Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
Inguinal Hernia in a Premature Infant | | | QUESTION | | | Dear Dr. Needlman,
My baby is six weeks old and has developed a hernia in his left testicle from straining and crying (as my pediatrician explained). He was born premature at 34 weeks, and I keep hearing people say that premature infants are going to have lots of problems because they were born before their due date. Is this hernia one of these problems and how can it be treated in a newborn?— Premiebaby | | | ANSWER |
February 6, 2002 | | | Dear Premiebaby,
Inguinal hernias are very common in premature infants. In all male fetuses, during development, there is an opening that connects the abdominal cavity (which contains intestines and other organs) to the scrotum. Normally, this opening closes before birth. Premature infants (and even some full-term ones) may be born before this opening fully closes. When that happens, a small loop of intestine can slip through the opening and end up in the scrotum, where it is felt as a mass or lump.
As long as the bit of intestine can slide freely in and out of the scrotum, there is no problem. But, if the intestine swells up or the opening narrows, the intestine can get trapped (the medical term is incarcerated). When this happens, the blood vessels that run to the intestine can become pinched off. In the worst cases, the intestine can become blocked or the trapped part can die.
So, an inguinal hernia doesn't cause any problems unless it gets trapped, which is then a medical emergency. To be safe, most doctors recommend having inguinal hernias fixed as soon as possible. Surgery is the only way to fix a hernia. Luckily, the operation is a simple one that surgeons do all the time. Most babies handle these operations very well. They don't seem to have a lot of pain. Within a day or so, they usually look as though nothing had happened (except for the presence of a very small surgical incision). The incision from a hernia repair usually heals to leave only a tiny scar that is barely visible.
In general, I think you can feel quite optimistic about your baby. Most infants who are born at 34 weeks of age do really well. They may have minor problems, just like any other child, but it is not likely that your child will have "lots of problems" simply because he was born premature. Children who are born much earlier--at about 24 to 30 weeks--are indeed likely to have more--and more serious--problems. But even these extremely small premature infants often do well, although some need special educational interventions or other special assistance.— by Robert Needlman, M.D., F.A.A.P. |
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