Baby spits up formula hours after feeding

Formula Feeding FAQs: Some Common Concerns (for Parents)

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

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

Sometimes, babies spit up when they have eaten too much, burp, or drool.

Many infants will spit up a little after some — or even all — feedings or during burping because their digestive tracts are immature. That's 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. Vomiting is a forceful ejection of stomach contents. Spitting up is a more gentle flow out the mouth or nose.

If you're concerned that your baby is vomiting, call your doctor. Keep a record of exactly how often and how much your baby is vomiting or spitting up. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical care. The doctor should be able to tell you if it's normal or something of concern.

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 your little one drinks 1–2 ounces from a bottle.
Don't give the bottle while your baby is lying down, and keep your baby’s head above their feet.
Keep your baby upright after feedings for at least 30 minutes. Holding your baby is best. The way your baby sits in an infant seat can make spitting up more likely.
Don't jiggle, bounce, or actively play with your baby right after feedings.
Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples can make babies gag or may give them more milk than they can handle at once. Many breastfed babies do well with a slow-flow nipple until they are 3 months old, or even older.
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.

Most babies grow out of spitting up by the time they're able to sit up.

How Do I Know If My Baby Has an Allergy?

Some babies are allergic to the protein in cow's milk formula. Symptoms of an allergic reaction may include:

vomiting
diarrhea
belly pain
rash
blood or mucus in the baby's poop

If your baby has any of these symptoms, tell your doctor. Also talk to the doctor before switching formulas.

If your baby has symptoms of a severe allergic reaction — like sudden drooling, trouble swallowing, wheezing, or breathing problems — see a doctor right away.

Is Soy Formula Safe for My Baby?

Store-bought iron-fortified soy formula is safe and nutritionally complete. Doctors usually recommend soy-based formulas if:

Parents don’t want their babies to eat animal protein.
A baby has congenital lactase deficiency, a rare condition where babies are born without the enzyme needed to digest lactose. Lactose is the main sugar found in cow’s milk.
A baby is born with galactosemia, a rare condition where babies can’t digest galactose. Lactose is made up of glucose and galactose.

Many babies who are allergic to cow's milk also are allergic to the protein in soy formulas, so doctors usually recommend hypoallergenic formulas for these infants.

Soy formula is a good alternative to cow's milk formula for full-term babies (those born at 39 weeks or later). Soy formulas are not recommended for premature babies. Talk to your doctor if you are considering a soy-based formula for your baby.

Do not try to make your own formula at home. Online recipes may look healthy and promise to be nutritionally complete, but they can have too little — or too much — of important nutrients and cause serious health problems for your baby.

Is it OK to Switch to a Different Formula?

It’s probably OK to switch brands of the same kind of formula. For example, parents might buy another brand of cow’s milk formula because it’s on sale or to see if it helps with constipation, or switch to an organic formula because they’re concerned about pesticides.

But before switching formulas, talk to your doctor. Some parents may think that formula plays a part in a baby's fussiness, gas, spitting up, or constipation. But that’s not usually the case. Your doctor can help find out what may be causing these symptoms and recommend the right formula for your baby.

Do I Need to Give My Formula-Fed Baby Vitamins?

No. Commercial infant formulas with iron have all the nutrients your baby needs. Babies who are drinking less than about 1 quart (1 liter) of formula will need a vitamin D supplement.

Does My Baby Need Fluoride Supplements?

Babies do not need fluoride supplements during the first 6 months. Your doctor may recommend fluoride supplements when your baby is 6 months to 3 years old, but only if fluoride is not in your drinking water.

Is it OK to Prop a Bottle in My Baby's Mouth?

Never prop your baby’s bottle. Your baby can choke drinking from a propped bottle. Propping a bottle also can lead to ear infections and tooth decay. Always stay with and hold your baby during feedings.

It is OK to Let My Baby Sleep With a Bottle?

Never put your baby to bed with a bottle. Like propping a bottle, sleeping with a bottle can cause choking, ear infections, and tooth decay.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 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)

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.
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.
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.
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.
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.
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.
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.
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.
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.
What to Expect:
- Reflux gets better with age.
- After learning to sit well, many babies are better by 7 months of age.
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: 12/08/2022

Last Revised: 01/13/2022

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.

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.

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 filled, part of the contents immediately comes out if the baby takes an inclined or horizontal position.

Infants 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 reverse reflux of food eaten into the esophagus.

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.

As for the increase in intra-abdominal pressure, it increases with a too tight-fitting 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.

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.

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 promotion to the esophagus after feeding is higher.

Your baby may spit up after every feed because:

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.

Case study:

A breast-fed child after 3 months 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.

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

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

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.

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.

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.

Points	Regurgitation frequency	Volume
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
four	After every feeding	Small amount over 30 minutes or more
5	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;
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 burping, and feels normal;
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.

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;
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 adjustment. 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.

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 the crib: so the masses, when returning from the stomach, will not enter the respiratory tract. If the child spit up, 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.

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.

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.

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 your knees, to prevent spitting up.

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.

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?

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.

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, spitting up continues 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 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 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”.

Regurgitation in many newborns can be triggered by other situations in which pressure in the abdomen 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?

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, so if it occurs, you should urgently contact your pediatrician to find out the cause and start 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 is 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 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 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.

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 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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