Umbilical hernia or expansion of the umbilical ring? Methods for the treatment of umbilical hernia in children.

Even with a normal pregnancy and successful delivery, no one is immune from unpleasant surprises, one of which may be the most common surgical pathology in childhood - umbilical hernia.

Doctors, referring to statistics, claim that this diagnosis can be found in every fifth full-term baby, and in children born prematurely, and even more often - in every third case, not to mention the fact that almost all newborns are diagnosed with at least minimal umbilical defects. rings.

Someone is trying to get rid of adversity using grandmother's conspiracies or methods, like gluing coins to the baby's navel, but it's not worth risking the child's health and wasting precious time. It is better to find out the features and nuances of this condition in order to understand what needs to be done, and whether everything is really so scary.

Let's understand everything in order. After the birth, after some time, the umbilical wound should heal in the child, and in its place, the navel should form. The emerging navel surrounds the umbilical ring, through which all the vessels and vital connections previously passed.

A newborn baby is cut off the umbilical cord, since he no longer needs such a connection with his mother, and the muscles that are around the navel begin to gradually contract.

As a rule, it takes three to four weeks for the wound to heal completely. If during this time the muscles of the umbilical ring have not closed, then upon examination, the pediatrician can diagnose the baby with a children's umbilical hernia.

How does she look?

Already in the very first days of a baby’s life, even completely inexperienced parents will be able to discern the symptoms and signs of pathology: when the baby cries a lot, screams or pushes, an oval or round protrusion occurs around the navel - this is an umbilical hernia.

Various fragments of the abdominal organs can protrude - the peritoneum itself, the greater omentum, the intestinal loop. They protrude under the skin in the opening of the umbilical ring, which did not close completely during the first month of the baby's life.

Feeling the navel area, you yourself can feel how your fingers simply fall into the abdominal cavity. After such palpation, the doctor determines how large the area that surrounds the hernial protrusion is. This area is also called the edges. hernia gate, and the protrusion itself is called a hernial sac.

So, a hernia consists of:

• actually, protrusions or internal membranes - a hernial sac;
• fragments of organs that got into the hernial sac and are there - hernial contents;
• the area surrounding the hernial sac, or the weakest place in the abdominal wall, through which the hernia will “crawl out” - the hernial ring.

The main symptoms and signs in a child

If you regularly undergo scheduled examinations with the baby at the pediatrician, then you don’t have to worry, as the doctor will definitely see even the slightest defects in the development of the crumbs.

In the absence of medical examinations, be sure to monitor the health of the crumbs yourself. The symptoms of a hernia in newborn babies are very simple, so you can't miss them:

• Babies with a hernia have a bulging navel when they scream/cry/cough or push to have a bowel movement.
• the protrusion has a rounded or oval shape;
• if the baby is calm and lies in a relaxed state, then the hernia is not visible, but as soon as it strains, it immediately appears;
• the protrusion area may increase every day;
• with strong crying, the baby's tummy may even swell a little;
• the baby is restless and irritable, sensitive to weather changes;
• if you press on the navel, the finger will fall into the abdominal cavity, and to the touch you will feel like a balloon;
• when pressed, a characteristic sound is heard, resembling a rumbling or gurgling.

A hernia can have different sizes - from a small pea, up to one centimeter in diameter, to a large plum and more (ten centimeters in diameter).

What are they like?

There are two main types of umbilical hernias.

1. Congenital pathology - it is detected immediately in the maternity hospital, since it is characterized by the fact that in the area of ​​\u200b\u200bthe navel of the crumbs a spherical protrusion will be visible, which has a fairly wide base, which passes into the umbilical cord.
2. Acquired - manifests itself two to three months after birth, if the baby has certain violations of the full functioning of all internal organs and under some other conditions for the formation of pathology.

Another subspecies is also distinguished - a hernia of the umbilical cord or an omphalocele (embryonic) hernia. It is considered one of the developmental anomalies, as a result of which there is a delay in the formation abdominal wall, a internal organs protrude into the umbilical cord.

Such intrauterine pathology belongs to the category of complex ones, since it is almost impossible to see it on any diagnostic examination ultrasound. In addition, embryonic hernia is accompanied by other developmental abnormalities, as well as defects in the internal organs and systems of the child.

To solve this problem, usually only urgent surgical treatment, which is possible either in the prenatal period, or as quickly as possible after the birth of the baby.

Degree of possible influence and consequences

Even if your baby was diagnosed with an umbilical hernia, then you should not worry and worry, because at this age the disease can even go away by itself without any outside interference. It's just that the baby will grow and his muscles will gradually get stronger, which will allow the umbilical ring to completely shrink and close the hernia.

Self-healing of hernias occurs even with very large hernial protrusions and a non-protracted umbilical ring in seventy to eighty percent of cases.

To a greater extent, pediatricians attribute the umbilical hernia of newborns to the category cosmetic defects, and not diseases, since there are quite good reasons for this.

1. Firstly, with umbilical hernias, cases of infringement or compression of the contents of the protrusion are practically unknown, as with inguinal ones, when circulatory disorders and other undesirable consequences are caused.
2. Secondly, this condition is not painful for the baby, since the hernia itself does not hurt.

However, often a hernia can be accompanied by painful bloating, which causes considerable discomfort to the crumbs. Also, as already mentioned, the child becomes very sensitive to the weather and even meteorologically dependent. And the course of the disease as a whole will depend on the size of the hernia.

In rare cases, complications are also possible, which are characterized by the following conditions:

• the baby does not experience severe bloating, to which pain is added;
• the protrusion sharply and rapidly increases in size;
• nausea or vomiting occurs;
• the hernia cannot be pushed into the abdominal cavity;
• you can notice that the skin of the hernial sac has acquired sensitivity, become red or coarsened.

With such signs, you should immediately consult a doctor, as they may indicate a strangulated hernia or severe compression of fragments of internal organs in the hernial sac.

Sometimes inflammation occurs, and even a hernia rupture, when the skin bursts, exposing the entire contents of the hernial sac. A condition called coprostasis, which means stagnation of feces in the large intestine, will also be dangerous.

Such complications are solved exclusively with the help of surgery, and in other cases, doctors prefer to refrain from surgical intervention and treat the hernia with more conservative methods.

Why it happens: main causes and risk factors

Very often, among the main reasons why a hernia is formed in a child, parents name the incorrect cutting of the umbilical cord in the maternity hospital, due to which the umbilical ring was too wide, and behind it a hernia. However, this is not the case at all, because the causes of the pathology are completely different.

The human abdominal wall consists of several layers:

• skin;
• muscles;
• peritoneum;
• subcutaneous fat;
• dense aponeurosis.

Since the main bearing layers are muscles and aponeurosis, it will depend on their strength and development whether a problem appears or not. If these layers have weakness, then the elastic peritoneum will begin to protrude through the hernial orifice, and when the hernial sac increases in size and goes under the skin, then such a protrusion can be both felt and seen.

In addition to the anatomical predisposition to the disease in the form of weakness of the muscles of the anterior abdominal wall, connective tissues or the umbilical ring, the effect of increased intra-abdominal pressure also plays a huge role.

As already mentioned, there are several types of hernias. First, let's look at what affects the appearance of a congenital hernia.

• The most common reason in this case is the usual heredity or genetic factor, which consists in the hereditary weakness of the connective tissue of the umbilical ring, that is, if you or your husband had a hernia, then the baby will most likely also make itself felt.
• Premature pregnancy - baby born ahead of schedule, will have a small weight, and its connective tissue is still completely immature, so umbilical hernia very often occurs in children born prematurely, as well as in low-weight infants with a body weight below critical (less than three kilograms).
• Also, the cause may be dysplasia or other disorders that cause underdevelopment of children's organs and connective tissues when carrying a child.
• A hernia can occur with a non-standard arrangement of internal organs, plus - if the work of the child's abdominal organs is greatly weakened.

The risk factors that affect the subsequent appearance of pathology include the unfavorable course of pregnancy:

• if during gestation the mother was ill with inflammatory, somatic or severe infectious diseases;
• led an unhealthy lifestyle - ate poorly, drank alcohol, smoked;
• been adversely affected chemicals or toxins;
• lived in an ecologically unhealthy environment;
• took various medications or other medical preparations, undesirable or prohibited for admission during pregnancy;
• if the pregnant woman herself suffers from any diseases, defects or pathologies.

All these factors have a strong Negative influence on a child growing in a woman’s stomach, provoking a delay in its development and the risk of all kinds of disorders, including anatomical weakness of the muscles, and undeveloped connective tissue, and improper formation of the structure of the umbilical ring.

However, this is not all, because a hernia can also become acquired, that is, it can occur in a completely strong, full-term and healthy child. Why? Let's get a look. Here are some reasons that can lead to such a result.

• Since the muscles of the umbilical ring in a newborn baby are still weak, even minor factors that can cause an additional decrease in their tone will contribute to the formation and development of a hernia.

These include the most common diseases - rickets and malnutrition. They create very favorable conditions for the development of pathology.

• The umbilical ring may close a little slowly, as a result of which, with accompanying provoking factors, a hernia will also begin to form.
• Perhaps the baby did not have a hernia immediately after birth, but if there is an anatomical predisposition, it will definitely make itself felt a little later.
• Very often, a hernia appears due to the partial closure of the umbilical ring area by the abdominal fascia, and also because the abdominal fascia is not as dense as it should be.

If, in addition to all this, the muscles of the abdominal wall of the child are constantly tense, and intra-abdominal pressure rises due to intestinal colic, increased gas formation, constipation or other disorders of the digestive tract, whooping cough or dysentery, respiratory diseases and nervous system with a syndrome of increased nervous excitability, frequent prolonged crying and crying of a baby, then the umbilical ring will overgrow even more slowly and worse, which provides favorable conditions for the development of a hernia.

In this video, a pediatrician talks about the causes of an umbilical hernia, shares tips on treatment methods.

What to do: basic methods and ways to solve the problem

After the pediatrician examines the baby and feels his tummy, he will be able to determine the size and nature of the problem using the size of the umbilical ring, as well as the localization of the hernia ring and their edges.

If the baby has a small umbilical hernia, which is not accompanied by any additional alarming symptoms and complications, then the doctor will prescribe a number of preventive and therapeutic actions that, in combination, will help remove the risk of progression and enlargement of the hernia, and will also contribute to the complete closure of the umbilical ring and the independent disappearance of the problem.

Let's look at the most common and mandatory recommendations.

Massage

Massage is prescribed for children after the umbilical wound has completely healed - from the third to fourth week of the child's life.

Preventive and therapeutic massage sessions are very beneficial for health and general development baby, however, it is necessary to perform the procedure correctly. That is why for newborns it is recommended to invite a qualified specialist. Then, having learned from him, you will be able to massage the baby yourself.

The procedure is not without reason considered one of the most effective and useful in the complex of measures against hernia or for its prevention. By doing massage, you improve blood circulation in the umbilical ring, and also help to strengthen the muscles of the anterior abdominal wall and increase the elasticity of the connective tissue.

In addition, with the help of massage, you will be able to normalize the functioning of the crumbs' intestines, so that you can cope with the problem of bloating, colic and painful discomfort.

But remember that the procedure will give a really tangible positive effect if you carry it out daily.

You can allocate time for massage in the morning, after bathing or before going to bed, so that in total you can do at least two or three procedures per day. The main thing is that massage should not be carried out immediately after feeding:

• undress the baby and put him on the bed or changing table;
• your hands should be clean and warm (no rings or other jewelry), and movements should be soft, gentle and soothing;
• correct the hernia with the finger of one hand, lightly pressing on it so that it “drowns” in the peritoneum;
• With the other hand, stroke the baby's tummy, leading in a circle in a clockwise direction;
• start moving from the right lower abdomen to the left;
• then make counter strokes, already along the course of the large intestine;
• perform movements in sync - left hand will go up right side the baby's abdomen, and the right one down the left side;
• gradually move on to stroking the oblique abdominal muscles of the crumbs;
• at the end, grab the posterolateral surface with brushes chest and move your fingers towards each other - first from top to bottom, and then forward so that the navel hides in the skin fold.

There are other massage techniques, such as the modern "I love you" technique, in which the baby's intestines appear as an inverted English letter U drawn on his tummy.

The procedure is that you, as if writing on the belly of the crumbs, this phrase in capital inverted letters:

• first I - from top to bottom on the left side, to expel the baby's gassies and move them down;
• then you move the gases and peristalsis further with the help of the letter L;
• and then massage the stomach in the form of the letter U to completely remove the accumulated gases from the baby's intestines.

In addition, it is worth doing a separate massage of the umbilical region - this will help you eliminate the weakness of the rectus abdominis muscles of the crumbs:

• place the thumb and forefinger to the right and left of the center of the navel;
• the distance should not be more than one or two centimeters;
• using small point movements, make ten light clicks;
• then move up and hold the same presses there;
• repeat the same from below the navel;
• now change your fingers to index and middle and make circular movements around the navel in a clockwise direction;
• at the end, press a little on the protrusion.

Massage should be a pleasant procedure, your kind of ritual of spending time with the baby, during which the child cannot feel bad or uncomfortable, therefore, if the baby cries or worries, it is better to stop the session or reschedule it to a more convenient time for you and the baby.

The author of the video talks about an interesting massage technique that helps with umbilical hernia in babies.

Exercise therapy and home gymnastics

Another measure that can also be both therapeutic and preventive, but has a huge benefit for the health and development of the body in any case.

In the presence of an umbilical hernia, the doctor himself must choose or develop for the baby therapeutic gymnastics, consisting of a set of special exercises aimed at strengthening the muscles of the anterior abdominal wall and connective tissue.

It is very important to at least first conduct classes with an instructor in physical therapy or under the supervision and guidance pediatrician in order to avoid all sorts of mistakes and not cause the opposite effect, provoking excessive tension in the anterior abdominal wall and an increase in intra-abdominal pressure.

Before performing any exercises, it is necessary to set the hernia and seal it with a band-aid.

Among the most effective exercises that are usually used in the complexes of physical therapy and gymnastics, it is worth noting: "bicycle", imitation of walking, raising legs, riding a ball - both on the tummy and on the back, lifting the baby by the handles, mastering coups through the left and right side, etc. Water and swimming also help very well.

Bandage

In addition, among the conservative methods of treatment, one can also find a bandage belt or an umbilical bandage.

This special piece is simply a wide elastic waistband made from soft tissue. Also in its central part there is a seal or hernial limiter. Supporting the umbilical ring and the hernial gate, through which the protrusion of the internal organs from under the skin occurs, the bandage will help fix the abdominal organs in the correct position.

However, it is not worth relying especially on the effect of wearing a bandage, since it does not have any therapeutic effect. Usually, pediatricians recommend wearing a bandage for babies for preventive purposes, that is, if there is no hernia yet, but there is a threat of its occurrence, for example, during premature pregnancy.

Also, the bandage can be a useful product for very whiny and noisy children and those who suffer from severe colic. By supporting their abdominal wall, the bandage belt will help its proper formation and will not allow the weak umbilical ring to diverge even more.

However, it is worth watching the baby. If he has strong allergic reactions, rash and irritation or diaper rash at the site of wearing a bandage, then this preventive method is not suitable for you.

It should be understood that it is possible to wear a bandage only in combination with other preventive or therapeutic measures, for example, while doing massage and therapeutic exercises for the baby.

Patch

A handy tool that was used by many parents before, when there were no hypoallergenic elastic bandage belts.

A similar method of treatment consisted in tying a copper coin to the navel of the crumbs or sticking a band-aid over his navel. Now this method is almost never used, since with such amateur medical activity there were frequent cases of damage to the tender skin infant and the development of infection under a foreign body or patch. Also, on your own, you can incorrectly correct the hernia for the baby, and this will only add to the problems.

Now on sale you can find special adhesive bandages for the treatment of hernia. They are produced by many famous brands and trademarks, such as Lohmann & Rauscher GmbH (Porofix patch), Hartmann (CosmoporE patch), Chicco, etc.

Having set the hernial protrusion, the doctor will put a bandage on the baby's stomach - from one lumbar region to the other. Usually the course of treatment with such patches is ten days. Ten days later, the bandage is removed and the result is checked. If the hernia still remains, and the umbilical ring has not completely closed, then one or two more courses of treatment are used.

You can also act according to another method, applying the patch exclusively to the umbilical region. In this case, you can bathe the baby without removing the bandage, and if necessary, change it yourself after a couple of days.

In this case, as in the case of a bandage, it is necessary to observe the behavior and reaction of the child. An adhesive bandage can be only part of a complex of conservative treatment and be used with other methods.

Laying out on the tummy

After complete healing of the umbilical wound, each baby is recommended to be laid out on the tummy:

• it helps to develop and strengthen the muscles of the abdomen and the anterior abdominal wall;
• improves intestinal motility;
• relieves the baby of excess gases, relieves bloating and colic;
• reduces pain and discomfort.

Tummy time can be done before each feed, or at least three to four times a day if you plan to keep your baby in this position for fifteen to twenty minutes.

If the laying out sessions are short - two or three minutes each, then you should try to find time and opportunity for more frequent procedures.

The main condition is a hard and even surface, but at the same time it should not be cold so that the baby does not catch a cold. Put the baby on the tummy, and place some interesting objects or bright toys in front of it. Try to interest the child - he should reach for toys, making active movements with his limbs and torso, and raise his head.

In the process, intra-abdominal pressure will decrease, the protrusion of the hernia will decrease, and gases will also begin to leave faster. In addition, laying out on the tummy is a great component. physical development and the necessary activity of the baby.

Be sure to remember that even if the baby still does not know how to roll over or crawl, it still cannot be left alone unattended for even a minute. Follow basic safety precautions to avoid injury and accidents.

Surgical intervention

In the absence of any results of treatment and a constant increase in the hernia after the age of three, and in some countries - five years of age, the child is recommended surgery to remove the hernia.

In more early age surgery is possible only in case of serious complications, such as infringement, inflammation or rupture of the hernia, as well as in danger to the life of the child.

For girls, the issue of surgery is more acute, since they may have more frequent cases of infringement. This becomes a particularly serious complication during pregnancy.

It is recommended to carry out the operation in preschool age to prevent a hernia from developing large sizes and stop the risk of complications that cause displacement of internal organs and disruption of their functions. also in childhood there is also good tissue elasticity, so both the operation and recovery will be easier and faster.

Among the main indications for surgical intervention are:

• discomfort and discomfort that the hernia delivers to the child;
• self-healing does not occur after a set of measures of conservative treatment;
• a hernia appeared some time after birth, and by the age of one or two years it began to increase in size;
• the size of the hernia is more than one and a half to two centimeters and it continues to become even larger;
• the hernia has a proboscis shape;
• with symptoms of complications.

Surgery to remove a hernia is considered uncomplicated and is usually performed under general anesthesia. Elimination occurs without obvious cosmetic defects and, as a rule, without relapses. You can also choose the laparoscopic method of the operation - then it will take only fifteen minutes and will not require the removal of sutures.

Conspiracies and other methods of alternative traditional medicine

Some parents do not trust qualified doctors and medical workers, but prefer to turn to various folk fortune-tellers - grandmothers who can whisper something over a baby or read magical conspiracy so that the hernia resolves by itself.

Of course, the choice is yours, but try to use common sense when making a decision and not trust the health and safety of your child to people with no special medical education.

Perhaps this healer or fortune teller helped someone, but all children are different, and you may have a completely different case, requiring, for example, emergency intervention doctors, so it's best to consult with your doctor.

Other preventive measures

Of course you can't control hereditary factor, but you can do something to prevent the occurrence of an umbilical hernia in your baby.

• First of all, this concerns the bearing of pregnancy and preparation for it, that is, compliance with the most basic rules of nutrition, daily routine, maintaining healthy lifestyle life, etc.
• After the birth of the crumbs, try to bathe him regularly, do gymnastics with him, put him on his tummy, and massage him.
• Watch your own diet if you are breastfeeding your baby - exclude all foods that cause increased gas formation and bloating, like legumes, cabbage, smoked meats, canned food, pastries, or sweets.

You should also avoid junk food and allergenic foods. Instead, eat whole grain cereals, bran, fresh fruits and vegetables, lean white meats, and fish.

• If the baby is bottle-fed, then choose a formula for nutrition together with the pediatrician so that the baby does not have allergies, colic, bloating or constipation.
• Ask the doctor to prescribe the child special preparations, which reduce gas formation and help with colic, like "Espumizan", "Plantex" or dill water, "Bebikalm".
• If the crumbs have severe constipation, you can give him a small enema with herbal decoction, use a vent tube or glycerin suppositories.
• Perhaps the child has a lactase deficiency, that is, lactose intolerance. Then you definitely need to consult a doctor to avoid fermentation in the intestines, bloating and constipation.
• Often provokes a hernia and dysbacteriosis, so you should take care of the healthy microflora of the baby's intestines.
• Make sure that the child does not increase intra-abdominal pressure - do not let him scream and cry a lot, treat colds in a timely manner, avoiding complications in the form of obstructive bronchitis or pneumonia.

Conclusion

Despite the fact that an umbilical hernia is the most common surgical pathology in newborns, its appearance in your baby is absolutely not a problem or tragedy, since it almost never poses a threat to his health and life. With timely treatment to the doctor and adequate complex treatment the hernia usually resolves on its own. Let your baby grow healthy!

An umbilical hernia in newborns is one of the most common surgical diseases in this age. But parents should not be afraid if a pathology is diagnosed in a child - with timely treatment manages to eliminate it. It is important to have an idea about the structure of the navel and the mechanisms of hernia.

Anatomically, the navel is a scar of the skin above the ring. It is a hole, or gap, in the white line of the abdomen with outlined edges, consisting of connective tissue aponeuroses of the abdominal muscles (see photo).

In the fetus, the umbilical cord (umbilical cord) containing blood vessels passes through the ring. It connects the child with the mother's body. Immediately after the baby is born, the umbilical cord is tied up, and the umbilical cord residue in newborns disappears for 5-7 days. Vessels inside the ring, as unnecessary, in infants are eventually replaced by connective tissue, scarred.

There are no muscles in the area of ​​the ring, which means that there is no holding frame for the internal organs. As a result, if the ring does not grow in time, the peritoneum and intestinal loops begin to protrude through it.

4 causes of hernias

The reasons are different. They are conditionally divided into those that act in utero (and a congenital hernia occurs), and those that provoke the appearance of an umbilical hernia after birth.

Causes (in the prenatal period):

• genetic predisposition - in infants whose parents suffered from a hernia in childhood, the risk of developing pathology is much higher. Due to congenital connective tissue failure in a child, transmitted from parents.
• malnutrition, reduced muscle tone, prematurity are also predisposing factors in which the gap in the white line of the abdomen does not overgrow;
• unfavorable environmental factors, bad habits mothers can also lead to impaired muscle and connective tissue development.
• After birth, the provoking factors for a hernia are prolonged crying of the newborn, colic, coughing, constipation, which leads to increased pressure, called intra-abdominal pressure, and protrusion of the navel.

There is an opinion among the people that the cause of hernias is the wrong actions of the midwife crossing the umbilical cord. The judgment is wrong - the process of crossing is in no way connected with either the appearance of a defect or the shape of the navel.

External manifestations of hernias

An umbilical hernia can appear immediately after birth. Often, symptoms occur in the infant and some time after birth.

External symptoms of hernias: protrusion of the skin in the navel area in an infant. Education is allowed in various sizes - from 1 cm to 4-5 cm or even more, it all depends on the ring defect in newborns. The contents are the peritoneum and intestinal loops. Signs of the presence of the intestine in the hernia - peristalsis.

A hernia, if it is not infringed, can be easily corrected. When repositioned, a crunch is heard when the intestines take their normal position. After reduction, you can feel the edges of the hernial orifice, and thereby determine the size of the defect.

It seems to parents that the disease greatly worries the newborn, it hurts, which is manifested by prolonged crying. In fact, the cause of crying is colic, constipation, and the protrusion itself does not cause any discomfort in the child and does not bother him, if it is not infringed. Fortunately, infringement occurs infrequently. Its signs:

• severe anxiety of the newborn, vomiting;
• compaction of hernial contents, discoloration;
• impossibility of control.

Parenting Tactics

Parents should be careful with their baby. It is necessary to examine newborns every time they change clothes or bathe, especially if there are risk factors. If there are any suspicious symptoms (protrusion of the navel, even if it goes away on its own), you need to tell the pediatrician or pediatric surgeon about it.

And if there are symptoms of infringement with an already established diagnosis, then you should immediately call ambulance, because this condition can lead to intestinal necrosis.

Therapeutic measures for hernias

Most often, the defect of the ring overgrows with time (especially if the diameter of the hole is small), and all external manifestations disappear on their own. This usually happens by 3 or 4 years of age. But this does not mean that it is not necessary to treat the disease. On the contrary, with the correct implementation of all measures, it is possible to get rid of the defect earlier, sometimes during the neonatal period.

Treatment consists of several methods, each of which is selected individually by the surgeon. Often the treatment will involve several modalities, i.e. carried out comprehensively. conservative methods treatment:

• gymnastics;
• massage (general and local);
• methods in which the hole is closed artificially (bandage, plaster).

Sometimes, if the hernia does not go away after 5 years, a surgery, which is reduced to the operation of suturing the defect.

Conservative treatment

The therapy begins with the normalization of bowel function: you need to adjust the stool, pick up effective drug from colic and bloating. In a word, it is necessary to eliminate all the reasons why intra-abdominal pressure rises.

The next step in the treatment of hernia in newborns is to strengthen the muscles. For this, massage and gymnastics are used. They can be carried out by a specialist. If you learn it yourself, then the behavior of these procedures at home is allowed on your own. The effect will be greater if you do massage and gymnastics several times a day, and it is more convenient to do this at home, in a comfortable environment for the child.

An indispensable condition for recovery is bringing the ring into a "normal" closed state, which is achieved using a patch or bandage.

• Gymnastics is used as the most accessible and easy way. Before starting gymnastics, it is imperative to set and seal the hernial protrusion using a patch. In newborns, classes are more passive - laying out on the stomach, stimulating crawling, turning over. With older children, rings can be used: pull-ups with support, reclining. For any age, classes on a fitball or gymnastic ball will be useful (see video).
• To strengthen the muscles, improve the discharge of gases, the newborn is massaged. In the first case - soft pressing in the area of ​​muscle localization (1-2 cm to the left and right of the ring), rubbing with the edge of the palm, tapping. In the second case, the massage is performed in the newborn in the direction of the natural movement of the intestinal contents: from the right iliac region up, then along the hypochondrium across the abdomen, then down to the left iliac region.
• As a conservative approach, a special patch is used. The main condition for gluing is the complete healing of the umbilical wound. The patch ("Porofix", "Chicco", "Hartman") for the first time should be glued by the doctor and show the parents the method of implementation. Basically, they are superimposed for 10 days, then they change to a new one. As a rule, three such cycles are enough for the disease to go away.

Another product that provides closure of hernias is a bandage. Wide elastic waistband to keep belly button in place. The bandage is especially convenient for newborns. In older children who are actively moving, the bandage constantly slips and therefore it is not very convenient to use it. The method is effective only when used in combination with others.

How to prevent hernia?

• Prevention of the disease begins with the normalization of the intestines: treatment of constipation, colic, organization proper nutrition excluding violations. It is important to strengthen the muscles of the whole body and abdomen in a timely manner. You should lay the baby on the tummy, do gymnastics.
• Prevention of infringement consists in early treatment of hernias.

Previously, our grandmothers and great-grandmothers spoke to get rid of the disease. Medicine in our time has an impressive arsenal of hernia treatment. Using them skillfully, there is every chance to cure the disease, saving parents and the baby from subsequent suffering - physical and psychological!

An umbilical hernia is a common diagnosis among newborns that causes fear in new parents. At the same moment, a million questions arise: what to do with it and how to treat it? Can surgery be avoided?

Briefly about the essence of the problem

After birth, a common medical procedure follows - tying the umbilical cord. It contains the vessels that enter the child's body through the white opening of the abdomen.

A photo of an umbilical hernia in newborns looks like a small soft ball on the navel. Every fifth baby at birth suffers from such a pathological formation, among premature babies - every third.

Symptoms

Symptoms of an umbilical hernia in newborns often force parents to seek medical attention. There are various anatomical changes due to which the size of the disease can vary from the size of a cherry stone to a large berry.

If the signs do not disappear before school age– this requires immediate surgery to avoid more serious problems in future.

Causes

Medical diagram of the structure of an umbilical hernia

The causes of the hernia are explained mainly the anatomical system of the baby.

The case of such a pathology is explained by the insufficient development of the muscles of the anterior abdominal wall, which is typical for children who appeared earlier than the required time.

But the occurrence of this pathology is not excluded in children born on time and without a hereditary predisposition. The main causes of appearance in newborns are distinguished:

• congenital factor (heredity);
• intrauterine pressure (with prolonged crying and constipation);
• in case of premature birth.

Varieties of pathology

congenital

Occurs as a result different pathologies. Such developmental defects are present in children with problems at the genetic level and under the influence of unfavorable situations during the gestation period: infectious diseases future mother, difficult working conditions, intoxication.

Acquired

They are found in babies with a weak muscular apparatus or a painful increase in body volume and weight. Often accompanied by the presence of a child with high intra-abdominal pressure as a result of constipation, bloating or colic. Umbilical hernia in newborn boys is less common than in girls.

As a result of a medical error when tying the umbilical cord during childbirth, there is a possibility of improper overgrowth of the umbilical ring.

Irina Andreevna Vlasova, Deputy pediatric department, Khabarovsk, Khabarovsk Clinical Hospital

Today, newborns must be under the supervision of surgeons during the first year, observed at least once a month. How to remove the disease in newborns if the child has a weak umbilical ring?

It is recommended to start early gymnastics to strengthen muscle tissue. If up to a year, the ring does not tighten, I recommend being very careful that the pressure is the least strong, as this leads to surgical intervention.

Parents have to do everything themselves possible actions not to bring up the operation.

Here you need swimming, bathing, gymnastics, massage and certainly the right diet. In addition, now there are enough methods of correction: patches, bandages.

Diagnostic method

A vivid example of what an umbilical hernia looks like in babies

With a palpation procedure- the pediatrician presses the navel with little force so that the finger is in the abdominal cavity.

With the existence of a large size of the umbilical ring, there is a certain swelling in this place, which tends to increase with any stress.

4 main methods of treatment

The initial method of how to treat an umbilical hernia in newborns at home is not complicated. It is necessary to properly develop the abdominal wall, and properly organize.

Laying on the tummy	The following method can be useful not only for the development of the muscles of the abdominal wall, but also for strengthening the rest of the muscles of the child. The baby should be laid on a regular, not soft surface several times a day., having previously placed several captivating toys in front of him, so that an interest was created to reach out to them.
Massage of the abdomen (muscles of the anterior abdominal wall)	This technique is well suited not only for treatment, but also for preventive purposes. Parents with simple light movements carry out such procedures with the child immediately after the wound has healed. But after 2 months it is better to entrust such a massage to a specialist, since it should not cause discomfort. There are several simple techniques for massage for newborns: every day the child needs to do 4-5 massage movements (from right to left) with the help of fingertips; you should cover the navel with your palm and turn it clockwise under light pressure; "Call" technique: done using thumb, which is placed on the navel and vibration movements are imitated; palms are placed on opposite sides of the navel, without breaking away from the tummy, gently moving them in opposite directions.
Plaster, bandage	Independent use is not recommended. Only by appointment of a pediatrician. The essence of this application is the fixation of the abdominal muscles with a plaster or bandage for newborns. As a rule, a course of 10 days is enough for the baby's umbilical ring to close successfully. You can buy a patch or bandage for newborns at any pharmacy.
General massage and exercise therapy	These procedures are carried out by masseurs and doctors of narrow specialization. General massage helps to strengthen the child's muscle corset, special exercises train the abdominal muscles.

It should be remembered that the last two methods can only be applied after the wound has completely healed.

How to properly massage with an umbilical hernia in a baby will show you a video.

Anton Moiseevich Lieberman, pediatrician, Haifa, Israel

It often happens that the disease disappears in a child up to 3 years. However, the task of parents is to help in a speedy recovery.

First of all, do not forget to lay a child who has signs of an umbilical hernia on his tummy on a hard surface.

one more in an efficient way treatment is massage - in the first weeks of the newborn, the tummy itself, and later general therapeutic massage.

Folk methods of treatment

ethnoscience has no scientific explanation, which shifts all responsibility for the consequences to the parents

Few people believe it, but sometimes diseases can be cured. unconventional method- a conspiracy.

But as additional information Let's take a look at this method.

An umbilical hernia plot in newborns is considered an old and “proven” way, especially in rural areas.

The only question is to choose a good grandmother. She whispers various prayers, rolls out an egg and thus your child is distracted, does not cry.

After that, the child no longer cries for no reason and does not strain, and there is no pressure in the abdominal wall. The defect goes away on its own.

If this technique does not satisfy the parents, then you can turn to traditional medicine.

The issue of umbilical hernia in newborns Komarovsky discussed in detail more than once in his speeches. He explains in detail that umbilical ring weakness may be present in almost all newborns. And it takes time to fully heal. It is very important at this time to establish proper diet for the baby and his mother, to engage in massage procedures and active gymnastics.

Difference between an umbilical hernia and an enlarged umbilical ring

Often confused concepts should be distinguished: umbilical hernia"and" hypotonicity of the umbilical ring", or expansion of the umbilical ring.

Photo 1 shows a classic hernia in an adult. This is a muscle protrusion that can form for several reasons, including:

• severe illness that violated tissue turgor and muscle tone;
• weakness and insufficient density of the abdominal fascia;
• overlapping of the umbilical ring with the abdominal fascia and so on.

A hernia creates discomfort and provokes risks to human health, it can only be cured by surgery.

In everyday practice, the expansion of the umbilical ring in infants is also called a hernia for simplicity (photo 2). Although in fact it occurs for other reasons - usually due to prematurity or due to the fact that when the umbilical cord has already fallen off, the umbilical ring closes more slowly than necessary. Unlike a true hernia, such a bulge is treated without surgery - bandages, exercise therapy massages, and special exercises are used for this. The baby should also be laid out on a flat, hard surface in accordance with the recommendations of the doctor.

How dangerous is an "umbilical hernia" in newborns?

The most important thing for parents is not to remain in the dark and not to exaggerate the extent of the problem. So-called hernia in newborns appears not so rarely, while it is found in girls more often than in boys. At risk are babies born prematurely, as well as those whose birth weight was less than three kilograms.

If a child has expansion of the umbilical ring This is no reason to panic! And even more so, this does not mean that an operation will definitely be required. In the overwhelming majority of cases, it is enough to use the reliable and effective Rupfix umbilical plates from Arilis, which have already helped many children get rid of the so-called hernia, as well as follow other doctor's recommendations.

Myths about umbilical hernia in newborns

Despite the development of medicine and the educational work of doctors, many parents are still dominated by myths and prejudices. So, some are sure that an increase in intra-abdominal pressure is supposedly capable of provoking a hernia in a child, and therefore they call coughing, screaming, crying, vomiting and bloating dangerous phenomena.

All this has nothing to do with reality. In fact, the expansion of the umbilical ring can appear only with an anatomical predisposition or with violations of the development of the abdominal fascia, which is usually diagnosed already in the first weeks after the birth of a child. These reasons, in turn, are not related to the factors that provoke a true umbilical hernia (severe illnesses, and so on).

As for screaming and crying, they are just a consequence, not a cause. With the development of hypotonicity of the umbilical ring, the baby experiences severe discomfort, which prompts him to cry. To eliminate such a problem, it is necessary to deal with it under the guidance and supervision of a pediatrician or perinatologist.

How and when is the expansion of the umbilical ring in children detected?

The umbilical ring is the anatomically weak point of any child. In some children, the muscles close quickly enough, in others this does not happen, resulting in a slight protrusion in the navel area. It is clearly visible to the naked eye, moreover, the child in this case will rarely feel good. Fortunately, getting rid of such a problem is quite easy.

discover expansion of the umbilical ring in a child, during a visual examination, parents or a doctor can. Usually, any violations are detected in the first weeks or months after the birth of the child. Quite rare, but still there are cases when a problem is detected in a baby already at the age of a year or even a year and a half. The resulting protrusion is difficult not to notice, especially when the child is sitting or standing, when he cries or for other reasons strains his stomach.

It should be remembered that at an early age, a protrusion in the navel is not a hernia: it is temporarily reduced, you just need to lightly press your fingers. But if suddenly a muscular bulge develops in a child aged three or more years, which was not there before, this is most likely the beginning of the development of a true umbilical hernia. The reasons for her may be different, and they differ from those that provoke the convex shape of the navel in newborns. An older child should definitely be shown to a doctor - most likely, he will confirm a true umbilical hernia, and surgical intervention will be required.

Do I need to see a doctor?

Yes, you should definitely consult a specialist! The baby's parents are not professional doctors, and they cannot make an accurate diagnosis. Only a pediatric surgeon can do this. It will be enough for parents to report that they have found a protrusion similar to a hernia in the child. Possible additional symptoms- fever, discoloration of the skin, stool disorders.

In any case, it is impossible to delay the appeal to the doctor! The sooner you report a problem, the easier it will be to eliminate it, avoiding risks and complications. According to statistics, about two thirds of cases are eliminated exclusively conservative ways i.e. without surgery. Excising a hernia and doing plastic surgery is strictly necessary only in severe cases, as well as at the age of five years. But regardless of age, diagnosis is needed.

Can the situation return to normal without treatment?

In some children, the deviation in the development of the umbilical ring from the norm is less than seven millimeters, while the protrusion is very small or completely invisible. In this case, the doctor diagnoses "expansion of the umbilical ring." Sometimes it goes away on its own - that's what the parents of children hoped for when medicine was not yet developed.

But today there are ways to solve the problem with guarantee, and you should not neglect them:

• The child should be regularly shown to the doctor.
• will fix the problem muscles and painlessly, gradually return them to their normal position. Due to the absence of allergenic properties, the plates can be worn for a very long time.
• A therapeutic massage is prescribed, which can be performed both in clinical and at home conditions.
• Special gymnastic exercises for newborns, regular laying baby on stomach on a hard surface additional measures to get rid of the hypotonicity of the umbilical ring.
• With an integrated approach, you can count on quick deliverance from the problem. Wearing will play a key role, as they will have a positive impact constantly.

Arilis has a good reputation among parents. According to many reviews, in just ten to twenty first days, you can see significant improvements. Rupfix plates do not cause discomfort, do not cause allergies, while holding very well and significantly exceed any medical bandages in terms of their characteristics. Thanks to the use of such plates, it is possible to significantly speed up the process of getting rid of the so-called umbilical hernia in a newborn.

P umbilical hernia is a fairly common pathology in modern children. Such a hernia is formed as a result of a defect in the development of the anterior abdominal wall, which is due to the anatomical features of this area. An umbilical hernia is manifested by a protrusion of a round or oval shape of different sizes. AT calm state and in the prone position, the hernial protrusion is easily reduced into the abdominal cavity, and in its place the umbilical ring is well palpable.

A large umbilical hernia in a newborn may be frightening for parents, who believe that the hernia causes pain to the child, and also causes upset stools, poor appetite, but in fact, the sensations of the child depend on the shape of the hernia, and not on its size. With a wide umbilical ring, a hernial protrusion appears at the slightest concern of the child and disappears just as quickly and easily when the child calms down. in this case, the contents of the hernia are not injured and do not cause pain. But with a small opening of the umbilical ring, with dense edges and a strong protrusion of the hernia, there is every reason to assume pain in the child, causing him concern. An umbilical hernia in children comes in different sizes. Often, only fatty tissue protrudes, which is usually painless. In cases where the child experiences pain, the membrane covering the internal organs, the peritoneum, is involved in the hernial sac.Of course, for the timely detection and treatment of umbilical hernias of all types, the child should be regularly examined by a surgeon.

How to treat an umbilical hernia in children?

Treatment of an umbilical hernia depends on its shape and the age of the child. In the vast majority of cases, it goes away by itself by 3-5 years. But at an older age, the umbilical ring does not close on its own and, accordingly, the hernia cannot disappear. In this case, the child undergoes an operation - plastic closure of the umbilical ring in a surgical hospital under general anesthesia.

But as long as the doctor does not insist on an operation to remove the umbilical hernia, the hernia can be treated conservatively at home, this is quite within the power of the parents. Self-closing of the umbilical ring is well promoted by massage for umbilical hernia and gymnastics, aimed at developing and strengthening the abdominal press. It is necessary to start such treatment already from the age of one month, laying the children on their stomach for 3-5 minutes up to 10 times a day. Next, lay the baby on the tummy less often, but for a longer time. In this position, children strain their back muscles, trying to raise their heads, make movements with their arms and legs, which helps to strengthen the overall tone and develop muscles, including the abdominals.

The following exercise develops the abdominal muscles well: for a child lying on his back, the legs are simultaneously bent at the knees, moved to the stomach, and then straightened, causing active resistance.

Removal of an umbilical hernia in a baby

If a doctor has diagnosed a hernia in your child, then you should remember that sometimes it can be infringed. This is very dangerous complication! When an umbilical hernia is infringed, part of the intestine bends and gets stuck in the umbilical ring, and blood vessels that feed the intestine are squeezed. there is a danger of bleeding and obstruction of this part of the intestine, which can cause vomiting and abdominal cramps. The infant becomes very restless and the hernia becomes hard and very painful. In this case, an urgent surgical operation is needed to remove the umbilical hernia.

MASSOTHERAPY

To prevent hernia and eliminate small hernias, you can use the following massage:

■ It is easy to massage the baby's tummy with circular movements of the palm in a clockwise direction.

■ Apply your thumb to the navel and carry out vibrating movements, as if pressing a bell.

■ Cover the navel area with your palm and, pressing lightly, turn your palm clockwise.

■ Place the palms on both sides of the navel and begin to move the left palm down first, and the right palm up, then change the direction of movement of the hands.

■ Press with two fingers folded together in a circle from the umbilical ring.