Usually, no treatment is needed unless the hernia continues past age 3 or 4. In very rare cases, bowel or other tissue can bulge out and lose its blood supply (become strangulated). This is an emergency needing surgery.
Most umbilical hernias get better without treatment by the time the child is 3 - 4 years old. Those that do not close may need surgery. Umbilical hernias are usually painless.
Strangulation of bowel tissue is rare but serious, and needs immediate surgery.
Call your health care provider, or go to the emergency room if the infant has abdominal pain, or if the hernia becomes tender, swollen, or discolored -- especially if the baby also has signs of peritonitis or shock.