Parents have been bulging into my office with questions as to whether or not their child has a hernia. Let me help you and your child “groin and bear it,” so to speak. Keep in mind that hernias in boys are called the same thing, even though you’d think they’d be called “him-nias.”

A hernia happens when intestines push through a weak spot in the abdomen’s muscle wall, making a lump or bulge. This is what we call a hernia.

A hernia can present as a swelling in the scrotum if it is a boy. For girls, the bulge can be in the groin area, or swelling out of the belly button. About five percent of children experience some kind of hernia.

What causes a hernia? Abnormal or non-closure of the muscles of the abdomen can happen at birth, as seen in preterm infants. As a child gets older, lifting, coughing or pushing can weaken the abdominal muscle. This allows the bowel to push through that weakened wall of muscle. Be reassured that hernias, when they do occur, are not contagious.

Hernias in the groin usually get bigger with standing and smaller or reduce in size with sitting or lying down. They can feel uncomfortable and eventually will need surgical attention to repair and close the abdominal wall opening. This is the usual treatment, which also includes tucking the intestines back into the abdominal cavity.

Most hernia surgery is a one-day procedure with no overnight stay required and a quick recuperation over several weeks. But some small hernias can heal over time. The muscle layer sometimes closes up by itself if the hole or weakness is small. By the way, taping a quarter over the bulge is not the answer – just a persistent myth.

When are hernias an emergency?

If your child is experiencing:

  • severe pain in the bulging area
  • a fever
  • vomiting
  • you note redness or a dark color to the bulge
  • it cannot be reduced in size

If any of the above are true, seek emergency care immediately. These symptoms may represent restricted blood flow to the intestines trapped in the bulge. If this is the case, immediate surgery is necessary. The surgical outcome is excellent if a surgeon operates on the hernia as soon as these emergency signs are noted.

Hopefully tips like these will cut through any concerns you have about whether or not your child has a hernia.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.  You can also catch “First with Kids” weekly on WOKO 98.9FM and MyNBC 5, or visit the “First with Kids” video archives at www.UVMHealth.org/MedCenterFirstWithKids.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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