Baby spits up after feeding on one side


Breastfeeding FAQs: Spitting Up, Gagging, and Biting (for Parents)

Breastfeeding is natural, but it takes practice to get it right. Here's what you need to know about spitting up, gagging, and other concerns during breastfeeding.

Is it Normal for My Baby to Spit Up After Feedings?

Sometimes, babies spit up when they eat too much, or when they burp or drool. Many infants will spit up a little after some — or even all — feedings or during burping because their digestive systems are immature. That's perfectly normal.

As long as your baby is growing and gaining weight and doesn't seem uncomfortable with the spitting up, it's OK. The amount of spit-up often looks like more than it actually is. But spitting up isn't the same as forcefully vomiting all or most of a feeding.

What’s the Difference Between Spitting Up and Vomiting?

Vomiting is a forceful projection of stomach fluids. Spitting up is a more gentle "flow" of fluids that come up. Babies don’t usually react to spitting up, but a vomiting baby will usually look upset or cry.

If you're concerned that your baby is vomiting, call your doctor. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical care. It helps to keep track of how often and how much your baby is vomiting or spitting up.

How Can I Keep My Baby From Spitting Up?

If the doctor says your baby's spitting up is normal, here are some things you can do to help lessen it:

  • Burp your baby after each feed from each breast. Sometimes giving smaller feeds more often can help, rather than giving larger-volume feeds.
  • Keep your baby upright after feedings for at least 30 minutes. Holding your baby is best, since the way your baby sits in an infant seat may actually make spitting up more likely.
  • Don't jiggle, bounce, or actively play with your baby right after feedings.
  • Keep your baby's head above the feet while feeding. Don't hold your baby in a dipped-down position when feeding.
  • Raise the head of your baby's crib or bassinet. Roll up a few small hand towels or receiving blankets (or you can buy special wedges) to place under — not on top of — the mattress. Never use a pillow under your baby's head. Make sure the mattress doesn’t fold in the middle, and that the incline is gentle enough that your baby doesn’t slide down.

If your baby also gets bottles of breast milk or infant formula supplements:

  • Burp after your baby drinks 1–2 ounces from a bottle.
  • Don't give the bottle while your little one is lying down.
  • Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples may cause babies to gag or may give them more milk than they can handle at once. Many breastfed babies do well with the slow-flow nipple until they are 3 months old, or even older.

Many babies outgrow spitting up by the time they're sitting up.

How Can I Keep My Baby From Gagging?

Sometimes the force of your milk (especially when it “lets down”) is so strong that it can cause your baby to gag and pull off of the breast. If this happens during feeding:

  • Try nursing your baby in a more upright position (head above the breast). This may ease the force of the milk.
  • Nurse in a side-lying position, which also might help slow the flow of milk. 
  • Make sure your breasts are not engorged or over-full. Nursing every 2–3 hours can help prevent engorgement. If your breasts are too full and you’re concerned about a forceful letdown, express or pump a little bit of milk a few minutes before feeding time to avoid a strong letdown.

If your baby is pulling off and gagging or coughing during feeding, sit your baby up in a seated burp position. Gently pat the back to help your baby calm down before continuing feeding. If you’ve tried the steps above and this continues to happen, talk to your doctor or lactation consultant.  

If your baby sometimes gags or chokes while taking a bottle of breast milk: 

  • Try a different nipple with a slower flow.
  • Practice “paced” bottle feeding. This is where you slow down the milk flow from the bottle by holding it at less of an angle and allowing your baby to pause for breaks.

My Baby Bites During Breastfeeding. What Can I Do?

Babies will often play with their mothers' nipples with their gums, not meaning to cause any harm. But once they start teething, a baby might bite down, not knowing this is hurting mom.

Sometimes you can tell when your baby's about ready to bite down — usually when satisfied and starting to pull away from the breast. When you sense that your baby is finished feeding and may be bored or feeling playful, end the feeding. Break the suction by slipping your finger into the corner of your baby’s mouth.

If your baby is already biting down, pull your baby closer to you to make it more difficult to pull off easily. Then, break the suction. React calmly without raising your voice. 

Here are more ways to make baby less likely to bite:

  • Before a feed, give your baby something to chew on. Make sure it's big enough that it can't be swallowed or choked on and that it can't break into small pieces. A wet washcloth placed in the freezer for 30 minutes makes a handy teething toy. Be sure to take it out of the freezer before it becomes rock hard — you don't want to bruise those already swollen gums. Wash after each use.
  • Say, "Mommy is not for biting. You can bite this." Then, offer your little one a teething toy or ring.
  • Praise your baby — with a hug, kiss, or cuddle — whenever they nurse without biting or trying to bite.

Usually this is enough to stop the biting, but if your baby continues, talk to your doctor or lactation consultant for advice.

Reviewed by: Jamila H. Richardson, BSN, RN, IBCLC

Date reviewed: January 2021

Spitting Up - Reflux

Is this your child's symptom?

  • Spitting up small amounts of breastmilk or formula. Also called reflux.
  • Spitting up 1 or 2 mouthfuls of milk at a time
  • No effort or crying
  • Normal symptom in half of young babies

Symptoms of Normal Spitting Up

  • Smaller amounts often occur with burping ("wet burps")
  • Larger amounts can occur after overfeeding
  • Most often seen during or shortly after feedings
  • Occurs mainly in children under 1 year of age
  • Begins in the first weeks of life
  • Caution: normal reflux does not cause any crying

Complications of Spitting Up (GERD)

  • Most infants are "happy spitters." Normal spitting up (normal reflux) occurs in half of babies. It does not cause crying or colic.
  • Normal crying occurs in all babies. Frequent crying (called colic) occurs in 15% of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
  • If they develop complications, it's called GERD (gastro-esophageal reflux disease). This occurs in less than 1% of babies.

Symptoms of GERD

GERD problems occur in less than 1% of infants:

  • Choking on spit up milk
  • Heartburn from acid on lower esophagus. Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort.
  • Poor Weight Gain

Cause

  • Poor closure of the valve at the upper end of the stomach (weak valve)
  • Main trigger: overfeeding of formula or breastmilk
  • More than half of all infants have occasional spitting up ("happy spitters")

Reflux Versus Vomiting: How to Tell

  • During the first month of life, newborns with true vomiting need to be seen quickly. The causes of vomiting in this age group can be serious. Therefore, it's important to tell the difference between reflux and true vomiting.

Reflux

The following suggests reflux (normal spitting up):

  • You've been told by a doctor your baby has reflux
  • Onset early in life (85% by 7 days of life)
  • Present for several days or weeks
  • No pain or crying during reflux
  • No effort with spitting up
  • No diarrhea
  • Your baby acts hungry, looks well and acts happy.

Vomiting

The following suggests vomiting:

  • Uncomfortable during vomiting
  • New symptom starting today or yesterday
  • Forceful vomiting
  • Contains bile (green color)
  • Diarrhea is also present or
  • Your baby looks or acts sick.

Pyloric Stenosis (Serious Cause)

  • This is the most common cause of true vomiting in young babies.
  • Onset of vomiting age 2 weeks to 2 months
  • Vomiting is forceful. It shoots out of the baby's mouth. This is called projectile vomiting.
  • 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.

When to Call for Spitting Up - Reflux

Call Doctor or Seek Care Now

  • Blood in the spit up
  • Choked on milk and turned blue or went limp
  • Age less than 12 weeks and spitting up changes to vomiting (forceful or projectile)
  • Age less than 1 month old and looks or acts abnormal in any way
  • 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

  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Chokes a lot on milk
  • Poor weight gain
  • Frequent crying
  • Spitting up is getting worse
  • Age more than 12 months old
  • Spitting up does not get better with this advice
  • You have other questions or concerns

Self Care at Home

  • Normal reflux (spitting up) with no problems

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 Spitting Up (Reflux)

  1. What You Should Know About Spitting Up:
    • Spitting up occurs in most infants (50%).
    • Almost always doesn't cause any pain or crying.
    • Spitting up does not interfere with normal weight gain.
    • Infants with normal reflux do not need any tests or medicines.
    • Reflux improves with age.
    • Here is some care advice that should help.
  2. Feed Smaller Amounts:
    • Skip this advice if age less than 1 month or not gaining weight well.
    • Bottlefed Babies. Give smaller amounts per feeding (1 ounce or 30 mL less than you have been). Keep the total feeding time to less than 20 minutes. Reason: Overfeeding or completely filling the stomach always makes spitting up worse.
    • Breastfed Babies. If you have a good milk supply, try nursing on 1 side per feeding. Pump the other side. Switch sides you start on at each feeding.
  3. Longer Time Between Feedings:
    • Formula. Wait at least 2½ hours between feedings.
    • Breastmilk. Wait at least 2 hours between feedings.
    • Reason: It takes that long for the stomach to empty itself. Don't add more milk to a full stomach.
  4. Loose Diapers:
    • Do not put the diaper on too tight. It puts added pressure on the stomach.
    • Don't put pressure on the stomach right after meals.
    • Also, do not play too hard with your baby during this time.
  5. Upright Position:
    • After meals, try to hold your baby in the upright (vertical) position.
    • Use a front-pack, backpack, or swing for 30 to 60 minutes after feedings.
    • Decrease the time in a sitting position (such as infant seats).
    • After 6 months of age, a jumpy seat is helpful. The newer ones are stable.
    • During breast or bottle feeds, hold your baby at a slant. Try to keep your baby's head higher than the stomach.
  6. Less Pacifier Time:
    • Frequent sucking on a pacifier can pump the stomach up with swallowed air.
    • So can sucking on a bottle with too small a nipple hole.
    • The formula should drip 1 drop per second when held upside down. If it doesn't, the nipple hole may be clogged. Clean the nipple better. You can also make the nipple hole slightly bigger.
  7. Burping:
    • Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
    • Do it when he pauses and looks around. Don't interrupt his feeding rhythm in order to burp him.
    • Burp each time for less than a minute. Stop even if no burp occurs. Some babies don't need to burp.
  8. Add Rice Cereal to Formula:
    • If your baby still spits up large amounts, try thickening the formula. Mix it with rice cereal.
    • Start with 1 level teaspoon of rice cereal to each ounce of formula.
  9. Acid Blocking Medicines:
    • Prescription medicines that block acid production are not helpful for normal reflux.
    • These medicines also can have side effects.
    • They do not reduce excessive crying from colic.
    • They are only useful for symptoms of heartburn.
  10. What to Expect:
    • Reflux gets better with age.
    • After learning to sit well, many babies are better by 7 months of age.
  11. Call Your Doctor If:
    • Spitting up changes to vomiting (forceful or projectile)
    • Poor weight gain
    • Your baby does not get better with this advice
    • 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: 12/13/2022

Last Revised: 01/13/2022

Copyright 2000-2022. 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

    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 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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    why this is happening and what needs to be done

    When parents first encounter this phenomenon, they may become quite alarmed. What is it - a symptom of a neurological disease or just whims? In most cases, when the baby arches, throwing his head back, there is nothing to worry about. But there are situations when the intervention of a specialist is necessary.

    What you need to know if the baby tilts his head back and arches

    The baby arches and throws his head back, but does not show dissatisfaction Most likely there is nothing to worry about. Perhaps he is trying to see something up or behind his back, or learning new skills. In some cases, this may be a manifestation of hypertonicity. In the first six months, this may be within the normal range, but if such phenomena are observed frequently or persist for a long time, you should see a doctor.
    The child is anxious Here a lot depends on the general condition of the baby. He may arch and whimper if his back is itchy or his nose is stuffy. More vivid signs of discontent will be if the child is tormented by colic, pain, or he is frightened. If you cannot find the cause and / or this condition recurs often, you need to see a doctor for a diagnosis.

    Variants of the physiological norm

    In some cases, the child can pull the back of the head back for the simplest reasons: he is studying his body and the world around him. But there may be other reasons as well.

    Below, we will consider in more detail all situations where “acrobatic stunts” are a physiological norm.

    Hypertonicity in infants under 6 months

    Physiological hypertonicity of the limb flexors in children under 6 months of age is considered normal. The fact is that at this age the maturation of the nervous system is still ongoing.

    Mastering the skill

    Baby mastering the skill of turning over on his stomach. In this case, the child lies on his side and throws his head back, trying to roll over from his back to his stomach. You can help the baby: throw one leg over the other crosswise in the direction where the child wants to roll over. After this, the baby must himself complete the coup with the upper body.

    Hysteria

    Often the baby, rolling in hysterics, arches, throws back his head, bursting into heart-rending crying. There is nothing wrong with this, take the baby in your arms and try to calm him down. You need to understand what alarmed him and eliminate the cause.

    Affective-respiratory attacks

    This is the name of the phenomenon when, for some reason, the child stops breathing for a short time. Often, such attacks are accompanied by tantrums, but they can also be provoked, for example, by fright or a sudden change in the environment (for example, when immersed in cold water). What it looks like: the child “rolls up” in a cry, his neck extensor muscles tighten, his torso arches, the nasolabial triangle turns blue, and at the height of the cry, the breath is suddenly held while inhaling, the skin turns blue (1). After a few seconds, the child comes to his senses, breathing becomes regular.

    These seizures can occur in healthy children during the first year of life and are usually harmless. But if such situations are repeated often and, perhaps, for no apparent reason, you should consult a doctor to rule out various diseases.

    Colic and bloating

    A nightmare for parents of babies under the age of 3-4 months. Colic is also a variant of the norm, since intestinal motility in a child is not yet fully developed.

    During colic, the baby screams heart-rendingly, arches and throws back his head, blushes strongly, clenching his fists and twisting his legs (2). The abdomen is hard and swollen, the child may refuse to eat. There are several ways to help a baby:

    • gently massage the tummy,
    • put on a clean diaper, ironed with a hot iron,
    • give medicine for colic (only after consulting a doctor!).

    If the baby is breastfed, the mother should take a closer look at her diet and exclude foods that increase gas formation: cabbage, legumes, carbonated drinks, chocolate. In the most extreme cases, the use of a gas outlet tube is acceptable.

    Runny nose

    It happens that with a runny nose, when it is difficult for an infant to breathe, he begins to arch and worry. Try to help the baby by raising his mattress by 30 degrees to improve the outflow of mucus, and also monitor the humidity and air temperature in the room where the child sleeps.

    Trying to find a sleeping position

    Sometimes babies arch their backs and tilt their heads back, trying to get comfortable before going to bed. The fact is that in the womb, children are often in unnatural positions, and in the first months of life they can unconsciously repeat them.

    Other reasons

    If the child arches over without showing displeasure, he may be trying to look at toys hanging over him.

    Try to hang the mobile and rattles so that the child does not have to dodge to look at them. Keep in mind that if the toys are hung too close to the baby's face, it may adversely affect his vision.

    In addition, the child may arch for very banal reasons: perhaps his back or neck itches.

    When the child should be seen by a pediatrician or a neurologist

    What to do if you are convinced that the baby does not suffer from colic, have tried all the ways, but the baby does not calm down and continues to cry and bend over, throwing his head back? To relieve yourself of anxiety, seek the advice of a pediatrician or neurologist.

    Let's consider situations when such behavior of the baby may indicate health problems.

    Increased intracranial pressure

    Sometimes, if the pregnancy was complicated, the child developed intrauterine hypoxia, or there was a difficult delivery, then in the first months the baby may have increased intracranial pressure, due to which he will arch, throw back his head and cry. If intracranial pressure is suspected, it is urgent to show the baby to the doctor to avoid complications.

    CSF hypertension symptoms

    Irritability, tearfulness, constant crying for no apparent reason, negative reaction to bright lights or loud sounds. Also, often increased intracranial pressure is accompanied by convulsions, profuse regurgitation after feeding. The baby sleeps little and constantly wakes up, when he screams, his lips and chin tremble violently, and the nasolabial triangle also turns blue. In severe cases, the baby's fontanel swells and protrudes, strabismus develops.

    Raised intracranial pressure can sometimes be a symptom of a serious illness, such as meningitis, which develops atypically in young children.

    Muscular hypertonicity

    Arching of the back and tilting of the head may be a sign of muscular hypertonicity in a child. Often, hypertonicity is a consequence of oxygen starvation, fetal hypoxia during pregnancy or during prolonged labor. The most severe consequences can be encephalopathy and cerebral palsy.

    Muscle tension can be all over the body or affect only one side of the baby's body. Parents should be alerted not only by the frequent arching of the child and throwing back the head, but also by the violation of the grasping function. Muscle hypertonicity is a reason to show the child to a doctor who, if necessary, will prescribe a course of treatment and massage.

    Torticollis

    Tilt-back of the child's head can also be caused by torticollis (a pathology of the musculoskeletal apparatus in the neck, due to which the child's head deviates to the side or can be turned to the side). Parents should be alerted if the child's head is always in the same position, and when you try to turn it in the other direction, the child worries and cries. Torticollis requires mandatory treatment, which includes wearing a special collar, massage courses and physiotherapy.

    Meningeal syndrome

    A complication may occur as a result of otitis media if treatment is started late. This is due to the underdevelopment of the structures of the middle ear in young children.

    In this case, the child throws back his head unconsciously, trying to alleviate his condition (3). The following symptoms may also be observed:

    • convulsions,
    • vomiting,
    • confusion,
    • decreased motor activity.

    You must go to the hospital immediately.

    Epilepsy

    During an epileptic seizure, the child may arch, throwing back his head strongly, and freeze in this state for a while. After the attack passes, the child relaxes, begins to cry, urination or defecation occurs. Treatment of epilepsy is prescribed only by a doctor and takes place under medical supervision.

    Cerebral palsy

    If a child often arches their back for no apparent reason, this may be a sign of a pathology such as cerebral palsy (4). But other characteristic signs should also be observed:

    • developmental delays (late crawling, sitting, walking, talking),
    • low or increased muscle tone,
    • problems with speech and swallowing, with only one hand, limps at an older age).

    Some of these signs may also be observed in healthy children, but if something worries you, it is worth taking the child to specialists in order to rule out a problem or start treatment in time.

    Diagnosis

    Photo: Andrey Arkusha, globallookpress.com

    If you are worried that the baby often arches and throws his head back, it is better to seek advice from a doctor who will determine reliably whether this is a norm or a pathology. The doctor will listen to complaints, ask how the pregnancy, childbirth and the first days of the child's life proceeded, specify how often and under what circumstances the baby throws his head back, whether he cries or behaves calmly, whether the nasolabial triangle turns blue, whether the fontanel swells.

    If necessary, the doctor can prescribe tests and examinations:

    • general blood and urine tests,
    • neurosonography (ultrasound of the brain through the fontanel),
    • electroencephalography (to rule out epilepsy).

    However, CT and MRI scans are extremely rare for young children, since these studies are performed under general anesthesia so that the child is completely immobile.

    Frequently asked questions and answers

    Our expert, Veronika Oranskaya, neurologist, epileptologist, member of the League of Evidence-Based Medicine.

    The baby throws back his head and arches after feeding - what can it be?

    Sometimes tilting the head back after eating or only in a horizontal position during sleep can be a manifestation of the so-called Sandifer's syndrome, which occurs due to gastroesophageal reflux (reflux of stomach contents into the esophagus). Requires medical advice and treatment.

    Can head tilt be a symptom of a child's vision problem?

    If for some reason (myasthenia gravis, oculomotor neuropathy, congenital feature) the child cannot raise the upper eyelid, he will tilt his head back.

    What other possible pathologies can the tilting of the head and arching of the child indicate?

    Sudden, paroxysmal tilting of the head may be epileptic seizures. A forced constant tilt of the head back may indicate a brain tumor. When combined with an increase in temperature, tilting the head back may indicate meningitis. But most often the reasons for head tilt are all benign: the child doesn't like something, he is learning to roll over, or he just wants to look at something that is behind his head. If in doubt, consult a doctor.

    Sources

    1. Age-dependent manifestations of neurosis in children. M.Yu. Bobylova // Pediatric practice. 2007. URL: https://medi.ru/info/11859/
    2. Infantile intestinal colic. Modern data. N.I. Ursova // Questions of modern pediatrics. 2011. URL: https://cyberleninka.ru/article/n/mladencheskie-kishechnye-koliki-sovremennye-dannye/viewer
    3. Features of the treatment of acute otitis media during the Covid-19 pandemic.

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