A swelling in your child’s groin or a bulge at the belly button needs a careful assessment first. Dr. Pritesh Maheshwari, an AIIMS-trained pediatric surgeon in East Delhi, explains whether pediatric hernia surgery is needed and when.
If a swelling in the groin, scrotum or belly button becomes hard, painful, red or dark, or will not go back in, or your child is vomiting, has a swollen tummy or seems very unwell, go to the nearest hospital emergency department now. Do not try to push the swelling back in.
A hernia is gut, fat or fluid pushing through a gap in the tummy wall. In children, the gap is usually present from birth; crying and straining only make it easier to see.
A painless swelling that comes and goes still needs to be seen, especially in the groin.
This groin hernia is the type most often operated on in children. Before birth, a small passage (the processus vaginalis) runs from the tummy into the groin and normally closes. If it stays open, gut, or in girls, an ovary, can slip into it. An inguinal hernia rarely goes away on its own and can become stuck (incarcerated), so it is usually repaired. It is more common in boys and babies born early.
This is a soft bulge at the belly button, often more obvious when a baby cries. It is very common in infants, and most close by themselves as the tummy wall grows, many by four to five years of age. Getting stuck is rare. Do not tape a coin or tie a belt over the navel; this does not help and can irritate the skin.
A hydrocele (fluid around the testis), an undescended testis, swollen glands or a small hernia above the belly button can also cause a lump. Examination tells them apart. See our page on hydrocele surgery for children.
Dr. Maheshwari asks when the swelling appeared, whether it comes and goes, and about pain, vomiting, prematurity and other health conditions, then examines your child.
Most hernias are diagnosed by examination alone. Ultrasound is kept for cases where the diagnosis is unclear.
A hernia may not show in the clinic, so a photo of the swelling taken at home helps.
Observation with review dates, or surgery with a recommended timing, and the warning signs to watch for.
Repair is usually advised soon after diagnosis rather than months later, because the risk of the hernia getting stuck is highest in babies under one year. In a Canadian study of children under two, waiting longer than two weeks roughly doubled that risk.
A baby still in a neonatal unit needs a plan made with the neonatal and anaesthesia teams. Recent evidence, including a 2024 trial, supports repair after discharge home for many preterm babies, with close watch for warning signs meanwhile.
Most can be watched. Surgery is considered if the hernia persists at about four to five years of age, the gap is large and not shrinking, it causes pain, or it ever becomes stuck. The decision is made for each child.
Hernia operations in children are done under general anaesthesia, so your child is asleep throughout.
Herniotomy is the standard operation for a child’s inguinal hernia. Through a small cut in the groin skin crease, the surgeon finds the open passage (the hernial sac), returns any contents to the tummy and ties the sac off at its top. Unlike many adult repairs, no mesh is needed. Stitches are usually dissolvable.
In laparoscopic (keyhole) repair, a small camera through the navel lets the surgeon close the opening from inside and check the other side. A 2026 Cochrane review of 12 trials found similar recurrence rates for open and keyhole repair in children, with low-certainty evidence. Neither suits every child.
Through a small curved cut in the fold of the belly button, the surgeon closes the gap with stitches and preserves the belly button’s shape.
Your child has a pre-anaesthesia check, and the hospital gives fasting instructions. Many planned hernia operations are done as day care surgery, so most children go home the same day. Young babies, babies born early and children with other medical conditions may stay overnight.
Go to the nearest emergency department straight away for heavy bleeding, breathing difficulty or a child who is very hard to wake.
+91 76699 55995Every operation carries some risk. Dr. Maheshwari will discuss the risks that apply to your child.
A hernia repaired on one side may later appear on the other.
Dr. Pritesh Maheshwari is a pediatric surgeon trained at AIIMS New Delhi. He consults at Maheshwari Multispeciality Clinic for families across East Delhi and nearby NCR. Operations are performed at partner hospitals, not at the clinic.
A fair estimate needs an examination first.
Ask for a written estimate listing what is included and excluded, and check your health insurance cover.
If you have noticed a groin swelling or a bulge near your child’s belly button, book an assessment at our Delhi clinic to understand the cause and the right next step.
If you have noticed a groin swelling or a bulge near your child's belly button, book an assessment at our Delhi clinic to understand the cause and the right next step. If the swelling is painful, firm, discoloured, or comes with vomiting, go to the nearest emergency department instead.
