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Baby is throwing up after every feeding


Children and vomiting - Better Health Channel

Summary

Read the full fact sheet
  • Mild vomiting is normal in most babies and improves over time.
  • Most babies need only simple treatment, or none at all.
  • Changing feeding and sleeping positions may help.
  • Medicine should not be given unless prescribed by your doctor.
  • Give a child who is unsettled after vomiting a drink or a little food.
  • If your child seems unwell or shows any worrying symptoms, see a doctor.

Vomiting can be part of many illnesses in children and babies. It is not usually a major concern as long as your child seems well in other ways.

Vomiting is common for babies and young children. Vomiting occurs when food is brought back up from the stomach. The amount of vomit can often seem larger than it actually is.

Types of vomiting

There are different types of vomiting, including:

  • Possetting – this is when your baby vomits up small amounts after a feed.
  • Reflux – this vomiting is common in babies. It is caused when the valve at the top of the stomach accidentally opens. The contents of the stomach come back up the food pipe (oesophagus) slowly. Reflux does not harm babies. They usually grow out of it by the time they are walking.
  • Projectile vomiting – this is when your baby brings up the stomach contents in a forceful way. The amount of milk or food can seem large on the floor, but is usually only the amount of the last feed. Babies may projectile vomit occasionally, but if it happens after every feed, see your doctor right away as it may be due to a blockage caused by thickening of the muscle at the outlet of the stomach.

Causes of vomiting

Vomiting is usually caused by:

  • minor infections like 'gastro' or the common cold
  • gastro-oesophageal reflux
  • motion sickness from travelling in a moving vehicle.

Sometimes, vomiting may be part of a more serious illness. Children may vomit if they have an infection, such as a urinary tract infection or meningitis, a bowel obstruction or appendicitis. If vomiting progresses to fever and diarrhoea, it will usually be caused by a virus infection. If this persists for 12 hours or more, dehydration is likely. so see your doctor or local hospital emergency department without delay.

Treatment for vomiting

Most babies and children vomit easily and recover quickly. After vomiting, your child may be hungry and thirsty. Give plenty to drink so your child does not become dehydrated. If your child keeps on vomiting and looks unwell, see your doctor. Do not use medication to try and stop the vomiting.

Reflux vomiting can be prevented or reduced

Different positions for feeding or in bed can help reduce your baby’s chance of vomiting. You can try to:

  • Feed your baby in an upright position.
  • Prop your baby up after feeds.
  • Lay your baby on the left side.
  • Avoid bouncing your baby after feeding.

To help with mild reflux, you can thicken your baby’s food with cornflour or infant food thickener. If your child is uncomfortable after vomiting or will not settle, try giving milk or water. This will wash any acid back into the stomach. Some babies get heartburn, which is a burning sensation in the chest. They may be unsettled after feeding or when lying flat. Your doctor can suggest an antacid to relieve heartburn.

When to see your doctor

Take your baby to the doctor if any of these symptoms occur:

  • poor weight gain because of the loss of feeds in vomiting
  • coughing or choking spells
  • blood or yellow-green bile in the vomit
  • heartburn
  • vomiting increases or becomes forceful after every feed
  • your baby seems unwell.

Where to get help

  • Your doctor
  • NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
  • Your local maternal and child health nurse
  • The 24 hour Maternal and Child Health Telephone Service. Tel.13 22 29
  • Your local hospital emergency or casualty department

Things to remember

  • Mild vomiting is normal in most babies and improves over time.
  • Most babies need only simple treatment, or none at all.
  • Changing feeding and sleeping positions may help.
  • Medicine should not be given unless prescribed by your doctor.
  • Give a child who is unsettled after vomiting a drink or a little food.
  • If your child seems unwell or shows any worrying symptoms, see a doctor.

This page has been produced in consultation with and approved by:

Vomiting (0-12 Months)

Is this your child's symptom?

  • Vomiting (throwing up) stomach contents
  • Other names for vomiting are puking, barfing and heaving

Causes of Vomiting

  • Viral Gastritis. Stomach infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery loose stools may follow within 12-24 hours.
  • Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Uncommon in infants, but main foods are eggs and peanut butter.
  • Coughing. Hard coughing can also cause your child to throw up. This is more common in children with reflux.
  • Serious Causes. Vomiting alone should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. An example is a kidney infection. A serious cause in young babies is pyloric stenosis. See below for more on this.

Pyloric Stenosis (Serious Cause)

  • The most common cause of true vomiting in young babies.
  • Onset of vomiting is age 2 weeks to 2 months
  • Vomiting is forceful. It becomes projectile and shoots out.
  • Right after vomiting, the baby is hungry and wants to feed. ("hungry vomiter")
  • Cause: The pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
  • Risk: Weight loss or dehydration
  • Treatment: Cured by surgery.

Vomiting Scale

  • Mild: 1 - 2 times/day
  • Moderate: 3 - 7 times/day
  • Severe: Vomits everything, nearly everything or 8 or more times/day
  • Severity relates even more to how long the vomiting goes on for. At the start of the illness, it's common for a child to vomit everything. This can last for 3 or 4 hours. Children then often become stable and change to mild vomiting.
  • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
  • The younger the child, the greater the risk for dehydration.

Dehydration: How to Tell

  • The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
  • Vomiting with watery diarrhea is the most common cause of dehydration.
  • Dehydration is a reason to see a doctor right away.
  • Your child may have dehydration if not drinking much fluid and:
  • The urine is dark yellow and has not passed any in over 8 hours.
  • Inside of the mouth and tongue are very dry.
  • No tears if your child cries.
  • Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

When to Call for Vomiting (0-12 Months)

Call 911 Now

  • Can't wake up
  • Not moving
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
  • Stomach pain when not vomiting. Exception: stomach pain or crying just before vomiting is quite common.
  • Age less than 12 weeks old with vomiting 2 or more times. Exception: normal spitting up.
  • Vomited 3 or more times and also has diarrhea
  • Severe vomiting (vomits everything) more than 8 hours while getting Pedialyte (or breastmilk)
  • Head injury within the last 24 hours
  • Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Vomiting a prescription medicine
  • Fever over 104° F (40° C)
  • Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • All other infants (age less than 1 year) with vomiting. See Care Advice while waiting to discuss with doctor.

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

Care Advice for Vomiting

  1. What You Should Know About Vomiting:
    • Most vomiting is caused by a viral infection of the stomach.
    • Vomiting is the body's way of protecting the lower gut.
    • The good news is that stomach illnesses last only a short time.
    • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
    • Here is some care advice that should help.
  2. Formula Fed Babies - May Give Oral Rehydration Solution (ORS) for 8 Hours:
    • If vomits once, give half the regular amount of formula every 1 to 2 hours.
    • If vomits formula more than once, offer ORS for 8 hours. If you don't have ORS, use formula until you can get some.
    • ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food stores or drug stores.
    • Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
    • After 4 hours without throwing up, double the amount.
    • Return to Formula. After 8 hours without throwing up, go back to regular formula.
  3. Breastfed Babies - Reduce the Amount Per Feeding:
    • If vomits once, nurse half the regular time every 1 to 2 hours.
    • If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, return to regular nursing.
    • If continues to vomit, switch to pumped breastmilk. (ORS is rarely needed in breastfed babies. It can be used if vomiting becomes worse).
    • Spoon or syringe feed small amounts of pumped milk. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
    • After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
  4. Pumped Breastmilk Bottle-Fed Infants - Reduce the Amount per Feeding:
    • If vomits once and bottle-feeding breastmilk, give half the regular amount every 1-2 hours.
    • If vomits more than once within last 2 hours, give 1 ounce (30 mL) every 30 to 60 minutes.
    • If continues to vomit, give 1-2 teaspoons (5-10 mL) every 5 minutes. Only if not tolerating breastmilk, switch to ORS (e.g., Pedialyte) for every 5 minutes for a few hours.
    • After 4 hours without vomiting, return to regular feedings. Start with 1 ounce (30 mL) every 30 minutes and slowly increase as tolerated.
  5. Stop All Solid Foods:
    • Avoid all solid foods and baby foods in kids who are vomiting.
    • After 8 hours without throwing up, gradually add them back.
    • If on solid foods, start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
  6. Do Not Give Medicines:
    • Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
    • Fever. Mild fevers don't need to be treated with any drugs. For higher fevers, you can use an acetaminophen suppository (such as FeverAll). This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
    • Call your doctor if: Your child vomits a drug ordered by your doctor.
  7. Try to Sleep:
    • Help your child go to sleep for a few hours.
    • Reason: Sleep often empties the stomach and removes the need to vomit.
    • Your child doesn't have to drink anything if his stomach feels upset and he doesn't have any diarrhea.
  8. Return to Child Care:
    • Your child can return to child care after the vomiting and fever are gone.
  9. What to Expect:
    • For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
    • Vomiting from a viral illness often stops in 12 to 24 hours.
    • Mild vomiting and nausea may last up to 3 days.
  10. Call Your Doctor If:
    • Vomits clear fluids for more than 8 hours
    • Vomiting lasts more than 24 hours
    • Blood or bile (green color) in the vomit
    • Stomach ache present when not vomiting
    • Dehydration suspected (no urine in over 8 hours, dark urine, very dry mouth, and no tears)
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 02/18/2023

Last Revised: 12/30/2022

Copyright 2000-2023 Schmitt Pediatric Guidelines LLC.

Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation - Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day, at least 50% of babies from 0 to 3 months old can spit up, more than 60% of children 3-4 months old, and in 5% of children spit up continues up to the year 1 .

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

  • Features of the structure of the upper digestive tract in babies
  • In newborns and infants up to a year of life, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year 2 .
  • Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
  • Normally, the lower esophageal sphincter should tightly "close" the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well 2 .
  • Slow movement of food through the gastrointestinal tract
  • The neuromuscular system of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters - if it is too large, the newborn swallows a lot of air 3 .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled 3 .

Promotes regurgitation after feeding and a predominantly horizontal position of the baby during the day, combined with relatively high intra-abdominal pressure 4 . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be provoked by other situations in which pressure in the abdominal cavity increases and stomach contents are thrown into the esophagus, in particular 3 :

  • tight swaddling;
  • stool disorders, in particular constipation;
  • long, forced cry and some others.

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How can you tell the difference between normal spitting up and vomiting?


Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation 1 .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more 1 .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 - 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. When the range of the jet of vomit is up to 50 cm, doctors talk about "vomiting a fountain." A variant of atonic vomiting is possible, when the contents of the stomach flow "sluggishly". It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus 1 .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor's consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day 1.3 .

Physiological regurgitation: symptoms


Regurgitation in newborns, which is considered a normal variant and does not cause concern to pediatricians 3 :

  • usually continues for a certain period of time;
  • is characterized by slow, "passive" leakage; if the baby spits up a fountain, it is better to consult a doctor;
  • has a sour smell of curdled milk;
  • occurs without the participation of muscles - the baby does not strain during regurgitation;
  • does not affect the general well-being of the baby.

How to help a newborn who spit up often?


If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

  • Frequent feeding of the baby
    It is known that the baby is more prone to spit up if his stomach is full. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all - on demand 5 .

  • Correct feeding technique
    Every feeding, the mother must ensure that the baby does not swallow too much air during suckling. When sucking, there should be no loud, smacking, clicking sounds. You also need to control that the baby captures the nipple along with the areola.

  • Choosing the right bottle and nipple
    If the newborn is bottle-fed and receiving formula, it is important to choose the right bottle and nipple. The hole in it should be such that the milk flows out in drops, and not in a stream. The nipple must not be filled with air

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    The AirFree valve prevents air from entering the baby's stomach.

    • Baby standing upright after eating

    To allow air that has entered the digestive tract during meals to escape, it is important to keep the newborn upright for 10-20 minutes after feeding 4 .

    • Ensure the correct position of the baby during sleep

    To reduce the negative impact of the acidic contents of the stomach on the esophagus, it is necessary to put the baby to sleep in the supine position. The side or prone position, which many pediatricians used to recommend, is no longer recommended. It was found to be associated with an increased risk of sudden infant death syndrome 5 .

    If parents notice alarming symptoms, such as spitting up too often or large volume, etc. , it is important to consult a pediatrician without delay. This will allow you to identify the real problem in time and help the baby grow up healthy and happy.

    References

    1 Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. V. 7. No. 4.

    Nagornaya 2900 V., Limarenko M. P., Logvinenko N. G. Experience with the use of domperidone in suspension in young children with regurgitation syndrome // Child Health, 2013. No. 5 (48).

    3 Zakharova IN Regurgitation and vomiting in children: what to do? //Pediatrics. Supplement to Consilium Medicum, 2009. No. 3. S. 58-67.

    4 Zakharova I. N., Sugyan N. G., Pykov M. I. Regurgitation syndrome in young children: diagnosis and correction // Effective pharmacotherapy, 2014. No. 3. P. 18-28.

    5 Vandenplas Y. et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) //Journal of pediatric gastroenterology and nutrition. 2009; 49(4): 498-547.

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    Preventive measures against regurgitation in children

    08.03.2017

    Regurgitation is the spontaneous reflux of gastric contents into the esophagus and mouth. This condition is not uncommon in infants and is often a cause for concern for parents. The frequency of regurgitation syndrome in children of the first year of life is 18-50%: up to 4 months - 67%, up to 6 months 24%, up to 1 year 5%. In most cases, regurgitation is "benign" and disappears on its own after 12-18 months. At the same time, “benign” or physiological regurgitation characterizes:

    • the age of the child is up to 12 months;

    • spitting up 2 or more times a day for 3 or more weeks;

    • sufficient weight gain;

    The child has no signs of metabolic disorders, diseases of the gastrointestinal tract or the central nervous system. The child does not experience difficulty in swallowing or feeding, there is no forced position of the body.

    Do not confuse regurgitation with vomiting. When a child burps, the abdominal muscles do not tense up. With vomiting, on the contrary, muscle tension occurs and food is ejected by pressure not only through the mouth, but also through the nose. In some cases, there may be general anxiety, pallor, cold extremities. Often with vomiting, the temperature rises, loose stools appear, which is a sign of an infectious disease. Vomit may contain unchanged milk, mucus, blood or bile.

    What causes physiological regurgitation

    What is the tendency of babies to spit up? This phenomenon is explained by the peculiarity of the structure of the gastrointestinal tract of young children. At the age of one year, the esophagus is shorter and wider, physiological narrowing is weakly expressed. The stomach is located horizontally, its capacity is small, and the muscles that close the entrance to the stomach and prevent the contents from being thrown back into the esophagus are poorly developed. As the child begins to walk, the axis of the stomach becomes more vertical. The capacity of the stomach increases by the year from 30-35 ml to 250-300 ml. The secretory apparatus matures, the work of the closing muscles (sphincters) improves, which leads to a gradual decrease in the frequency and disappearance of regurgitation. These features explain the predisposition of young children to regurgitation and even the inevitability of this condition. However, there are measures to help reduce the frequency of regurgitation.

    Factors contributing to physiological regurgitation include:

    1. Overfeeding. As a rule, actively sucking babies begin to suffer from overfeeding, with abundant milk secretion, as well as when switching to artificial or mixed feeding with an incorrect calculation of the required amount of milk formula. Regurgitation appears immediately or some time after feeding in the amount of 5-10 ml. Milk can flow out unchanged or curdled.

    2. Swallowing air during feeding (aerophagia). A similar situation arises if the child suckles greedily at the breast, and the mother's milk is not very plentiful; due to the retracted, flat nipple of the mother's breast, since the child fails to fully capture the nipple and areola; with artificial feeding, if the hole at the nipple of the bottle is large enough or the nipple is not completely filled with milk. Babies with aerophagia often experience anxiety after feeding, bulging of the abdominal wall (belly inflates). After 10-15 minutes, the swallowed milk flows out unchanged, which is accompanied by a loud sound of air eructation.

    3. Intestinal colic or constipation. These conditions lead to an increase in pressure in the abdominal cavity and a violation of the movement of food through the gastrointestinal tract, causing regurgitation.

    Until the child is four months old, spitting up up to two teaspoons of milk after feeding, or one spitting up of more than three spoons during the day, is considered the norm. You can check the amount of spitting up in the following way: take a diaper, pour one teaspoon of water on its surface, and then compare this spot with the spot formed after the next spitting up.

    Abnormal regurgitation may be due to:

    • surgical diseases and malformations of the digestive system;

    • diaphragmatic hernia;

    • pathology of the central nervous system, trauma of the cervical spine during childbirth;

    • food intolerance, lactase deficiency;

    • increased intracranial pressure.

    Such regurgitation is characterized by intensity, systematicity, the child spits up a large amount of milk. At the same time, there is a violation of the general condition of the baby - the child is whiny, loses or does not gain weight, cannot eat the amount of food necessary for his age. In such a situation, a pediatrician, gastroenterologist, surgeon, allergist, neurologist should be examined. It also requires examination and exclusion of anomalies in the structure of the upper gastrointestinal tract, the preservation of regurgitation for more than 1 year.

    Scale for assessing the intensity of regurgitation:

    1. Less than 5 regurgitations per day with a volume of not more than 3 ml - 1 point.

    2. More than 5 regurgitations per day with a volume of more than 3 ml - 2 points.

    3. More than 5 regurgitations per day up to half the amount of formula or breast milk, not more often than in half of the feedings - 3 points.

    4. Spitting up a small amount of milk for 30 minutes or more after each feeding - 4 points.

    5. Regurgitation from half to full volume of formula or breast milk in at least half of the feedings - 5 points.

    Regurgitation with an intensity of 3 or more points requires a visit to a doctor.

    Preventive measures against regurgitation in children

    If regurgitation is physiological in nature, then it is not worth treating or correcting in this case. It is necessary to deal with the elimination of the cause, if possible, and carry out prevention.

    Prevention of regurgitation in children includes the following measures:

    1. Postural therapy: when feeding, it is necessary to hold the baby at an angle of 45 °, make sure that he completely grasps the nipple with the areola; after feeding, hold the baby in an upright position ("column") for 20 minutes - to drain the swallowed air. Due to this, the air that has entered the stomach will be able to go out. If nothing happened, then put the baby down and after a minute or two, lift him upright again.

    2. Make sure that the opening in the bottle is not too large and that the nipple is filled with milk. Experiment with nipples - perhaps the other will be better. Milk should come out in drops, not a trickle.

    3. Before you start feeding your baby, lay him belly down on a solid base.

    4. After feeding, try to minimize the baby's physical activity, do not disturb him unnecessarily, and change clothes only if there is an emergency.

    5. Avoid squeezing diapers or clothes on the abdomen of the child.

    6. If the baby's appetite is good, then it is better to feed him often, but in small portions, otherwise, due to the large amount of food, the stomach may overflow, and this, as a result, leads to regurgitation of excess food.

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