From my experience in my country, Egypt for more than 34 years dealing with umbilical hernia, I can say that there is Umbilical hernia in Middle East, which differ completely from Westerns countries in many Aspects:

We had I higher incidence reach to about 15- 20 % of newborns.

We have many cases which not responding to conservative measures and not improving with time, may be due to high incidence of parasitic infestation and subsequent abd distension.

We have many variants of Umbilical hernia like probiscoid one.

So the management may be different and should be tailored accordingly.

In an ideal situation beyond 3-4 years  and before the 5th birthday

This is not so common in Western Societies, so I was surprised, when I dealt with one in clinic in the UK, that a colleague from Egypt told me that he treated lots of patients there, although he stated that the vast majority resolved spontaneously.  My understanding is that the majority resolve by 2 years.  If, as Dr Dhua has said, the protruaion persists beyond 3 years, then aesthetic correction could be considered and would probably be best carried out at about age 5 years, before starting school, or in the early stages of school life.  I have one patient, age 12, who is suffering significant verbal abuse at school, because of this problem.

In general, surgical repair with its benefits and risks should be balanced with the benefits and risks of the alternatives, and surgery chosen if it either has less risk or more benefit. If uncomplicated umbilical hernia --no connective tissue disease, no disoloration with threat of ischemia or rupture, no incarceration, no infection or local trauma, easily reducible - then waiting can be a less risky alternative with about an 80% chance of spontaneous closure in appropriate patients in the first few years of life.  

Until the age of 4-5 the hernia can close or become smaller with the use of the abdominal wall muscles. If the hernia is uncomplicated there is no hurry even if the excess skin is big. After 5 if it hasn't closed it will not so there is no point in postponing.

In our experience we indicate the surgical repair after 3 years, but in our country, Cuba, the most accepted surgical time is over 4 year.

Larger ones by 3 yrs and smaller ones after 5 yrs.

When the fascial ring is more than 2 cms in a boy  after 3 years and  after 5 years in a girl child, we advise surgery

Recent data from an article in NEJM suggests postponing repair until 3 years of age owing to the possible adverse developmental effects of anaesthesia below that age from data in animal experiments

Anesthetic Neurotoxicity — Clinical Implications of Animal Models ... N Engl J Med 2015; 372:796-797February 26, 2015DOI: 10.1056/NEJMp1414786 ... surgical procedures requiring anesthesia in children younger than 3 years of age .

Patients with hernia diameter size of 2.5 cm or more are operated earlier than 5 years, around 3 years of age. Smaller sizes are observe until 5 years.

We usually repair after four years of age and before such children  go to school.

I prefer to repair after 4 years, however if the fascial defect appears to decreased, waiting until 6 years of age is my common aproach. 

Hello I repair about 4 years old.

Never have a bad surprise .

4-5 years old, 

Beyond 2 years and before the 6th year of life. But in cases of mitigated laparoschisis this has to be modified.

If uncomplicated hernia, one can wait up to 5 years.

5 yers old

Me too 5 years old

Never before 1year as some close spontaneously. Increasingly it is anaesthetist driven with a preference from them to wait until 2 years for elective repair. The parents don't like the look of the hernia and repairing before school avoids teasing. So 2 years + for me.

After two years old for elective repair.

3 to 6 months is ideal..

After 2 years old. Majority of umbilical herniae will close by 2 years of age and if they don't means they need repair so thats the rationale.

This is an attending surgeon comfort zone issue. For all definitely before school age - 4-5 yrs. For fascial defect greater than 2cm by age 3yrs less likely to close spontaneously, earlier OR repair. My experience as senior surgical PA in pediatric surgery for 21 years only 4 cases of incarceration, one emergency operation in those because of underlying mucopolysaccharidosis exacerbating non reduction. As we do about 200 per year the occurrence is about 1/1,000.

 Sorry, I mistook it as inguinal hernia..

Waiting up to 4-5 yrs is recommended as mentioned by Dr Robert..

I do not do pediatric surgery but sometimes I am asked about this issue, the recommendation is that if the child has to be operated before he/she is 4 y.o. Defects smaller than 2 cm that do not close by itself at age 2-4 has to be closed surgically. The other advice for my family and friends is that they have to take this patient with a pediatric surgeon.

I`m in accord with Yahya Al Abed, that majority of umbilical herniae will close by 2 years of age but needs follow-up during this period to observe the relative wideness of hernia ring if it`s increasing or reducing favored by positive Puericulture of the child.

Pre-school but after 2 years as the majority will close prior to this. Strangulation of gut is rare

I usually plan to do them around 4 years old, before the child starts school. The exception would be very large ones, over 2cm or so, that are unlikely to close on their own. These I would fix probably around 1 year. 

Caucasian children I perform the surgery after 2 years old. Brazil is a country with extensive miscigenation, therefore, most of the children have a darker skin. In these, I perform the repair when they are 6-7 years old, for this group of patients may resolve spontaneously by this age. In general, I only perform an earlier repair if there is a pain complaint. And, in general, when this complaint exists, it starts by 3-4 years old.

Really big hernias rarely close with age, but for me, to perform an earlier repair would lead to a loose skin, higher risk of wound hematoma, longer surgery (due to a wider ring) and longer anesthesia. So I prefer to wait till the baby is older and the ring is probably narrower.

Infantile umbilical hernia is a common problem in infants. And most of them will be closed by the age of 

I agree that for the very large umbilical hernia that has very little chance of resolving spontaneously, I would be tempted to repair at an earlier stage.