Congenital diaphragmatic hernia is the condition where there is a presence of an abnormal opening in the diaphragm, the muscles that help in the breathing process. Children having this condition require regular checkups with an experienced pediatrician. Typically, hernia in children are congenital but can be cured.

In a child having a congenital diaphragmatic hernia, the contents of the stomach; spleen, liver and intestine go up into the chest leaving little room for the lungs to grow and develop.

Main cause of congenital diaphragmatic hernia is abnormal joining of structures during fetal development. Family history of the condition also increases the risk of the newborn getting the condition.

Symptoms

If the newborn has a congenital diaphragmatic hernia, it may find it difficult to breathe soon after birth. This happens due to the action of the diaphragm and crowding of the lung tissue. Some other symptoms that may point towards the presence of this condition are:

Bluish color of skin (Due to lack of oxygen)
Erratic heartbeat rate
Rapid breathing
The stomach appears to have sunk in
Sounds following each breath
Retractions of the skin during breathing

Diagnosis

In most cases, the presence of a congenital diaphragmatic hernia is determined during pregnancy. It will be diagnosed with the help of an ultrasound at around 18 weeks of pregnancy. The doctor may suggest other tests like MRI scan and some advanced ultrasounds, if required.

After birth on examining the infant, it may show the following sign:

An absence of breathing sounds in the side affected
Abdomen does not seem fuller
Abnormal chest movements
The presence of bowel sounds in the chest

In some cases, the neonatologist will suggest an X-ray of the chest of the baby to detect the presence of abdominal organs in the chest cavity.

Treatment

A baby having a congenital diaphragmatic hernia will require a surgery. The surgery involves placing the organs in their proper place and closing of the abnormal opening in the diaphragm. The child may need breathing support post-surgery until he/she recovers completely. The child may be placed on a heart or lung bypass machine to help the organs heal efficiently. The success ratio of the surgery depends upon how well the child's lungs develop.

If a diaphragmatic hernia is detected during early stages of pregnancy, a fetal surgery will be recommended.

Children having congenital diaphragmatic hernia may not cover their development milestones at the expected rate. Such babies may need additional therapy to help with feeding and enhancing muscle strength. Children affected by this condition often need the extra calories for proper growth and functioning. If the child has a chronic lung disease, a feeding tube might be required to feed the child and meet his nutritional needs. Children having the condition require regular checkups with the pediatrician.

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