Inguinal Hernia in Babies and Children: Symptoms, Causes, and Surgical Repair
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is an inguinal hernia in a baby?
An inguinal hernia in a baby is a bulge in the groin or scrotum caused by part of the intestine pushing through an inguinal canal that did not close fully before birth. It is treated with surgery, typically an outpatient procedure lasting less than an hour, in which the surgeon pushes the contents back and closes the opening. [1]
What the research says
Waiting can carry a real risk that the hernia gets stuck. A systematic review of 22 studies with 14,959 children who waited for elective repair found a crude incarceration rate of 7% for all children and 11% for preterm children, with testicular atrophy and recurrence each at about 1%. The authors did not support delaying surgery unnecessarily (Olesen et al., Hernia, 2019 [2]).
Shorter waits were linked to fewer stuck hernias in young infants. Among 1,065 children under 2 years old who had hernia repair in Ontario, the overall incarceration rate was 11.9%, and infants under 1 year who waited more than 14 days had about twice the risk of incarceration (odds ratio 1.92) (Zamakhshary et al., CMAJ, 2008 [3]).
Newer data suggest serious problems while waiting may be less common than once believed. Among 33,530 infants diagnosed with an inguinal hernia in a US national database, 15% of those discharged without repair had an unplanned readmission within a year, but only 2% of preterm and 1% of full-term infants had a hernia repair during those readmissions, and none had procedures suggestive of a strangulated hernia (Ferrantella et al., Surgery, 2021 [4]).
These studies reached different conclusions about waiting, so the right timing for your child is a decision to make with their surgeon.
Key Takeaways
Feature | Details |
|---|---|
Primary Symptom | A bulge in the groin or scrotum that may come and go and often gets larger with crying, coughing, or straining. |
Main Cause | The inguinal canal does not close fully before birth. |
Primary Treatment | Surgical repair of the hernia. |
Who Is Affected | About 90% of newborn inguinal hernias are in boys, and they are more common in premature infants. |
How Common | 1% to 5% of healthy full-term baby boys and up to 30% of premature babies. |
Recovery Time | Most children return to normal activities within one to two weeks. |
Understanding Inguinal Hernias in Infants
An inguinal hernia occurs when part of a child's intestine pushes through an opening in the abdominal wall through the inguinal canal. The inguinal canal is a passage that extends from the baby's abdomen to the genitals. It is supposed to close before birth, but sometimes it does not close all the way. This leaves a hole for the intestine to slide through, and you can see and feel an abnormal bulge or mass in the groin or scrotum [1].
Inguinal hernias can affect infants, toddlers, children, and adults, but in children they are most common under 6 years old. About 90% of inguinal hernias in newborns are in boys. They usually develop on one side of the groin, more often on the right than the left, and about 10% of the time they develop on both sides [1].
Symptoms and Warning Signs
The main symptom is a bulge you can see under the skin in the groin or scrotum. It may get larger after your child has been crying or straining, and it may come and go. It may get smaller or go away when your child is relaxed or asleep [1].
When the Bulge Is Most Visible
Crying or Coughing: These raise pressure in the abdomen and can make the bulge larger.
Straining: Straining can make the bulge more noticeable.
Relaxation or Sleep: The bulge may get smaller or go away. [1]
Other Symptoms
Symptom | Description |
|---|---|
Visible Bulge | A lump in the groin or scrotum, on one or both sides, that may come and go. |
Pain or Discomfort | Discomfort that improves with rest. |
Heaviness or Pressure | A feeling of heaviness or pressure in the groin. |
Swollen Scrotum | The scrotum may look swollen. |
Burning | A burning feeling at the site of the bulge. |
Crankiness and Feeding Problems | In infants, crankiness and difficulty feeding. |
Emergency Warning Signs
An incarcerated or strangulated hernia is a medical emergency. Get medical care for your child right away if they develop any of the following [1]:
Severe pain or tenderness.
Redness and bruising around the site of the bulge.
No appetite.
Fever.
Nausea and vomiting.
Bloody poop (stool).
Causes and Risk Factors
All babies are born with an inguinal canal. In a baby boy, the testicles form inside the abdomen and then move through the inguinal canal into the scrotum. Normally the canal closes before birth. When it does not close all the way, it leaves an opening from the belly into the canal, and the intestines can slide through. Inguinal hernias are rare in baby girls, but they can happen, and in girls the hernia may contain part of the reproductive system, such as an ovary [1].
Who Is at Higher Risk?
Premature Infants: Inguinal hernias are more common in premature babies, and up to 30% of premature babies are born with one. [1]
Boys: About 90% of inguinal hernias in newborns are in baby boys, and they occur in 1% to 5% of healthy full-term baby boys. [1]
Young Children: In children, inguinal hernias are most common in those under 6 years old. [1]
If a baby is born with an opening in the inguinal canal, a hernia can develop at any time, and there is no way to prevent it [1].
Potential Complications
Rare but serious complications can develop if an inguinal hernia is not treated [1]:
Incarcerated Hernia: The contents of the hernia get stuck, and a healthcare provider cannot push the hernia back into the abdomen. [1]
Strangulated Hernia: When a hernia gets stuck, the blood supply to the intestine can be cut off. Lack of blood flow can cause tissue death. This is a very serious and painful medical emergency. [1]
Diagnosis and Clinical Evaluation
A healthcare provider can usually diagnose an inguinal hernia with a physical exam. They look for a bulge in the groin or scrotum while your child is crying or straining and check whether it goes away when your child is relaxed. If your child is old enough, they may ask them to stand or cough, and they may try to gently massage the hernia back into place. Rarely, an ultrasound is ordered to confirm the diagnosis [1].
Treatment and Surgical Repair
Your child will need surgery to fix an inguinal hernia. The surgery usually takes less than an hour and is typically an outpatient procedure, which means your child can go home the same day [1].
The Surgical Procedure
Anesthesia: An anesthesiologist gives your child general anesthesia, which relaxes their muscles and puts them to sleep. Your child will not feel pain during the surgery.
Repair: The surgeon makes a small cut in the skin of the groin, pushes the contents of the hernia back into the abdomen, and closes the opening in the inguinal canal to prevent another hernia.
Closure: Small strips of tape cover and close the incisions. [1]
Post-Operative Care and Recovery
Going home: Your child should be able to go home a few hours after surgery. If your child was premature or has certain medical conditions, they may need to spend the night for observation.
Follow-up: A follow-up appointment is usually scheduled for seven to 10 days after surgery to check the incision and recovery.
Pain: Mild pain or discomfort should lessen within one to two weeks. Your provider may prescribe pain medication.
Bathing: You can give a sponge bath the day after surgery, but do not bathe your child in a bathtub for two to three days.
Tape strips: The small pieces of tape should fall off on their own. Do not pull them off yourself.
Activity: Your child can resume normal eating as soon as they are able and should be back to other normal activities within one to two weeks. [1]
When to Call Your Provider After Surgery
Minor swelling around the incision is normal and can last a few weeks. Call your child's healthcare provider if your child [1]:
Is unable to pee, or has fewer wet diapers than usual.
Has a fever above 100.4°F (38°C).
Has excessive swelling, redness, or bleeding at the incision site.
Has increasing pain or vomiting.
Hernia, Hydrocele, or Umbilical Hernia?
A hydrocele is a sac filled with fluid in the groin or scrotum. It can look like an inguinal hernia, but there is no tissue inside the sac. About 10% of baby boys have a hydrocele when they are born, and it does not need surgery right away unless it is painful. An umbilical hernia happens near the belly button and sometimes goes away on its own, while an inguinal hernia happens near the groin and usually needs surgery [1].
Conclusion
Inguinal hernias are common in babies and children, especially in premature infants and boys. The prospect of surgery can be worrying, but the operation is quick, usually outpatient, and most children feel better within days to weeks. If you notice a bulge near your baby's groin, take them to a healthcare provider right away, and get emergency care if you see any of the warning signs.
Frequently Asked Questions
What is an inguinal hernia?
A bulge that happens when part of the intestine pushes through an opening in the abdominal wall at the groin.
Is it the same as an umbilical hernia?
No. An umbilical hernia happens near the belly button and sometimes goes away on its own. An inguinal hernia happens in the groin and usually needs surgery.
Can girls get inguinal hernias?
Yes, but it is rare. In girls, the hernia may contain part of the reproductive system, such as an ovary.
Is surgery always necessary?
Surgery is the recommended treatment for an inguinal hernia in a child. Some studies suggest that waiting can be reasonable in selected cases, but the timing should be decided together with your child's surgeon.
How long does the surgery take?
Usually less than an hour.
Will my child stay overnight in the hospital?
Usually not. The surgery is typically outpatient, so your child can go home a few hours later. A premature baby or a child with certain medical conditions may stay overnight for observation.
What are the signs of a strangulated hernia?
Severe pain or tenderness, redness and bruising around the bulge, no appetite, fever, nausea and vomiting, and bloody stool. This is a medical emergency.
Can a hernia come back after surgery?
The surgeon closes the opening in the inguinal canal to prevent another hernia. In one systematic review of elective repairs, the recurrence rate was about 1%.
Is a hernia painful for a baby?
A hernia can cause discomfort, crankiness, and difficulty feeding. Some children have pain that improves with rest.
When can my baby resume normal activities?
Most children return to normal activities within one to two weeks, and can go back to normal eating as soon as they are able.
Are there non-surgical treatments?
No. Surgery is the treatment that closes the opening and fixes the hernia.
What causes the hernia?
The inguinal canal is supposed to close before birth, but sometimes it does not close all the way. This leaves an opening that the intestine can slide through.
Can crying cause a hernia?
No. The opening is present from birth. Crying, coughing, or straining can make the bulge larger and easier to see.
What is an incarcerated hernia?
A hernia whose contents are stuck, so a provider cannot push it back into the abdomen. It can lead to a strangulated hernia, which is an emergency.
How is it diagnosed?
Usually with a physical exam. The provider looks for a bulge in the groin or scrotum while your child is crying or straining, and checks whether it goes away when your child is relaxed.
Does my child need an ultrasound?
Rarely. An ultrasound is only used if the physical exam does not make the diagnosis clear.
Is general anesthesia safe for my baby?
An anesthesiologist gives the general anesthesia, which relaxes your child's muscles and puts them to sleep so they do not feel pain. Talk with the surgical team about any concerns, especially if your baby was premature.
Will there be a scar?
The surgeon makes a small cut in the skin of the groin and covers it with small strips of tape. Ask your surgeon what to expect as it heals.
What if the bulge disappears?
The bulge can come and go and may get smaller or disappear when your child is relaxed or asleep. It is still a hernia, so your child should be seen by a provider.
Can I push the hernia back in myself?
Ask your provider first. If your child has severe pain, redness or bruising, vomiting, fever, or bloody stool, get emergency care right away.
What happens if we wait for surgery?
Rare but serious complications, such as an incarcerated or strangulated hernia, can develop if a hernia is not treated. Studies differ on how likely this is while waiting: a systematic review found about 7% of children had incarceration (11% of preterm children), while a large US database study found serious complications to be rare. Ask your surgeon about timing.
What kind of doctor performs the surgery?
A surgeon. Your child's healthcare provider can refer you.
How do I care for the incision?
You can give a sponge bath the day after surgery, but do not bathe your child in a tub for two to three days. Follow your surgeon's instructions.
When will the surgical tape fall off?
The small strips of tape should fall off on their own. Do not pull them off yourself. If they do not fall off, your provider will remove them at the follow-up visit.
Can my child eat before surgery?
Follow the instructions from your child's surgical team about food and drink before anesthesia.
What pain relief is used after surgery?
Your child may have mild pain or discomfort that should lessen within one to two weeks. Your provider may prescribe pain medication.
Is there a risk of infection?
Call your provider if your child has a fever above 100.4°F (38°C), redness around the incision, bleeding, excessive swelling, or increasing pain.
Can a hernia occur on both sides?
Yes. About 10% of the time, inguinal hernias develop on both sides of the groin. They develop on the right side more often than the left.
Why are premature babies at higher risk?
Inguinal hernias are more common in premature infants, and up to 30% of premature babies are born with one.
How common are inguinal hernias in babies?
Inguinal hernias in babies occur in 1% to 5% of healthy, full-term baby boys, and about 90% of inguinal hernias in newborns are in boys.
What is the inguinal canal?
A tunnel-like passage that extends from a baby's abdomen to the genitals. It is supposed to close before birth.
Does a hernia cause fever?
Fever can be a sign of an incarcerated or strangulated hernia, which is a medical emergency.
Can a hernia cause vomiting?
Nausea and vomiting are warning signs of an incarcerated or strangulated hernia. Get medical care right away if your child has them along with other emergency symptoms.
Is a hernia a medical emergency?
A hernia that comes and goes is not usually an emergency, but an incarcerated or strangulated hernia is.
What should I do if the bulge turns red or bruised?
Redness and bruising around the bulge are emergency signs. Seek medical care for your child right away.
What is a hydrocele?
A sac filled with fluid in a baby's groin or scrotum that can look like a hernia. There is no tissue in a hydrocele sac. About 10% of baby boys have one at birth, and it does not need surgery right away unless it is painful.
When is the follow-up appointment?
Usually seven to 10 days after surgery, so the provider can check the incision and your child's recovery.
What is a reducible hernia?
A hernia whose contents can be pushed back into the abdomen. An incarcerated hernia cannot be pushed back.
Can an inguinal hernia be prevented?
No. If a baby is born with an opening in the inguinal canal, a hernia can develop at any time, and there is no way to prevent it.
Is some swelling after surgery normal?
Yes. Minor swelling around the incision is normal and can last a few weeks.
When should I call the provider after surgery?
Call if your child cannot pee, has fewer wet diapers than usual, has a fever above 100.4°F (38°C), or has excessive swelling, redness, bleeding, increasing pain, or vomiting.
What is the outlook?
Inguinal hernias are common in babies and children, and the surgery is quick. Most children feel better within days to weeks.
Related Reading
Inguinal Hernia: Symptoms, Causes, and When Surgery Is Needed explains groin hernias in adults and when repair is needed.
What Is a Communicating Hydrocele? Symptoms, Causes, Diagnosis, Treatment & Outlook describes a fluid-filled scrotal swelling closely related to inguinal hernias.
Undescended Testicle in Babies: Causes, Timing, and Treatment Explained (2026 Guide) explains another common groin condition found in baby boys.
Umbilical Hernia in Babies and Adults: When It Closes on Its Own and When Surgery Is Needed covers belly button hernias, another common hernia in children.
References
Cleveland Clinic. Inguinal Hernia in Babies. Cleveland Clinic. March 8, 2022. https://my.clevelandclinic.org/health/diseases/4337-inguinal-hernia-treatment-for-children
Olesen CS, Mortensen LQ, Öberg S, et al. Risk of incarceration in children with inguinal hernia: a systematic review. Hernia. 2019;23(2):245-254. PMID 30637615. https://doi.org/10.1007/s10029-019-01877-0
Zamakhshary M, To T, Guan J, et al. Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery. CMAJ. 2008;179(10):1001-1005. PMID 18981440. https://doi.org/10.1503/cmaj.070923
Ferrantella A, Sola JE, Parreco J, et al. Complications while awaiting elective inguinal hernia repair in infants: not as common as you thought. Surgery. 2021;169(6):1480-1485. PMID 33500157. https://doi.org/10.1016/j.surg.2020.12.016
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for diagnosis and treatment of any medical condition. The clinical information in this guide reflects source material last reviewed in March 2022.
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