Let $(R,\mathfrak {m})$ be a Noetherian local ring and I an ideal of R. We study how local cohomology modules with support in $\mathfrak {m}$ change for small perturbations J of I, that is, for ideals J such that $I\equiv J\bmod \mathfrak {m}^N$ for large N, under the hypothesis that $R/I$ and $R/J$ share the same Hilbert function. As one of our main results, we show that if $R/I$ is generalized Cohen–Macaulay, then the local cohomology modules of $R/J$ are isomorphic to the corresponding local cohomology modules of $R/I$, except possibly the top one. In particular, this answers a question raised by Quy and V. D. Trung. Our approach also allows us to prove that if $R/I$ is Buchsbaum, then so is $R/J$. Finally, under some additional assumptions, we show that if $R/I$ satisfies Serre’s property $(S_n)$, then so does $R/J$.