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Baby keeps throwing up after every feed


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: 12/24/2022

Last Revised: 09/21/2022

Copyright 2000-2022 Schmitt Pediatric Guidelines LLC.

Infant Vomiting - HealthyChildren.org

My baby vomits a lot. Is this a sign of a problem?

Because many common childhood illnesses can cause vomiting, you should expect your child to have this problem several times during these early years. Usually it ends quickly without treatment, but this doesn’t make it any easier for you to watch. That feeling of helplessness combined with the fear that something serious might be wrong and the desire to do something to make it better may make you tense and anxious. To help put your mind at ease, learn as much as you can about the causes of vomiting and what you can do to treat your child when it occurs.

Vomiting vs Spitting Up

First of all, there’s a difference between real vomiting and just spitting up. Vomiting is the forceful throwing up of stomach contents through the mouth. Spitting up (most commonly seen in infants under one year of age) is the easy flow of stomach contents out of the mouth, frequently with a burp.

Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed. This reflex action is triggered by the “vomiting center” in the brain after it has been stimulated by:

  • Nerves from the stomach and intestine when the gastrointestinal tract is either irritated or swollen by an infection or blockage

  • Chemicals in the blood (e.g., drugs)

  • Psychological stimuli from disturbing sights or smells

  • Stimuli from the middle ear (as in vomiting caused by motion sickness)

Causes of Vomiting

The common causes of spitting up or vomiting vary according to age. During the first few months, for instance, most infants will spit up small amounts of formula or breastmilk, usually within the first hour after being fed. This “cheesing,” as it is often called, is simply the occasional movement of food from the stomach, through the tube (esophagus) leading to it, and out of the mouth. It will occur less often if a child is burped frequently and if active play is limited right after meals. This spitting up tends to decrease as the baby becomes older, but may persist in a mild form until ten to twelve months of age. Spitting up is not serious and doesn’t interfere with normal weight gain.

Occasional vomiting may occur during the first month. If it appears repeatedly or is unusually forceful, call your pediatrician. It may be just a mild feeding difficulty, but it also could be a sign of something more serious.

Persistent Vomiting

Between two weeks and four months of age, persistent forceful vomiting may be caused by a thickening of the muscle at the stomach exit. Known as hypertrophic pyloric stenosis, this thickening prevents food from passing into the intestines. It requires immediate medical attention. Surgery usually is required to open the narrowed area. The important sign of this condition is forceful vomiting occurring approximately fifteen to thirty minutes or less after every feeding. Anytime you notice this, call your pediatrician as soon as possible.

GERD

Occasionally the spitting up in the first few weeks to months of life gets worse instead of better—that is, even though it’s not forceful, it occurs all the time. This happens when the muscles at the lower end of the esophagus become overly relaxed and allow the stomach contents to back up. This condition is known as gastroesophageal reflux disease, or GERD. This condition usually can be controlled by doing the following:

  1. Thicken the milk with small amounts of baby cereal as directed by your pediatrician.

  2. Avoid overfeeding or give smaller feeds more frequently.
  3. Burp the baby frequently.
  4. Leave the infant in a safe, quiet, upright position for at least thirty minutes following feeding.

If these steps are not successful, your pediatrician may refer you to a gastrointestinal (GI) specialist.

Infection

After the first few months of life, the most common cause of vomiting is a stomach or intestinal infection. Viruses are by far the most frequent infecting agents, but occasionally bacteria and even parasites may be the cause. The infection also may produce fever, diarrhea, and sometimes nausea and abdominal pain. The infection is usually contagious; if your child has it, chances are good that some of her playmates also will be affected.

Rotaviruses are a leading cause of vomiting in infants and young children, with symptoms often progressing to diarrhea and fever. These viruses are very contagious, but are becoming less common than in the past, due to the availability of a vaccine that can prevent the disease. The rotavirus is one of the viral causes of gastroenteritis, but other types of viruses—such as noroviruses, enteroviruses, and adenoviruses—can cause it as well.

Occasionally infections outside the gastrointestinal tract will cause vomiting. These include infections of the respiratory system, infections of the urinary tract otitis media, meningitis , and appendicitis. Some of these conditions require immediate medical treatment, so be alert for the following trouble signs, whatever your child’s age, and call your pediatrician if they occur.

  • Blood or bile (a green-colored material) in the vomit

  • Severe abdominal pain

  • Strenuous, repeated vomiting

  • Swollen or enlarged abdomen

  • Lethargy or severe irritability

  • Convulsions

  • Signs or symptoms of dehydration, including dry mouth, absent tears, depression of the "soft spot", and decreased urination

  • Inability to drink adequate amounts of fluid

  • Vomiting continuing beyond twenty-four hours

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

why baby spit up after feeding

If a child spits up after feeding, this is in most cases due to the anatomical immaturity of the upper digestive system. More often than others, premature babies, babies with congenital pathologies suffer from regurgitation. Sometimes the cause is the wrong breastfeeding technique.

Regurgitation in infants is perhaps the most common occurrence in modern pediatrics. More than half of children spit up at least once a day, which is almost always a physiological reaction. nine0003

As the baby grows older, spitting up less and less and by 6 months it practically stops doing so. However, sometimes the problem remains, and burping continues for up to a year. In such a situation, you need to make sure that the gastrointestinal tract is functioning normally and consult a doctor.

Why does the baby spit up after every feed

There is a very simple explanation for this. The esophagus of newborns is a funnel with a wide part at the top, and the sphincter at the transition to the stomach actually gapes and hardly retains food. nine0003

Normally, after food enters the stomach, the sphincter contracts and prevents it from “returning” into the esophagus. But in this case, when the stomach is full, part of the contents immediately comes out if the baby takes an inclined or horizontal position.

Babies have two more features: increased pressure over the lower esophageal sphincter, as well as a straight and sometimes obtuse angle of His, formed by the side walls of the esophagus and stomach. In adults, this angle is sharp, which also prevents the return of food eaten into the esophagus. nine0003

After feeding, do not put the baby on his stomach, it is better to hold him upright in your arms, trying not to put pressure on his chest. But if he still burps, you should not worry, this is a normal process. If in doubt, please contact our doctors. At a remote consultation, they will explain the causes of regurgitation, talk about pathologies. If necessary, they will tell you which specialists to go through.

A few more reasons why a child often spit up

Physiological belching after feeding is due to two factors: swallowing air (aerophagia) and increased intra-abdominal pressure. The first is usually associated with fast and greedy suckling, improper attachment of the baby to the breast, or the wrong position of the bottle when it comes to artificial feeding. An air bubble forms in the stomach, pushing out a small amount of milk or formula.

The same results are obtained by a quick change in the position of the baby's body after feeding, which will easily burp if it is immediately started to swaddle, shake, bathe or massage. After all, his stomach resembles an open bottle: tilted / turned over - the contents spilled out. nine0003

As for the increase in intra-abdominal pressure, it increases with a too tight diaper or tight swaddling, as well as against the background of increased gas formation, intestinal colic or stool retention.

Regurgitation in newborns after feeding may be due to the lack of a feeding regimen and overeating.

Baby burps an hour after feeding: what does it mean

The most common cause is constipation, which increases intra-abdominal pressure. Food moves slowly through the gastrointestinal tract, so the child can burp an hour or two after feeding. nine0003

Attention! Delayed regurgitation combined with delayed defecation may be a sign of a lazy stomach. But such a diagnosis should be made by a doctor.

5 causes of regurgitation in newborns after formula feeding

The selection of artificial nutrition is a purely individual process with an unpredictable result. There is no 100% guarantee that the mixture will suit the child, even if the brand is very popular. nine0003

Poor digestion of the mixture may well cause not only frequent spitting up, but also other digestive problems, including colic, constipation and allergic reactions. In addition, store-bought baby food has a denser texture than breast milk and lasts longer in the stomach. Therefore, the likelihood of its reverse advance to the esophagus after feeding is higher.

Your baby may spit up after every feed because: nine0003

  • the proportions of dilution of the mixture are violated;
  • the feeding regime is not observed;
  • the transition from breastfeeding to artificial feeding was too abrupt;
  • the wrong bottle is selected;
  • allergy.

Misproportioning when diluting the mixture

Each manufacturer indicates on the packaging of the mixture how much water is required to dilute it, and what volume is suitable for the baby by weight and age. Sometimes mothers mistakenly or intentionally dilute food in a way that is not recommended, and the child eats more than normal. As a result, the surplus, of course, comes out. nine0003

Case study:

After 3 months, a breastfed child suddenly began to behave restlessly, sleep poorly, spit up after eating, weight gain became slightly below normal. From a conversation with the mother, the doctor learned that the baby was fed too often, the feeding regimen was not observed. After increasing the intervals between breastfeeding, the regurgitation stopped.

Refusal of night feedings is also undesirable: the daily volume of food is distributed during the daytime, which leads to stomach overload and regurgitation. nine0003

Feeding schedule not followed

Unlike natural, artificial feeding involves eating by the hour.

Baby food takes longer to digest, so the recommended interval between feedings is at least 3 hours. If you feed the child more often, he will “give out” the excess back, since the previous portion has not yet been absorbed.

Abrupt transition from breastfeeding to artificial feeding

nine0002 When changing the diet, the child's body must first get used to, adapt to the new food. This applies not only to the transition from breastfeeding to artificial feeding, but also from one type of mixture to another.

Wrong bottle selected

This refers to the too wide neck of the container, because of which the child swallows a lot of air along with food. Its discharge will provoke regurgitation after feedings.

Allergy

nine0002 An allergic reaction to cow's milk protein causes inflammation of the intestinal wall, which in turn leads to malabsorption. Carbohydrate metabolism worsens, since secondary lactase deficiency occurs against the background of an inflammatory reaction - a decrease in the synthesis of the lactase enzyme.

As a result, sugar is broken down incorrectly, increased gas formation occurs, and the baby spits up a fountain. In addition, the baby may feel discomfort at the beginning of feeding and react with an increase in nervous excitability during the period of increased intestinal motility. This also often leads to belching. nine0003

What does curd spitting up mean

Belching with curdled milk after feeding only indicates that the food was in the stomach for some time and managed to curdle - it was fermented. The reason may be in a change in body position or indicate pyloric stenosis with profuse vomiting with a fountain.

Attention! When spouting against the background of pyloric stenosis, the child spits up profusely, the jet scatters to a distance of half a meter. nine0003

What to do

First you need to make sure that you really need to do something. Pediatricians are advised to determine the intensity and frequency of regurgitation on a five-point scale.

nine0120

Points

Regurgitation frequency

Volume

nine0111

one

No more than 5 per day

Not more than 3 ml

2

> 5 times a day

> 3 ml

3

> 5 times a day

> 0. 5 volume of food eaten

4

After every feeding

Small amount over 30 minutes or more nine0003

five

At least half of the meals are accompanied by regurgitation

> 0.5 volume of food eaten

Now you can determine if there really is a problem. The criteria are:

  • the baby is not yet a year old; nine0046
  • he spits up 2 times a day for 3 weeks or longer;
  • before burping there are no precursors, specific signs;
  • during regurgitation, the tension of the anterior abdominal wall is not felt;
  • there are no difficulties with swallowing, sucking, the child does not take any specific forced position;
  • the baby does not begin to sweat a lot, turn pale after he burps, and feels normal; nine0046
  • he is active, has a good appetite, and is gaining weight appropriately for his age.

The above points indicate that everything is in order.

If the intensity and frequency of spitting up is 3 points or more, this is a reason to consult a doctor. Our doctors are ready to advise on all issues at any time of the day. At a remote consultation, possible causes will be identified, and a plan of further actions will be drawn up. nine0003

How parents determine the amount of rejected food

Normal regurgitation after feeding occurs in small volumes, within 1-2 tablespoons. You can determine how much food came out when you burp.

When the child burps into the diaper, you need to pour 1 tbsp nearby. l. water and compare the size of the spots. If they are almost the same, there is no reason to worry.

Alarm symptoms

Medical assistance is necessary if the child spits up a lot after feeding, while crying and acting up. A bad symptom is the requirement of supplementary feeding, that is, the baby remains hungry after he has eaten his portion.

Serious illnesses can present with symptoms such as:

  • sudden weight loss, weight gain does not meet the standards;
  • lack of stool;
    • nine0045 profuse vomiting with an admixture of bile;
  • urination less than 8-10 times a day;
  • continued spitting up after the child is one year old.

How to deal with regurgitation: a step-by-step guide

If the baby is spitting up after feeding breast milk or formula, you can start with a nutritional correction. When breastfeeding, it is important to ensure that the baby completely captures the nipple along with the areola. His lower lip is usually slightly twisted. nine0003

Step 1

It is better to feed the baby while sitting, holding the baby at an angle of 45-60 ° to the chest. In this position, the air freely leaves the stomach, due to which the likelihood of reflux of food into the esophagus is reduced. After eating, it is preferable to put it on its side in a crib: this way, when returning from the stomach, the masses will not enter the respiratory tract. If the child burped while lying on his back, you should lift him up and turn him face down.

Step 2

After the baby has eaten, it must be held upright (pose of a soldier) for at least 20 minutes. nine0003

Step 3

You can partially remove the air from the stomach before feeding, putting the baby on the stomach for 10-15 minutes. With a tendency to intestinal colic, a light massage of the abdomen, which is done in between meals, will help.

Step 4

Even if the child is constantly spitting up, this is not a reason to transfer him to artificial mixtures. But a clear feeding regimen is desirable after a more or less strict period of time. In addition, mom should follow a hypoallergenic diet and exclude foods that can provoke flatulence - cabbage, legumes, black bread. nine0003

Step 5

For artificial babies, it is preferable to use a special anti-colic bottle and a nipple with a special design. The bottle has a valve that prevents you from swallowing air while eating. It is also necessary to make sure that the milk does not flow like a river, but slowly drips, that is, the hole in the nipple must have the appropriate diameter.

Step 6

When buying a mixture for a spitting up baby, it is better to consult a pediatrician. He may recommend a hypoallergenic formula or a formula that does not contain bovine protein. For some children, the so-called anti-reflux mixture is suitable. nine0003

Step 7

Normally, complementary foods are introduced from the 4th month of a child's life, but in the presence of regurgitation, it is allowed to include food thickeners in the diet after the 1st month. It can be mixtures with rice flour, rice porridge without milk. But they are used in an amount of a maximum of 1 tsp. in one feeding.

Pitch 8

Do not swaddle too tightly, massage, and generally somehow disturb the child after eating. You can only lightly pat him on the back, putting him on his knees, to prevent spitting up. nine0003

Step 9

Is the child overeating? To check this, you just need to weigh it before feeding and after. And it does not matter what he eats - mother's or artificial milk.

FAQ

What symptoms should you call an ambulance for?

+

If, after spitting up, the child does not breathe or has lost consciousness; lips and face take on a bluish tint; reflux - gastric contents - has a green or brownish color, which may indicate intestinal obstruction, gastric bleeding. nine0003

Why does a baby spit up breast milk, but formula does not?

+

If everything is in order with the calculation of “doses”, and there is no overfeeding with breast milk, most likely it is lactose intolerance. To clarify the diagnosis, it is necessary to take tests.

Should I supplement my baby if he burps?

+

No, by no means.

What complications can regurgitation cause? nine0003

+

Lack of weight gain and even weight loss are the most harmless consequences. With a long-term existence of the problem, 15% of children have a developmental delay, however, only in the physical. Insufficient digestion of food leads to anemia, vitamin deficiency and an increased risk of aspiration pneumonia when inhaled gastric masses.

Expert opinion

If the baby spit up after feeding, this is completely normal in the absence of alarming symptoms. In case of profuse regurgitation, insufficient weight gain, restless behavior, the baby should be shown to the pediatrician. nine0003

Why does the baby spit up after feeding?

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Search Keywords

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? nine0003

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 can spit up at least 50% of babies from 0 to 3 months, more than 60% of children 3-4 months, and 5% of children spit up until the year 1 .

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

  • Structural features 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 apparatus 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 post-feeding regurgitation and baby's predominantly horizontal position 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”. nine0003

Regurgitation in many newborns can be triggered by other situations in which abdominal pressure 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.

Want to avoid common feeding problems? nine0057


Start with a baby bottle with an anti-colic system that helps you avoid common feeding problems such as colic, gas and spitting up*

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 normal and not of concern to pediatricians 3 :

  • usually lasts 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 can I help a newborn who vomits frequently?


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 babies are more prone to spit up if their 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

    New Anti-colic bottle with AirFree valve

    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 turned out that it is 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. nine0003

    References

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

    Nagornaya 29031 V., Limarenko M. P., Logvinenko N. G. Experience in 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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