Innies Vs. "Outies"

Many times, parents ask the question: "what is the difference between an "outie" and an "innie" belly button?" We went straight to the expert to find the answer. Dr. Trey Eubanks, chief of Surgery and medical director of Trauma Services for Le Bonheur Children's Hospital, gives our readers the real truth about belly buttons. Here's what Dr. Eubanks had to say:

Parents often ask if their child's belly button's appearance, otherwise an "innie" or an "outie," is determined by the method of which their obstetrician cuts and ties the cord. The umbilicus, or belly button, is actually not formed by the obstetrician. The obstetrician does cut the umbilical cord at birth, but that's it. What happens next is what sets up the appearance of the umbilical cord for life. The remaining umbilical cord, after having been cut, has no blood supply to keep it alive, so it dies and subsequently falls off the infant. Cleaning of the site is all that is needed for the umbilical cord insertion site to heal and form the umbilicus.

The difference between an "innie" and an "outie" belly button has nothing to do with management of the umbilical cord at birth. Most people who have an "outie" fall into one of two categories: either they were born with a tiny umbilical hernia, which is most likely, or had a small infection at the base of the umbilical cord that went unnoticed. This will cause unusual tissue called granulation tissue to form. Later in life, this looks like a knot or polyp of skin protruding from the base of the umbilicus.

The only concern with an "outie" belly button is if it is caused by an umbilical hernia. If so, there is a small risk of incarceration, which is when abdominal contents get stuck in the hernia sac, potentially causing a surgical emergency. However, most umbilical hernias are no more than just a nuisance.

Parents ask me many times if "outies" can be fixed. The answer is yes, and the decision to fix one should be based on the presence and size of the umbilical hernia. If a child is born with an "outie" belly button, there is a 90 percent chance that it will close on its own by the time the child turns 5 years old. However, if the defect is not closed by age 5, the chances are much less that it will ever close completely. Of course, as a child grows into adulthood, the "outie" can and usually does become less noticeable.