Irregular Belly Button: What Changes in the Navel Mean

Normal belly button variations

The belly button (umbilicus) is the scar left where the umbilical cord attached. Its shape depends on how the cord stump healed and the fat and muscle around it, not on how the cord was cut. Most people have an "innie". About 1 in 10 have an "outie", which is just extra scar tissue and is not a problem by itself. Belly buttons also stretch and change shape with pregnancy, weight gain or loss, abdominal surgery and aging.

Causes of an irregular belly button

Umbilical hernia

An umbilical hernia is a soft bulge at the navel where fat or bowel pushes through a weak spot in the abdominal wall. It gets bigger with coughing, crying, straining or standing and can usually be pushed back in.

• In babies: very common, especially in premature babies. Most close by themselves by age 4 to 5.
• In adults: caused by pregnancy, obesity, heavy lifting, chronic cough, fluid in the belly, or previous surgery. Adult hernias do not close on their own and can enlarge.

Diastasis recti

Diastasis recti is a separation of the two long abdominal muscles, common after pregnancy. It causes a ridge or doming down the middle of the belly when sitting up, and can make the navel look stretched or flattened.

Infection

Moisture, sweat, lint and skin folds make the navel a good place for bacteria and yeast. Infection causes redness, itching, odor, swelling and discharge. Piercings are another common source of infection. In newborns, infection of the cord stump is called omphalitis and needs prompt treatment.

Umbilical granuloma

In babies, a small, moist, pink or red lump can form in the navel after the cord falls off. It may leak a little clear or yellow fluid. A doctor can treat it with silver nitrate or salt, and it usually resolves quickly.

Cysts and skin growths

Epidermoid cysts, skin tags, pyogenic granulomas (bleeding red lumps) and moles can form in the navel. An omphalolith (navel stone) is a hard, dark plug of compacted skin oil and debris that can form in deep navels.

Rare causes

• Urachal remnants: the urachus is a channel between the bladder and navel before birth. If it does not close, it can cause a cyst, infection, or leakage of urine from the navel.
• Omphalomesenteric duct remnant: a channel to the bowel that can leak stool-like fluid.
• Endometriosis: a nodule in the navel that swells, hurts or bleeds with periods, sometimes after surgery. See endometriosis.
• Sister Mary Joseph nodule: a firm, sometimes painful nodule in the navel caused by the spread of an abdominal or pelvic cancer. It is rare but important to rule out in a new hard lump.
• Fluid in the belly (ascites): from liver disease, can push the navel outward.

How doctors find the cause

A clinician will look at the navel, feel for a gap in the muscle, and ask you to cough or strain to see if a bulge appears. They will check for redness, discharge and tenderness. A swab can identify infection. Ultrasound confirms a hernia or cyst, and a CT scan may be used for complex hernias, urachal problems or suspected tumors. A biopsy is needed for a suspicious lump.

Treatment

• Umbilical hernia in babies: usually watchful waiting. Surgery is offered if it is still present at age 4 to 5, very large, or causes symptoms. Taping coins over it does not help.
• Umbilical hernia in adults: surgical repair, often with mesh, is recommended for hernias that are painful or growing. Small painless hernias can be watched. Emergency surgery for a trapped (incarcerated or strangulated) hernia.
• Infection: keep the area clean and dry. Antifungal or antibiotic cream, or antibiotics by mouth for more severe infections. Remove an infected piercing only on advice.
• Granuloma: silver nitrate applied by a clinician.
• Diastasis recti: targeted core physical therapy. Surgery is rarely needed.
• Urachal remnants and endometriosis: surgical removal.

Belly button care

Clean the navel gently with mild soap and water when you shower, then dry it thoroughly. Avoid creams and lotions inside a deep navel. For a newborn, keep the cord stump clean and dry and fold the diaper below it until it falls off, usually within 1 to 3 weeks.

Frequently asked questions

Why is my belly button sticking out all of a sudden?

A belly button that starts to pop out is most often an umbilical hernia, from pregnancy, weight gain, straining or coughing. It may also be pushed out by fluid in the abdomen. If the bulge is hard, painful or discolored and does not go back in, get emergency care.

Is an outie belly button a hernia?

Usually not. Most outies are simply extra scar tissue from how the cord healed. A hernia is a soft bulge that gets bigger when you cough, cry or strain and can often be pushed back in. A doctor can tell the difference with a quick examination.

Why is my belly button leaking fluid?

The most common cause is infection, especially in deep navels or piercings. In babies, a granuloma can leak clear or yellow fluid. Rarely, clear urine-like fluid comes from a urachal remnant, or stool-like fluid from a bowel connection. Any leakage with redness or fever should be checked.

Can an umbilical hernia go away on its own?

In babies and young children, most umbilical hernias close by themselves by age 4 to 5. In adults they do not close on their own and may slowly grow. Painful or enlarging hernias in adults are usually repaired with surgery.