Is it ok to choose to do nothing about my 4 yr old's umbilical hernia? i have a feeling the surgeon will suggest surgery b/c it never closed.

Depends: For some this is just a cosmetic issue since an "outie" makes them self conscious. However, it is a true hernia where the small intestines enter the sac, it is potentially dangerous over time. The intestines can become trapped or twist,cutting of blood supply and need emergency surgery to save the bowel.We often delay the surgery for a few years to see if will resolve.After 4, it is unlikely to.