Neonatal umbilical hernia (congenital umbilical hernia) is due to a congenital developmental defect and requires aggressive surgical treatment in the first instance.
Umbilical hernias in infants and young children generally do not require specific treatment and are mainly treated with observation and non-surgical treatment, and most will heal spontaneously by around 2 years of age.
Non-surgical treatment involves holding a coin or small piece of wood, larger than the umbilical ring and covered with gauze, against the umbilical ring after retrieval of the hernia mass and then securing it with tape or bandages to ensure it does not move. This method is most effective in infants under 6 months of age.
An umbilical hernia band can be used in a similar way, but is not suitable for all children and is recommended under medical supervision.
Surgical intervention may be recommended in cases where the umbilical ring is >1.5cm in diameter in children over 2 years of age, or in children over 5 years of age where the umbilical ring has not closed, or in some cases where the hernia has become entrapped and requires emergency surgery.
In adults, umbilical hernias are mostly acquired and are usually treated surgically.