Remember, everything is still covered completely by the skin. This is why sometimes a calm baby with an umbilical hernia may appear to have a completely flat belly, especially if they are laying on their back. But, if they try to sit up or strain, the hernia bulges out a bit. This is what we expect with umbilical hernias. 

Reducing an Umbilical Hernia

An umbilical hernia exam may include gently pressing on the hernia until it is level with the rest of the baby’s belly. This is basically pushing the intestines back into the belly (where they would be anyway if there were not an opening in the muscles). It should cause no discomfort for the baby. This gentle pressing is called “reducing” the hernia. Consider asking your baby’s physician how to make sure the umbilical hernia can be reduced. This is important. Not being able to reduce the hernia can be an emergency. 

If an umbilical hernia can be easily reduced, this is a good sign that the baby will be comfortable enough in a tummy time position. Being on their belly applies enough pressure to gently reduce the umbilical hernia.

However, every baby is unique. Everything you read here is general information, not any medical advice for any specific situation. Your baby’s doctor can give specific instructions on your baby’s umbilical hernia.

Reasons to seek emergent medical care with umbilical hernias

Usually umbilical hernias cause no problems. However, there are a few times when a family should seek immediate medical care for an umbilical hernia in their baby. If any of the following happen, call your baby’s doctor or go to the emergency room.

• The skin covering the umbilical hernia changes color
• Touching the hernia seems painful to the baby
• The umbilical hernia feels harder than normal or cannot be “reduced.” If it seems “stuck,” please seek immediate medical care.

What needs to be done about umbilical hernias in babies?

What’s the upside of abdominal muscles that don’t “close” right after the umbilical cord falls off? Eventually, they often do close. They can come together. This means many umbilical hernias in infants heal on their own. It just takes time. Most infant umbilical hernias close by the time a child is 4 years old, without any intervention. More on that later. If they haven’t closed, a child may need surgery. Some families choose to meet with a surgeon even before age 4, but usually a child’s primary physician monitors umbilical hernias. 

Other FAQ About Umbilical Hernias in Infants

In the meantime, before surgery is even considered, parents (and often grandparents) have more questions. I’ll answer these below. 

Do you need to put a quarter on a baby’s umbilical hernia?

Many families asked me this question! They refer to placing a coin on an umbilical hernia, then either taping it to the skin or wrapping a towel around the baby’s belly to keep it in place. This is not necessary and does not make the hernia heal faster. Remember that most hernias heal on their own. So almost anything may seem like it helps. I discourage using quarters because sometimes they get lost or slip out of place. This can be a choking hazard, especially for a baby’s toddler-aged siblings. 

So, not only do quarters not heal umbilical hernias faster, but they also have their own risks.

Do you need to wrap an umbilical hernia in infants?

Families often try wrapping a swaddling blanket or strips of fabric around their baby’s belly, trying to keep the hernia reduced. Umbilical hernias in babies do not need to be wrapped unless specifically directed by the baby’s physician. This will not help it heal faster. There is some research supporting specific medical adhesives, but this is different than a family wrapping it with cloth.

Will babies with umbilical hernias grow up to have “outie” belly buttons?

Even though umbilical hernias happen at the same location as belly buttons, it does not mean that a baby with an umbilical hernia will have an “outie” belly button. 

What if the hernia is draining?

If there is any kind of liquid oozing from the belly button or around the hernia, please seek medical care. 

What if an umbilical hernia makes gurgling noises?

As mentioned earlier, umbilical hernias in babies may have some of the intestines in them. This is especially true if a baby is upright, upset, or trying to sit up. When a baby digests their food, it passes through the intestines. Gurgling sounds come with that process. Rumbling tummies anyone? If the intestine is closer to the surface, we’ll hear it make those rumbling gurgling noises. In this case, the intestines aren’t tucked under an extra layer of muscle. So, gurgling sounds usually aren’t anything to worry about.

Does constipation or straining cause umbilical hernias in babies?

Nope. If you’ve read this far, you now know that the umbilical hernia is just the way a baby’s abdomen developed. It won’t be caused by straining to poop. However, if a baby strains, there’s going to be more pressure in their belly. All that effort! With all that pressure, the hernia may bulge even more. So, I understand why this question comes up. Umbilical hernias in babies look bigger when the baby strains or grunts. Thankfully, the straining did not cause the hernia in an infant.

(In my newborn booklet, I discuss normal straining with bowel movements for newborns, along with some tips to help make the process easier for them as they learn. Read it here).

Along the same lines, crying does not cause umbilical hernias in babies. Again, all that pressure from crying may cause the hernia to stick out a bit more, but it didn’t cause the hernia itself.

Summary: Babies with umbilical hernias can usually still do tummy time.

Most umbilical hernias in babies cause no problems. Babies don’t usually need to limit any activities (including tummy time) due to their umbilical hernia. In fact, most hernias heal on their own with time. That being said, if hernias ever appear painful, “stuck,” or discolored: it can be an emergency and parents should seek immediate medical care for their child.

For babies with hernias that do not heal on their own, surgery is needed.

Everything on this site is for information only. Please follow the advice of your child’s doctor. Nothing you read here should delay real-life medical care from your family’s health care team.

Maya M. Mahmood, D.O., F.A.A.P. is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier. Subscribe to the newsletter or follow on social media @mayapeds.

Photo by Laura Ohlman on Unsplash