Umbililcal Hernia
------------------
Normal closure"
-Closure of the umbilical ring is complete in almost all children by five years of age, but may be slower in black children.
Although closure is complete in almost all children by five years of age, closure can continue in older children as manifested by lower rates of umbilical hernia 
-The fascial defect not the degree of protrusion is most indicative of whether spont closure will occur

Associated conditions:
-Beckwidth-Wiedemann
-Ehlers Danlos
-Down
-Mucoplysaccharidoses
-Hypothyroidism
-T18

Management:
-most asymptomatic umb hernias can be observed

INDICATION FOR REFERRAL:
-incarcerated bowel = emergency
-Large proboscoid hernias
-no change or decrease in size over 1st 2 years of life
-symptomatic/painful
-or causing behavioral problems