Hernia in Special Cases (Pregnancy, Children, Elderly)

Hernias can affect people of all ages. Care differs for pregnancy, children and older adults.

Pregnancy

Pregnancy stretches the abdominal wall and can cause or enlarge umbilical, incisional and groin hernias. Most do not need surgery during pregnancy and are repaired after delivery. Avoid heavy lifting, treat constipation and tell your doctor. Hiatal hernia and reflux are common in pregnancy and are treated with diet and safe medicines. Seek urgent care for a hard, painful, non-reducible bulge, vomiting or fever.

Babies and children

• Umbilical hernias are common in infants. Most close by themselves by age 4 to 5, and surgery is considered if they persist or are large.
• Inguinal hernias in infants and children do not close by themselves and need surgery. Premature babies are at higher risk, and the risk of trapping is greater in young babies, so a surgeon should see them soon.
• Do not tape, bind or apply a coin or home remedy to a baby's belly.
• Call 112 or 102 or go to hospital if a baby has a firm, tender bulge, repeated vomiting, a swollen belly or is inconsolable.

Older adults

Hernias are common and tend to enlarge. Femoral and incisional hernias are more likely to become trapped. Repair is usually safe with good planning, even in older adults, and the surgeon will weigh other health problems, medicines such as blood thinners and anaesthesia risks. If surgery is not suitable, a watchful approach with clear emergency instructions may be used.

People on blood thinners or with long-term illness

Tell the surgeon about all medicines before surgery.

Key point

Whatever the age, a firm, painful, non-reducible hernia is an emergency.

Before your appointment

Note when you first noticed the bulge, whether it goes in when you lie down, and what brings it on, such as lifting, coughing or straining. List any pain, vomiting, constipation or urinary problems, and past surgeries. Bring your medicines, including blood thinners, and past reports. Ask about repair options, recovery and the warning signs that mean you should call 112 or 102.