Symptoms and treatment of hernias in newborns

In infants, hernia is common. Although the size may be small, and the manifestations do not cause concern to the baby, parental supervision is required. In some cases, the disease is life-threatening.

To understand whether a hernia threatens the health of your baby, you need to contact the surgeon. The doctor will determine the symptoms and treatment of the pathology, he will tell you whether it is possible to cure a small protrusion in the navel without resorting to surgery.

Umbilical hernia

In a newborn child, a hernia of the umbilical ring is more common. It is an oval or round protrusion. When a baby's navel is formed, the muscle pulp tightens and scars. If, due to muscle weakness, the umbilical ring is not completely compressed, the abdominal organs or the greater omentum get under the skin. This condition is called a hernia. The size of education varies from a pea to a walnut.

Causes

Factors contributing to the formation of congenital hernia in infants:

• Genetic predisposition to muscle weakness of the umbilical ring and abdominal wall.
• In infants with low birth weight and premature babies, this problem occurs 3 times more often due to the immaturity of the connective tissue.
• Complications during pregnancy.
• Prolonged and frequent crying of the baby, constipation and bloating lead to an increase in intra-abdominal pressure. As a result, a weak umbilical ring, with frequent relaxation, does not shrink to the end, which creates the prerequisites for the formation of the disease.

A hernia in the umbilical region can appear already in the first days of a baby's life. Acquired disease develops as a result of rickets and regular digestive problems.

Symptoms of a small umbilical hernia

How to recognize the disease at an early age, doctors determine. Signs of a hernia in newborns:

• The visual manifestation of the disease is a bulge in the navel area ranging in size from 0.5 to 2 cm;
• the protrusion is imperceptible when lying down, but increases during coughing and straining;
• is freely reduced into the abdominal cavity by pressing a finger;
• over time, the hernia in the baby increases.

According to such signs, it should be understood that the bulging does not pose a danger to the child. The swelling of the navel does not cause discomfort to the baby, but it worries the mother.

 Infringement of umbilical hernia

The most dangerous complication of the disease is the infringement of the abdominal organs and the development of peritonitis, which requires urgent surgery. This condition is manifested by a sharp spasm of the umbilical ring. His muscles harden, disrupt the blood circulation of the intestinal loop up to necrosis. Acute intestinal obstruction develops.

Consider how a strangulated hernia in an infant manifests itself:

• severe pain in the navel makes the newborn cry loudly;
• vomiting appears;
• the child is restless, irritable;
• the protrusion is not reduced, and the skin over it turns red when pressed;
• increase in body temperature.

Important! With the appearance of such signs, in no case should you try to set the navel yourself! A strangulated hernia can only be treated surgically.

Inguinal hernia

Hernia in newborn boys is detected 5-10 times more often than in girls. This is explained by the fact that the testicles, which are formed in the abdominal cavity, at a certain moment of development move into the scrotum and must pass through the inguinal canal. The protrusion in infants appears due to the immaturity of the connective tissue.

Girls have other causes of the formation of pathology. The uterus is above its normal position before birth. Gradually descending in the process of development of the child, it entails the peritoneum. Its fold can penetrate into the opening of the inguinal canal at the stage of fixation of the round ligament of the uterus.

Hernias in newborns are formed when the abdominal organs penetrate the inguinal canal. In girls, the fallopian tubes or ovaries fall into the hernial pocket.

Symptoms

What does a hernia look like? Already in the first or second month after birth, it can manifest itself as a small bulge in the groin area. The swelling continues into the scrotum or labia.

Manifestations of a hernia:

• boys are characterized by left-sided localization;
• the bulge is painless on palpation;
• if intestinal loops penetrate into the hernial pocket, rumbling is heard on palpation;
• in the supine position, the swelling disappears, and when coughing and straining increases.

In this state, swelling is not dangerous, but with strong and frequent crying or digestive problems, abdominal organs can get into the inguinal canal.

Symptoms of a strangulated hernia

How to determine a hernia in case of infringement, the surgeon will tell you. Signs of a dangerous bulge:

• the newborn screams loudly from severe pain in the groin area;
•  the discharge of gases and feces stops;
• pronounced bloating;
• urge to vomit;
• the temperature rises.

Important! With the progression of the disease, necrosis of strangulated intestinal loops occurs, peritonitis develops - inflammation of the peritoneum, accompanied by poisoning of the body. The child needs urgent hospitalization.

With partial infringement, the surgeon can correct the protrusion in infants by such measures:

• the use of antispasmodic drugs;
• emptying of the intestinal loops beyond the place of clamping in the ring.

With a detailed clinical picture of complete infringement and signs of an acute abdomen, an urgent operation is performed.

Conservative treatment of a small umbilical hernia

Until the age of 3, conservative methods are used. Babies need to be laid on their stomach more often. This strengthens the abdominal press, enhances intestinal motility. Massage and physiotherapy exercises help to remove the bulge. Improving blood circulation increases the elasticity of the muscles of the umbilical ring. Regular classes with a professional massage therapist lead to a complete contraction of the muscle pulp. When the baby grows up, the household can do the massage in a clockwise direction in a circular motion.

Therapeutic exercise is performed with a reduced protrusion, sealed with a plaster. With a hernia in newborns, 3 main exercises are done:

1. Holding the child by the arms, spread them apart and pull them towards you. Rising, the baby strains the abdominal muscles.
2. Supporting the newborn by the chest, roll on the ball alternately with the stomach and back.
3. Grabbing the left arm and leg, help the baby turn to the right side. Change sides next time.

Such simple and fun exercises strengthen the abdominals of the child. The exercise therapy complex removes the protrusion by the age of three. Massage and gymnastics help with systematic exercises.

Remember! It makes sense to treat an umbilical hernia by conservative methods until the age of 3, while the connective tissue is elastic and amenable to structural changes. Older than this age, the muscle ring does not recover on its own. So they are planning an operation.

To speed up recovery, it is important to adhere to the regimen and proper nutrition of the baby. Diet regulates the full function of the digestive tract. This means that the muscles will receive the necessary set of nutrients - proteins, minerals and vitamins. In addition, the child will get rid of constipation, which increases intra-abdominal pressure.

For some children, the bulge goes away on its own over time. As you grow older, the abdominal muscles become stronger, the umbilical ring shrinks.

Conservative treatment in the hospital

If the newborn has colic in the abdomen, you need to contact the surgeon. Reduction of the umbilicus may be required. The specialist will seal the tightened umbilical ring with a medical plaster. On the first day, the baby should not be bathed. After 10 days, the doctor will repeat the sealing of the tightened umbilical sphincter. After several such manipulations, the ring around the navel will tighten, and the bulge will disappear.

Surgery

A planned operation to remove an umbilical hernia in children is done if the protrusion increases in size and does not go away with time. Surgical intervention is performed more often after 5–7 years. At an early age, this method of treatment is resorted to in rare cases with a large hernial formation. Under anesthesia, the umbilical ring is sutured, followed by hernial ring plasty. Symptoms of the disease disappear after surgery.

Important! Inguinal hernia in newborns is treated on the operating table from 6 months of age. Laparoscopic manipulation is performed under anesthesia through 3 small skin incisions on the abdomen.

After dissection and examination of the hernial pocket, the intestinal loops are set into the abdominal cavity, and the opening is sutured. The operation under endoscopic control lasts 15–30 minutes , after which the child is discharged from the hospital the next day. The doctor explains the rules for using a bandage after surgery, as well as the need for massage and exercise therapy.

In newborns, umbilical hernia is treated with conservative measures until the age of 3 years. The only way to get rid of an inguinal hernia is through surgery. Both pathologies are dangerous by infringement of organs clamped in the muscle ring. For any protrusion in the navel or groin area, the baby should be periodically consulted by a surgeon until a complete cure.