Childhood umbilical (tummy-button) hernia repair (Paediatric umbilical hernia repair)
A small children's operation to close a gap behind the tummy button when an umbilical (belly-button) hernia has not closed on its own.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Most tummy-button hernias close by themselves in the first few years, so surgery is usually not needed early.
- Repair is generally only offered if the hernia is still present at around age 3–4, is large, or causes problems.
- It is a short operation under a general anaesthetic, and most children go home the same day.
- Recovery is quick — most children are back to nursery or school in about a week.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Closes the gap and removes the visible bulge
A young child whose hernia is likely to close on its own, where waiting is usually safer than operating.
Your child wakes on the ward and is offered a drink and food once ready. They may be drowsy, clingy or unsettled from the anaesthetic.
Clear, written advice on pain relief, wound care, bathing and return to nursery/school.
Your child wakes on the ward and is offered a drink and food once ready. They may be drowsy, clingy or unsettled...
Some children feel sick after the anaesthetic. Discomfort is usually mild and helped by regular paracetamol (and...
Keep the wound clean and dry — usually no bath or shower for about two days, then gentle showering is fine. Some...
Most children are comfortable and ready to return to nursery or school and normal gentle play.
What is a childhood umbilical (tummy-button) hernia repair?
An umbilical hernia is a soft bulge at or near the tummy button. It happens because the small opening that the umbilical cord passed through before birth has not fully closed, so a little of the tummy lining (and sometimes fat or bowel) pushes through. It often becomes more obvious when a child cries, coughs or strains, and can usually be gently pushed back.
Most umbilical hernias in babies close on their own as the opening continues to shrink during the first few years. Because of this, surgery is usually not offered early. An operation is generally considered only if the hernia is still there by about age three to four, is large, or is causing problems.
The operation closes the gap with stitches through a small cut hidden in a natural skin crease near the tummy button. It is different from a groin (inguinal) hernia, which does not close on its own and is repaired once found.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Open umbilical repair
The surgeon makes a small cut in a skin crease near the tummy button, pushes the contents back inside and stitches the gap closed. The usual method in children.
Repair with epigastric hernia
If there is also a small hernia just above the tummy button (an epigastric hernia), it can often be repaired in the same operation.
Larger or symptomatic hernia repair
Larger gaps, or hernias causing pain or discomfort, may be repaired sooner rather than waiting to see if they close.
Preparing for your surgery
- Consent is usually given by a parent or carer with parental responsibility. An older child or young person who understands what the operation involves may be able to consent for themselves; either way, your child should be involved and their views and agreement sought. The exact legal rules differ slightly in Scotland compared with England, Wales and Northern Ireland, and the team will explain who signs the consent form. Ask anything you are unsure about beforehand.
- Follow the fasting (nil by mouth) instructions in your letter exactly — eating or drinking too close to the operation can mean it is delayed or cancelled.
- Tell the team if your child has a cold, fever or is unwell on the day, or has any other health problems.
- Mention all medicines, allergies and any family history of anaesthetic problems.
- Bring a comfort item such as a favourite toy, blanket or dummy, and easy clothing that does not press on the tummy.
- Plan for a parent to stay with your child where allowed, and arrange care for siblings.
- Check whether your child will be a day case or might need to stay overnight.
What happens
The operation is done under a general anaesthetic, so your child is asleep and feels nothing. You can usually stay until they are asleep and be there when they wake up.
The surgeon makes a small cut in a natural crease near the tummy button, gently pushes the bulging tissue back inside, and stitches the gap in the muscle closed. The skin is usually closed with dissolvable stitches and covered with glue or small tapes, so there are normally no stitches to remove. The operation usually takes about 30 minutes to an hour, with extra time to go to sleep and wake up.
Afterwards your child recovers on the ward. Once they are comfortable, awake and have had a drink, most go home the same day; occasionally a child stays overnight.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A young child whose hernia is likely to close on its own, where waiting is usually safer than operating.
- A child who is acutely unwell with another illness on the day, when elective surgery is best delayed.
- A trapped or strangulated hernia (uncommon at the umbilicus), which would be an emergency rather than an elective case.
- Situations where the anaesthetic carries added risk and a specialist children's setting is needed.
Delay surgery if…
- Your child has a fever, cold, chest infection or is otherwise unwell on the day.
- The fasting instructions were not followed, for safety with the anaesthetic.
- The hernia is small and your child is still young enough that it may close on its own.
- There is a recent illness or vaccination your team advises waiting after.
Alternatives to discuss
- Watchful waiting, since most umbilical hernias close on their own in the first few years.
- Reassurance and monitoring by your GP or paediatric team rather than early surgery.
- Urgent surgery only in the rare event the hernia becomes trapped.
- Choosing the NHS pathway, which is the usual route, rather than private care.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Closes the gap and removes the visible bulge
- Treats any discomfort the hernia was causing
- Usually a single, definitive operation
- Quick recovery for most children
- Tidies the tummy-button shape where the hernia was stretching it
Risks & complications
- Soreness or bruising around the tummy button for a day or two
- Feeling sick for the first day after the anaesthetic
- Mild swelling or firmness around the wound that settles
- Wound infection, usually treated with antibiotics
- A small collection of fluid or blood (seroma or haematoma) under the wound
- The hernia coming back (recurrence)
- A stitch reaction or a small area of delayed wound healing
- An unexpected change in the look or position of the tummy button
- A rare reaction to the general anaesthetic
Umbilical hernia repair is a small operation and serious problems are uncommon. Recurrence is the main thing to be aware of, and is a little more likely if the hernia is repaired at a very young age or was large. Ask your surgeon whether it is better to wait a little longer to see if it closes on its own.
Published figures to discuss
This is a small operation and serious complications are uncommon. Rates depend on the size of the hernia and the age at repair. The ranges below are cautious figures from paediatric sources and should be discussed with your surgeon.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Recurrence of the hernia | Roughly around 2% in reported follow-up | A little higher when repair is done at a very young age (under about four) or for larger defects. | Paediatric umbilical hernia — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure |
| Wound (superficial) infection | Reported in under about 1% of cases | Usually settles with simple treatment or antibiotics. | Paediatric umbilical hernia — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govPublished figure |
| Fluid or blood collection (seroma/haematoma) | Uncommon | Often settles on its own without needing a further procedure. | Paediatric umbilical hernia — StatPearls (NCBI Bookshelf)ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Children usually recover quickly from this small operation. The wound is little and most are back to their normal selves within a few days, with full healing over a couple of weeks.
- Being clingy, tired or off their food for a day after the anaesthetic
- Mild soreness around the tummy button that eases with paracetamol
- Some bruising or swelling around the wound that settles over days
- A small, slightly firm ridge under the wound as it heals
- Quickly returning to normal play within a few days
Aftercare
- Give regular pain relief such as paracetamol (and ibuprofen if advised) for the first day or two as needed.
- Keep the wound clean and dry; avoid baths and swimming for about two days, then gentle showering is fine.
- Let any dissolvable stitches, glue or tape come away on their own — do not pick at them.
- Encourage calm play at first and avoid rough activity or anything that strains the tummy for a week or so.
- Dress your child in soft, loose clothing that does not press on the tummy button.
- Offer plenty of fluids and a normal diet once they are eating again.
- Keep any follow-up appointment and know who to contact if you are worried.
- Child's paracetamol (and ibuprofen if advised) at home and in date
- Soft, loose clothing that won't press on the tummy
- Fasting instructions from the letter understood and followed
- Time off nursery/school planned (about a week)
- Comfort item (toy, blanket, dummy) packed
- Care arranged for any siblings
- Ward or clinic contact number saved for problems
Scars and how they heal
The cut is small and tucked into a natural skin crease near the tummy button, so the scar usually becomes faint over time and the belly-button shape is preserved as far as possible. Closed with dissolvable stitches and glue or tape, there are normally no stitches to remove. The scar may look pink or slightly raised at first and fades over months.
⚠ Get urgent help if…
- Your child is in a lot of pain that pain relief does not help
- A high temperature that does not come down with paracetamol, or your child seems generally unwell
- The wound becomes increasingly red, hot, swollen or starts to ooze
- A new firm, tender bulge at the tummy button that will not go back, especially with vomiting (seek urgent help)
- Repeated vomiting, a swollen tummy or not passing stool
- Your child is unusually drowsy, floppy or hard to wake, or has any breathing difficulty (seek emergency help)
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a flat tummy with no more bulge, a comfortable child and a small, neat wound. The operation usually fixes the problem in one go and most children have no further trouble.
Surgery cannot completely guarantee the hernia will never come back, and the tummy-button shape may look slightly different afterwards. Your surgeon will explain what to expect.
For most children the repair lasts for life and they go on to lead completely normal lives. Recurrence is uncommon but a little more likely if the repair was done at a very young age or the gap was large, which is part of why waiting is often advised first.
Combining with other procedures
If there is also a small hernia just above the tummy button (an epigastric hernia), it can usually be repaired during the same operation. Your surgeon will discuss anything extra before the operation so you know exactly what is planned.
Follow-up & long-term care
Many children do not need a routine follow-up appointment and are reviewed only if there are concerns; some units offer a check by phone or in clinic. Dissolvable stitches and glue come away on their own. Contact the ward or your team if the wound looks infected, your child is in unrelieved pain, or the bulge comes back.
Revision and secondary surgery reality
- Recurrence is uncommon but, if it happens, a further repair may be needed.
- Repairing very early can carry a slightly higher chance of recurrence, which is why waiting is often advised.
- A small fluid collection can appear after surgery and usually settles without intervention.
- Occasionally the tummy-button shape needs minor attention if the parent and surgeon agree.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear, written advice on pain relief, wound care, bathing and return to nursery/school.
- A named contact and a route to be seen quickly if the wound looks infected or the bulge returns.
- Specific 'come back now' instructions for severe pain, persistent vomiting or an unwell child.
- Honest discussion about timing and whether waiting is reasonable.
- A plan for review if there are any concerns, even where routine follow-up is not needed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The paediatric surgeon's fee and experience
- The paediatric anaesthetist's fee (a general anaesthetic is always needed)
- Theatre and hospital facility fees
- Whether an additional (epigastric) hernia is repaired at the same time
- Whether an overnight stay is needed
- Follow-up appointments if required
- The surgeon's and paediatric anaesthetist's fees
- Theatre and facility fees, and any overnight stay
- Pre-operative assessment and any tests
- Whether repair of any extra (epigastric) hernia is included
- Follow-up appointment(s) and aftercare advice
- What happens — and who pays — if a complication arises or the hernia recurs
- The cancellation policy, including if your child is unwell on the day
On the NHS? Childhood umbilical hernia repair is available on the NHS, but is usually only offered when the hernia is still present at around age three to four or is causing problems, because most close on their own; families sometimes choose private care for timing or surgeon choice.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that most umbilical hernias close on their own, so early surgery may be unnecessary.
- Treating an umbilical hernia as urgently as a groin hernia, which is a different situation.
- No discussion of recurrence, especially if repairing at a young age.
- Unclear fasting instructions, which can lead to last-minute cancellation.
- No written aftercare advice or emergency contact for parents.
Marketing red flags
- Recommending early surgery for a small hernia likely to close on its own.
- “No-risk” or “completely pain-free” claims for surgery under general anaesthetic.
- Promising a perfect tummy-button appearance.
- Not mentioning that the hernia can occasionally come back.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Is it better to wait longer to see if the hernia closes on its own?
- Is my child likely to go home the same day or stay overnight?
- How likely is the hernia to come back at my child's age?
- What pain relief should I give at home, and for how long?
- What exactly should make me bring my child back urgently?
- Will the tummy button look different afterwards?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Does an umbilical hernia need an operation?
Why wait until my child is older?
Is it the same as a groin hernia?
Will my child stay in hospital?
When can my child go back to nursery or school?
Are there stitches to remove?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Great Ormond Street Hospital — Umbilical and epigastric hernia Sheffield Children's NHS — Umbilical hernia Cambridge University Hospitals NHS — Umbilical hernia in children Paediatric umbilical hernia — StatPearls (NCBI Bookshelf) Scottish Government — Children's consent (Age of Legal Capacity (Scotland) Act 1991 guidance) Welsh Government — Children's consent when engaging specialist services
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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