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Learning About Diastasis Recti (DR) in Children

What is diastasis recti (DR)?

Diastasis recti (say “dy-AS-tuh-sus REK-ty”), or DR, is a condition that happens when there's a gap larger than 2 centimeters (cm) between the two long muscles at the front of the belly (abdomen). These muscles are called the rectus abdominus.

There is connective tissue, called the linea alba, between the rectus muscles to help them stay together. It's normal to have a gap between the muscles that's less than 2 cm wide. But with DR, the connective tissue in this space may become weak, or too relaxed to keep those muscles connected.

What causes it?

Some babies are born with it. It can also be caused by weakened tissues in the belly (abdominal) wall. This can happen from being very overweight (having obesity) or having abdominal surgery. The muscles often heal on their own.

What are the symptoms?

Your child may have no symptoms. If they do have symptoms, they may have a bulge in the middle of their belly that's visible when they engage their belly muscles. They may also have belly pain.

How is it diagnosed?

It's diagnosed with a physical exam. The gap between the rectus muscles is measured in different places when the muscles are at rest and when they're being used. Tension in the connective tissue can also be measured this way.

You can check the size of the gap on your own. Have your child lie down on their back with their knees bent and feet flat on the floor. Place your fingers across their navel. Have them raise their head a few inches, almost like doing crunches or a sit-up. When their head is lifted, you may be able to feel your fingers sink into the space between their rectus muscles. You can measure how far apart the muscles are and how deep your fingers sink.

Your doctor may also request imaging using an ultrasound.

How is it treated?

Treatment for DR depends on what's causing it. It may also heal on its own without treatment.

Treatment options may include:

  • Exercise programs and physical therapy. These focus on training the deep core muscles.
  • Weight loss.
  • Surgery. Different options include open, laparoscopic, or robot-assisted surgery or a tummy tuck (abdominoplasty).
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