At what age should I consider surgical intervention for an umbilical hernia in a child, and what are the referral criteria?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Surgical intervention for an umbilical hernia in a child is generally considered if the hernia persists beyond the age of 3 to 5 years, if it is large, symptomatic, or complicated (e.g., incarceration or strangulation).

Referral criteria include:

  • Hernias that do not close spontaneously by age 3 to 5 years.
  • Presence of symptoms such as pain, tenderness, or signs of incarceration (e.g., irreducibility, redness, or swelling).
  • Large defects that are unlikely to close on their own.
  • Any suspicion of complications requiring urgent surgical assessment.

Children with these features should be referred to paediatric surgery for specialist assessment and management.

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