Babies born with omphalocele need treatment to put their organs into their bellies. Because they need a special level of care, it’s best for these babies to be born at a hospital that has a neonatal intensive care unit (NICU). After they are born, they can be transferred to Seattle Children’s Level IV NICU, where they'll receive the highest level of care after treatment. Seattle Children’s is the first hospital in Washington to have a Level IV NICU.
Omphalocele Treatment Options
Omphalocele treatment consists of two main options:
- Reducing the organs
- Paint and wait
Which treatment your child needs depends on the size of the bulge of organs outside the belly button.
Reducing the organs
If the bulge of organs is small- to medium-sized, surgeons may be able to treat the omphalocele right away. They push the organs through the hole and into your child's belly. This is called reducing the organs. When the organs have been moved, the surgeon sews the hole closed.
Paint and wait
If the bulge of organs is large, there may not be room inside your baby’s small body for all the organs right away. In these cases, doctors use a technique called “paint and wait.” The sac covering the omphalocele is “painted” with an antibiotic cream. Over time, your baby's skin grows over the sac. This may take several months.
When the baby is stable, breathing well and eating without problems, doctors wrap the sac with an elastic bandage, like the ACE bandages you can buy at a drug store. The elastic of the bandage slowly pushes the bulge back into your child's belly.
In many cases, babies do not need to be in the hospital for paint and wait treatment. Our nursing staff will teach you how to use the bandage and care for your baby. When all of the contents of the sac are pushed into your child's belly, the surgeon will talk with you about an operation to close the remaining hole.
It may take six to nine months for the elastic bandage to push the bulge into your child's belly. This may seem like a long time. But paint and wait is very successful in children with large omphaloceles. It has greatly reduced the number of problems babies used to have when surgeons tried to push all the contents of a large bulge back into the belly right away.
If your baby's lungs are small, the paint and wait technique may be the best way to treat the omphalocele at first. As your baby grows, the lungs and belly get larger. This makes more room inside for organs. Breathing should no longer be a problem.
After Surgery for Omphalocele
Your baby may need an IV (intravenous) line. This is a tube that goes into a vein to give your baby fluids.
After surgery, a few babies can have breast milk or formula right away. Most babies need to get nutrition other ways. They may be fed through a tube that goes into a large vein (PICC line or central line) or through a feeding tube that passes through the nose or mouth into the stomach (nasogastric tube, NG tube, or orogastric tube, OG tube). This continues until your baby is able to get all nutrition by mouth. We give your baby pain medicine as needed to make them comfortable.
As your baby’s health improves, they move from the NICU to a regular hospital room, and eventually to home. The size and severity of omphalocele can vary widely. So can the length of the hospital stay. Some babies may need to be in the hospital for a week while others stay for several months. At the least, your baby will need to be in the hospital:
- Until all the organs are moved into the belly and the hole is closed
- If your baby has the paint and wait technique, until you have learned what you need to do to care for your baby at home
With either treatment, your baby must be able to get adequate nutrition before you take them home. Your baby's healthcare team will be able to give you a better idea how long it will be before your baby can go home.