Small umbilical hernias in kids less than 3-5 years of age, reassure and observe.
“It is important to be able to tell children and their families that many small umbilical hernias resolve without surgical repair and that the rate of both incarceration prior to surgery and complications from surgery are very low. Surgical repair of pediatric umbilical hernias is indicated if the hernia has not resolved by 3–5 years of age or for incarcerated hernias at any age. The primary care physician may observe younger children who are asymptomatic, limiting the need for surgical referral. Smaller hernias (<1.0–1.5 cm in diameter) typically resolve more quickly than larger hernias. The surgery is usually done on an outpatient basis, which is often reassuring to parents. Less than 1% of patients experience incarceration. Imaging studies are not routinely required and applying pressure over the defect has no benefit.” ABFM