Umbilical Hernia in Babies: What It Looks Like and When to Worry

If your baby’s belly button suddenly looks like it has decided to “pop out” and star in its own little performance, you are not alone. Umbilical hernias are one of the most common things parents notice in the first weeks and months of life, and they tend to look more dramatic than they actually are.

As a pediatric nurse and a mom who has stared at more baby belly buttons than I ever expected to in life, here’s the reassuring truth: most umbilical hernias are painless, harmless, and they close on their own with time.

What is an umbilical hernia?

An umbilical hernia happens when a small opening in the baby’s abdominal muscles at the belly button (often called the umbilical ring) lets a bit of tissue bulge outward. That opening is where the umbilical cord passed through the abdominal wall during pregnancy.

After birth, that opening usually tightens and closes. If it closes slowly or not all the way at first, you may see a soft bulge at the belly button.

Why it looks bigger when your baby cries

When babies cry, strain, cough, or even laugh (yes, it happens), pressure inside the belly increases. That pressure can make the bulge look larger for a moment. When your baby relaxes, it often flattens back down.

Why it is common

Umbilical hernias are common because newborn abdominal muscles are still developing and the belly button opening can take time to fully close.

They are seen more often in:

• Premature babies
• Low birth weight babies
• Babies with a family history of umbilical hernias
• Infants of African American heritage

Most of the time, this is simply a normal variation of how the body heals after birth.

What it looks like

Parents usually describe it as:

• A bulging belly button or swelling right at the navel
• A bulge that becomes more obvious with crying or straining
• A soft “pouch” that may flatten when baby is calm or lying down

Often, it feels:

• Soft
• Squishy
• Not tender when you touch around it gently

Many umbilical hernias are also reducible, meaning the bulge can gently slip back in when the baby relaxes. Do not push hard, and do not try to force it to stay in with pressure, tape, or a band. If you are unsure what you are seeing or feeling, let your pediatrician check it.

Hernia vs normal outie

Outie belly buttons and umbilical hernias can look similar, but there are a few clues that help.

A normal outie

• Usually a small, stable shape
• Does not change much with crying or straining
• Feels like regular skin and tissue

An umbilical hernia

• Looks like a soft bulge at the belly button
• Often gets bigger with crying or straining
• May flatten when relaxed

If you are not sure which one you are dealing with, that is completely normal. This is exactly the kind of “quick look” question pediatricians love because it is usually an easy reassurance visit.

When it goes away

Most umbilical hernias close on their own as the abdominal muscles strengthen and the opening seals.

• Many close by around age 2.
• Most close by age 4 to 5.

Your child’s clinician will pay attention to the size of the opening under the skin (the defect), not just how big the bulge looks on the outside. In general, smaller openings are more likely to close on their own, and larger ones can take longer or may not fully close without help.

What you can do at home

Usually, the best “treatment” is time and routine checkups.

• Leave it alone. No special exercises are needed.
• Keep regular well visits so your pediatrician can track it.
• Expect it to look worse sometimes, especially during crying spells or constipation.

Skip home remedies

If someone suggests taping a coin over it, binding it, or using a tight belly band, you have my full permission to say no thank you.

• Coins and tape can cause skin irritation, breakdown, and infection.
• Binding does not help the muscle opening close faster.

When surgery is needed

Surgery is not the norm for infants with umbilical hernias, but it is sometimes recommended.

Your pediatrician may refer if:

• The hernia is still present around age 4 to 5
• The opening is large and not shrinking over time
• The hernia is causing pain or frequent problems
• There are signs of incarceration or strangulation (more on that below)

Some clinicians refer earlier for very large openings or if it is not getting smaller as your child grows. Exact size cutoffs vary by clinician and surgeon, so it is a good question to ask at well visits.

When surgery is needed, it is typically a straightforward outpatient procedure. Your surgeon will talk you through timing, anesthesia, and recovery in plain language, and you deserve that clarity.

Emergency signs

Most umbilical hernias are harmless, but a small number can become incarcerated (tissue gets stuck) or strangulated (blood flow to that tissue is reduced). This is uncommon with umbilical hernias, but it is the reason we take certain symptoms seriously.

Go to the ER now if your baby has an umbilical hernia and:

• The bulge becomes hard, swollen, or very tender
• The bulge will not go back down when your child is calm
• Skin over the belly button looks red, purple, or dark
• Your baby has persistent vomiting
• Your baby seems in significant pain, is inconsolable, or you notice sudden, unusual distress
• Your baby has a bloated belly or is not feeding normally along with the bulge

Trust your instincts. If the belly button bulge looks different than usual and your baby is acting sick, it is absolutely appropriate to seek urgent evaluation.

If you are unsure, call your pediatrician’s nurse line. If the symptoms above are present, head to the emergency department.

Call your pediatrician soon

• You notice a new belly button bulge for the first time
• The hernia seems to be getting larger over time
• Your baby seems uncomfortable when you touch around the belly button
• The skin looks irritated or there is drainage
• Your child also has fever or seems unwell, even if you are not sure it is related

One important note about drainage: an umbilical hernia itself does not usually cause oozing. Drainage, a foul smell, spreading redness, bleeding, or a moist red “bump” in the belly button can point to other issues like an umbilical granuloma or infection, and those deserve a prompt call.

For most families, the visit ends with reassurance and a plan to monitor it at well checks.

What to expect at the visit

Most of the time, your clinician can diagnose an umbilical hernia with a simple exam. They will usually check:

• The size of the opening in the muscle
• Whether it is soft and reducible
• Whether there is any sign of pain, skin color change, or trapping

Imaging like an ultrasound is not always needed, but may be used if the exam is unclear or symptoms suggest a complication.

FAQs

Does an umbilical hernia hurt my baby?

Typically, no. Most babies are completely unbothered by it. Pain, marked tenderness, or significant fussiness along with a firm bulge is a reason to get checked quickly.

Can my baby do tummy time?

In most cases, yes. Tummy time does not cause umbilical hernias and it does not prevent them from closing. If your baby seems uncomfortable, talk with your pediatrician, but tummy time is usually safe and encouraged.

Did I cause this by cutting the cord wrong?

No. Umbilical hernias are related to how the abdominal wall closes after birth, not how the cord stump was cared for or when it fell off.

Is it dangerous if it gets bigger when my baby cries?

Not by itself. That is very common. What matters is whether it stays stuck out, becomes hard, changes color, or your baby seems sick or in pain.

The bottom line

A bulging belly button can look alarming, especially at 3 AM when everything feels like an emergency. Most umbilical hernias in babies are benign and resolve naturally with time.

Keep an eye out for the true red flags: a bulge that is hard, painful, discolored, stuck, or paired with vomiting or significant distress. Otherwise, bring it up at your next visit, take a deep breath, and know that this is a very common, very fixable part of babyhood.