Common Medical Concerns in the First Few Months /

Umbilical hernias, granulomas etc

01 What Do I Need To Know?

UMBILICAL GRANULOMAS

  • The umbilical cord usually separates in the first 3 days to 2 months. In some infants, after separation an excess of granulation tissue (the tissue formed when healing) may persist at the base. The formation of this excess tissue is known as an umbilical granuloma and  is thought to result from low grade infection of the umbilical stump.
  • It appears as  fleshy red/pink tissue at the base of the umbilicus and some may protrude and  be associated with a yellow discharge.
  • Your doctor should assess it as other causes although uncommon, may be present.
  • Treatment is usually with silver nitrate sticks which should be applied with care to avoid chemical burns to the normal skin surrounding the umblicus.
  • Application of silver nitrate;
    • The skin around the umbilicus should be dried and cleaned of any discharge.
    • The surrounding skin should be protected with petroleum jelly.
    • The silver nitrate stick should be applied only to the granuloma and care should be taken not to burn the surrounding skin.
    • Apply three times a day until resolved.
  • Occasionally freezing the tissue or removal with a surgical ligature may be required.

UMBILICAL HERNIA

  • These are seen commonly in babies and result from delay in closure of the defect in the abdominal wall where the blood vessels enter the cord from beneath the liver. 
  • The defect then allows fat or the bowel to protrude into the skin overlying and causes a bulge.
  • They are not associated with pain and rarely ever cause any symptoms such as strangulation i.e. bowel becoming trapped and then causes a blockage. 
  • Most resolve by the age of 2-3 yrs.
  • Those that  persist and are unsightly may be closed surgically.

02 What Others Say

  • Children's Hospital at Westmead

Umbilical Hernia

  • Children's Hospital Boston

Hernia (umbilical or inguinal)

03 Clinicians Tools and Resources

  • Excellent reference and discusses differential diagnosis of umbilical granuloma

American Family Physican: Double-ligature treatment for pedunculated Umbilical Granulomas 2002 May 15:65(10): 2067-2069

 

The information published here has been reviewed by Flourish Paediatrics and represents the available published literature at the time of review.
The information is not intended to take the place of medical advice.
Please seek advice from a qualified healthcare professional.
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Last updated: 05/08/2011 by Dr Elizabeth Hallam*