An inguinal hernia will not go away without surgery. Most hernias in children are indirect (the abdominal tissue has bulged down the inguinal canal). These hernias need to be repaired, because they are likely to become incarcerated.
Prompt surgery is needed for younger children especially, because they may not complain about pain until there is a risk of the intestine becoming tightly trapped and its blood supply being cut off (strangulation).
Hernias that are incarcerated, even if they can be pushed back into the abdomen, need to be repaired as soon as possible because of the risk of strangulation.
Surgery may be delayed on premature babies with hernias that are not incarcerated. Premature babies are at risk for complications before and after surgery, because their hearts and respiratory systems are not fully developed.