Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency medical care if your child has an umbilical hernia and:
The bulge suddenly becomes very painful, firm or tender
The bulge remains stuck outside and does not become smaller
The skin over it becomes red, purple, dark or unusually swollen
Your child has repeated vomiting or green vomit
Your child develops severe abdominal pain or a swollen abdomen
Your child seems very unwell, unusually sleepy or difficult to comfort
These symptoms can mean that intestine or other tissue is trapped.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Arrange a prompt medical assessment if the hernia starts causing milder pain, changes noticeably, develops skin damage or discharge, or you are unsure whether it is behaving as usual.
3
Does any of this apply?
Book an appointment
Routine follow-up is appropriate for a soft, painless bulge that appears with crying and becomes smaller when your child relaxes.
It is also reasonable to discuss the hernia at regular health visits, especially if it is not getting smaller as your child approaches age 4 to 5.
Every sign above is quoted from the sofidex article on Umbilical hernia in children. If you are not sure, err upward — it is always reasonable to be checked.