Congenital Diaphragmatic Hernia

What is a congenital diaphragmatic hernia?

The diaphragm is a thin layer of muscle and tissue that separates the chest and abdominal cavity. It is the muscle that the body uses to breathe. When your child has a congenital diaphragmatic (CDH), it means that there’s a hole in that layer — or, rarely, that the diaphragm is missing altogether. CDHs affect about one in every 2,500 babies.

There is also a condition called acongenital diaphragmatic, when the contents of your child's abdomen, including the stomach, intestines, liver and spleen may go through the hole and into the chest. This prevents the normal development of the lung on that side, and may also affect the growth of the other lung. And when your child’s lungs don’t fully develop, they will have trouble breathing after birth. 

What are the different types of CDHs?

 There are two kinds of CDH: 

  • A Bochdalek hernia is a hole in the back of the diaphragm. Ninety percent of CDHs are this type.
  • A Morgagni hernia involves a hole in the front of the diaphragm.  

A CDH is a serious, life-threatening condition. But because of advances in treatment, the outlook for babies born with a CDH has greatly improved.

How we care for CDH

Boston Children's treats more than 20 newborns with a CDH each year, with a success rate among the best in the world. Children's survival rate is close to 90 percent, while the national average at major medical centers is only 65 percent. 

When a CDH is diagnosed or suspected during pregnancy, treatment is coordinated through Boston Children's Advanced Fetal Care Center. Children also come into the care of the program when a CDH is diagnosed after birth, and on an outpatient basis for long-term treatment.