What causes a baby to throw up after feeding

Why This Happens and What to Do

It can be difficult to tell the difference between vomit and spit-up. Both might look the same since your baby is currently on a steady of diet of milk or formula. The main difference is in how they come out.

Spit-up usually happens before or after a burp and is most common in babies under the age of 1 year. Spit-up will easily flow from your baby’s mouth — almost like white, milky drool.

Vomit typically comes out forcefully (whether you’re a baby or an adult). This is because vomiting happens when the muscles around the stomach are triggered by the brain’s “vomiting center” to squeeze it. This forces whatever is in the stomach to be hurled out.

In a baby’s case, vomit may look like milky spit-up but have more clear stomach juices mixed into it. It may also look like milk that has been fermented for a little while — this is called “cheesing.” Yes, it sounds gross. But the texture probably won’t bother you when you see it — you’ll be more concerned with baby’s well-being.

Your baby may also cough or make little retching noises before they vomit. This is likely the only warning you’ll have to grab a towel, bucket, burp cloth, sweater, your shoe — hey, anything.

Additionally, spit-up is normal and can happen at any time. Your baby will only vomit if there’s a digestive issue or they have another illness.

Feeding difficulty

Babies have to learn everything from scratch, including how to feed and keep the milk down. Along with spit-up, your baby may vomit occasionally after being fed. This is most common in the first month of life.

It happens because your baby’s tummy is still getting used to digesting food. They also have to learn to not gulp milk down too fast or overfeed.

Post-feeding vomiting typically stops after the first month. Give your baby more frequent, smaller feeds to help stop the vomit.

But let your pediatrician know if your baby vomits often or has very forceful vomits. In some cases, it might be a sign of something other than feeding difficulty.

Stomach flu

Also known as the tummy bug or “stomach flu,” gastroenteritis is a common cause of vomiting in babies and children. Your baby may have cycles of vomiting that come and go for about 24 hours.

Other symptoms in babies may last for 4 days or longer:

watery, runny poop or mild diarrhea
irritability or crying
poor appetite
stomach cramps and pain

The tummy bug can also cause a fever, but this is actually less common in babies.

Gastroenteritis usually looks a lot worse than it is (thank goodness!). It’s typically caused by a virus that goes away by itself in about a week.

In babies, severe gastroenteritis can lead to dehydration. Call your pediatrician immediately if your baby has any signs of dehydration:

dry skin, mouth, or eyes
unusual sleepiness
no wet diapers for 8 to 12 hours
weak cry
crying without tears

Infant reflux

In some ways, babies really are like tiny adults. Just like adults of any age can have acid reflux or GERD, some babies have infant reflux. This can lead to baby vomiting in the first weeks or months of your baby’s life.

Vomiting from acid reflux happens when the muscles at the top of the stomach are too relaxed. This triggers baby vomiting shortly after feeding.

In most cases, the stomach muscles strengthen, and your baby’s vomiting goes away on its own. Meanwhile, you can help slow down the vomiting by:

avoiding overfeeding
giving smaller, more frequent feeds
burping your baby often
propping your baby up in an upright position for about 30 minutes after feeding

You can also thicken milk or formula with more formula or a bit of baby cereal. Caveat: Check with your pediatrician before you try this. It might not be suitable for all babies.

Cold and flu

Babies catch colds and flus easily because they have shiny new immune systems that are still developing. It doesn’t help if they’re in day care with other sniffling kiddos, or they’re around adults that can’t resist kissing their little faces. Your baby may have up to seven colds in their first year alone.

Cold and flu can cause different symptoms in babies. Along with a runny nose, your baby may also have vomiting without a fever.

Too much mucus in the nose (congestion) can lead to a nasal drip in the throat. This can trigger bouts of forceful coughing that sometimes cause vomiting in babies and children.

As in adults, colds and flu in babies are viral and go away after about a week. In some cases, sinus congestion may turn into an infection. Your baby will need antibiotics to treat any bacterial — not viral — infection.

Ear infection

Ear infections are another common illness in babies and children. This is because their ear tubes are horizontal rather than more vertical like in adults.

If your little one has an ear infection, they might have nausea and vomiting without a fever. This happens because an ear infection can cause dizziness and loss of balance. Other symptoms of ear infections in babies include:

pain in one or both ears
tugging or scratching at or near the ears
muffled hearing
diarrhea

Most ear infections in babies and children go away without treatment. However, it’s important to see a pediatrician in case your baby needs antibiotics to clear up the infection. In rare cases, a serious ear infection can damage a baby’s tender ears.

Overheating

Before you swaddle your baby or put them in that adorable fluffy bunny suit, check the temperature outside and in your home.

While it’s true that the womb was warm and cozy, babies can overheat quickly in hot weather or in a very warm house or car. This is because their tiny bodies are less able to sweat out heat. Overheating might cause vomiting and dehydration.

Overheating can lead to heat exhaustion or in much more serious cases, heatstroke. Look for other symptoms like:

pale, clammy skin
irritability and crying
sleepiness or floppiness

Immediately remove clothing and keep your baby out of the sun and away from heat. Try to breastfeed (or give your baby water if they’re 6 months or older). Get urgent medical attention if your baby doesn’t seem their usual self.

Motion sickness

Babies below the age of 2 years don’t commonly get motion or car sickness, but some babies may get sick after a car ride or being twirled around — especially if they’ve just eaten.

Motion sickness can make your baby dizzy and nauseous, leading to vomiting. It might be more likely to happen if your baby already has an upset tummy from bloating, gas, or constipation.

Strong smells and windy or bumpy roads can also make your baby dizzy. Nausea triggers more saliva, so you might notice more dribble before your baby vomits.

You can help prevent motion sickness by traveling when your baby is ready to sleep. (Great trick if your baby loves to sleep in the car!) A sleeping baby is less likely to feel queasy.

Keep their head well supported in the car seat so it doesn’t move around too much. Also, avoid going for a drive right after giving your baby a full feed — you want your baby to digest the milk, not wear it.

Milk intolerance

A rare kind of milk intolerance is called galactosemia. It happens when babies are born without a certain enzyme needed to break down sugars in milk. Some babies with this condition are even sensitive to breast milk.

It can cause nausea and vomiting after drinking milk or any kind of dairy products. Galactosemia can also cause a skin rash or itching in both babies and adults.

If your baby is formula fed, check the ingredients for any dairy, including milk proteins.

Most newborns are screened at birth for this rare condition and other illnesses. This is usually done with a heel prick blood test or a urine test.

In the rare event that your baby has this, you’ll know it very early on. Make sure your baby completely avoids milk to help stop vomiting and other symptoms.

Pyloric stenosis

Pyloric stenosis is a rare condition that happens when the opening between the stomach and intestines is blocked or too narrow. It can lead to forceful vomiting after feeding.

If your baby has pyloric stenosis, they may be hungry all the time. Other symptoms include:

dehydration
weight loss
wave-like stomach contractions
constipation
fewer bowel movements
fewer wet diapers

This rare condition can be treated with surgery. Tell your pediatrician immediately if your baby has any of the symptoms of pyloric stenosis.

Intussusception

Intussusception is a rare intestinal condition. It affects 1 in every 1,200 babies and most commonly happens at the age of 3 months or older. Intussusception can cause vomiting without a fever.

This condition happens when the intestines are damaged by a virus or other health conditions. The damaged intestine slips — “telescopes” — into another part of the intestine.

Along with vomiting, a baby may have severe stomach cramps that last for about 15 minutes. The pain can cause some babies to curl their knees up to their chest.

Other symptoms of this intestinal condition include:

fatigue and tiredness
nausea
blood or mucus in bowel movements

If your baby has intussusception, treatment can push the intestine back into place. This gets rid of vomiting, pain, and other symptoms. Treatment includes using air in the intestines to gently move the intestines. If that doesn’t work, keyhole (laparoscopic) surgery heals this condition.

See your baby’s pediatrician if your baby has vomiting for longer than 12 hours. Babies can get dehydrated quickly if they’re vomiting.

Get immediate medical attention if your baby is vomiting and has other symptoms and signs like:

diarrhea
pain or discomfort
constant or forceful coughing
hasn’t had a wet diaper for 3 to 6 hours
refusing to feed
dry lips or tongue
few or no tears when crying
extra tired or sleepy
weakness or floppy
won’t smile
swollen or bloated stomach
blood in diarrhea

Baby vomiting without a fever can happen because of several common illnesses. Your baby will likely have one or more of these several times in the first year. Most of these causes go away on their own, and your little one will stop vomiting without any treatment.

But too much vomiting can lead to dehydration. Check for signs of dehydration and call your pediatrician if you’re not sure.

Some causes of baby vomiting are more serious, but these are rare. Your baby will need medical care for these health conditions. Know the signs and remember to keep the doctor’s number saved in your phone — and take a deep breath. You and baby got this.

Baby Vomiting After Feeding Formula: Causes and Treatment

Your little one is happily gulping their formula while cooing at you. They finish off the bottle in no time flat. But shortly after feeding, it seems to all come out as they vomit.

There are several reasons why your baby might be vomiting after a formula feeding, but it’s important to remember that it can be — and often is — very normal.

It’s common for babies to throw up sometimes after feeding on formula or breast milk. Their shiny new digestive systems are still learning what to do with all the yummy milk coming down into their tummy.

However, if your baby often has a hard time keeping their formula down on a regular and frequent basis, let your pediatrician know.

Having a baby around means getting used to soft mushy stuff coming out fairly often. This includes spit-up and vomit.

Spit-up and vomit might seem pretty much the same — and require similar amounts of cleaning to get them off of your sweater and the sofa — but they’re very different. Spitting up is an easy, gentle dribble of milk. Baby may even smile at you as the curd-like spit-up flows from their mouth.

Spit-up is normal in healthy babies, especially if they’re under the age of 1.

On the other hand, vomit takes more effort, as it comes from deeper in your little one’s stomach. It’s a sign that your baby’s stomach is saying nope, not now, please. You might see your baby strain and recoil just before they projectile vomit. This force happens because vomit is squeezed out by the stomach muscles.

Your baby might also look more uncomfortable during and after vomiting. And vomit looks and smells different. This is because it’s usually formula, breast milk, or food (if your baby is eating solids) mixed with stomach juices.

If you’re not sure whether your baby is vomiting or spitting up, look for other vomiting symptoms, like:

crying
gagging
retching
turning red
arching their back

That said, there doesn’t seem to be agreed-upon definitions of these two terms among healthcare providers, caregivers, and others. Plus, their symptoms may overlap. For example, spitting up may sometimes be forceful, and vomiting may sometimes seem painless.

Overfeeding

It’s easier for your baby to overfeed when they’re drinking from a bottle than when they’re breastfeeding. They can also gulp down milk faster from a bottle and rubber nipple. What’s more, because formula is always available, it’s easier for you to give them more milk than they need by accident.

Babies have tiny stomachs. A 4- to 5-week-old infant can only hold about 3 to 4 ounces in their tummy at a time. This is why they need lots of smaller feedings. Drinking too much formula (or breast milk) in one feeding can overfill your baby’s stomach, and it can only come out one way — vomit.

Not burping properly

Some babies need to be burped after every feeding because they swallow lots of air as they gulp down milk. Bottle feeding your baby breast milk or formula may lead to more air-swallowing, as they can gulp even faster.

Too much air in the stomach can make your baby uncomfortable or bloated and trigger vomiting. Burping your baby right after feeding them formula may help prevent this.

To help prevent your baby from swallowing too much air and vomiting after formula feeding, check your baby’s bottle. Make sure you’re using a smaller bottle that’s just big enough to hold a few ounces of milk. Also, check to make sure the nipple hole is not too big, and don’t let your baby continue gulping when the bottle is empty.

Baby or infant reflux

Baby can have acid reflux, indigestion, or occasionally gastroesophageal reflux disease (GERD just like grown-ups! This happens because their stomach and food tubes are still getting used to holding down milk.

Baby reflux happens when milk travels back up toward your baby’s throat and mouth. This usually just causes some painless spitting up, but it can irritate your baby’s throat and trigger gagging and vomiting.

Sometimes, smaller feedings can help prevent baby reflux. If not, don’t worry! Most little ones outgrow baby reflux by the time they’re 1 year old.

Constipation

While simple constipation would be an uncommon cause of vomiting in an otherwise healthy infant, sometimes baby vomiting happens because of what isn’t happening at the other end.

Most babies who are formula-fed need to poop at least once a day. Anything less than your baby’s typical pattern, though, might indicate they’re constipated.

If your baby is vomiting after a formula feeding, they might be constipated if they have other symptoms, including:

gassiness
not pooping for longer than 3–4 days
a swollen or bloated stomach
a firm or hard stomach
crying bouts or irritableness
straining very hard but not pooping or pooping only a little
small, hard pellet-like poop
dry, dark poop

Stomach bug

If your baby doesn’t usually vomit after having formula, they might have a stomach bug. Also known as gastroenteritis or the “stomach flu,” a stomach bug is a very common cause of vomiting in babies. Your little one may vomit several times for up to 24 hours.

Other symptoms of a stomach bug include:

crying
stomach cramps
stomach rumbling
bloating
diarrhea or watery poop
mild fever (or none at all in babies)

Allergy

In rare cases, the cause of your baby’s vomiting might be in the formula. Although it’s uncommon for babies to be allergic to cow’s milk, it may happen to up to 7 percent of babies under the age of 1.

Most children outgrow a milk allergy by the time they’re 5 years old, but it can cause vomiting and other symptoms in babies. A cow’s milk allergy might cause vomiting right after your baby eats. It can also cause vomiting and other symptoms hours or rarely days later.

If your baby has an allergy to milk or something else, they might have other symptoms of an allergic reaction, like:

skin rash (eczema)
diarrhea
cough
hives
difficulty breathing
wheezing

Lactose intolerance

An allergy to milk is different than being lactose intolerant. Lactose intolerance usually causes digestive symptoms like diarrhea. It can also make your baby vomit after drinking formula containing cow’s milk.

Your baby might get temporary lactose intolerance after getting a tummy bug or gastroenteritis, although this is uncommon.

Other symptoms include:

diarrhea or watery poops
constipation
bloating
gassiness
stomach pain
stomach rumbling

Note that lactose intolerance is rare in babies under the age of 1.

Other causes

Some common health conditions can cause vomiting at any time, including after breastfeeding or formula feeding. Some rare genetic conditions can also cause vomiting in babies.

Other causes of vomiting in babies include:

colds and the flu
ear infections
some medications
overheating
motion sickness
galactosemia
pyloric stenosis
intussusception

In most cases, minor tweaks can help stop your baby’s vomiting. Remedies to stop your baby’s vomiting after formula depend on what’s causing it. Try some of these tried and tested methods to see what helps your baby:

feed your baby smaller amounts of formula more often
feed your baby slowly
burp your baby after the feeding
hold your baby’s head and chest up while feeding
hold your baby upright after a feeding
make sure your baby doesn’t move around or play too much right after a feeding
try a smaller bottle and smaller-hole nipple to feed
check the ingredient list on your baby’s formula
ask your baby’s doctor if you should try a different kind of formula
talk to your baby’s doctor about a possible allergic reaction
dress your baby in looser clothing
make sure their diaper isn’t on too tightly

If your baby has the stomach flu, you’ll both usually just have to ride it out for a day or two. Most babies and children with a stomach bug don’t need treatment.

If your baby is vomiting, see your doctor or pediatrician right away if they:

are vomiting often
are vomiting forcefully
aren’t gaining weight
are losing weight
have a skin rash
are unusually sleepy or weak
have blood in their vomit
have green bile in their vomit

Also, see your doctor urgently if your baby has any sign of dehydration from all the vomiting:

dry mouth
crying without shedding tears
a weak or quiet cry
floppiness when picked up
no wet diapers for 8 to 12 hours

It’s pretty common for babies to vomit, especially after feeding. This happens for many reasons, including that these little people are still just getting used to keeping down their milk.

Check with your doctor about what you can do. See your doctor urgently if your baby vomits often for any reason.

Spitting up and vomiting in infants

Spitting up and vomiting in babies is a common reason for visiting a doctor.

Regurgitation and vomiting is a reflex action that occurs when receptors located in various anatomical zones are irritated, incl. in the stomach, esophagus, pharynx, oral cavity. The signal is transmitted to the vomiting center, which is located in the medulla oblongata and a gag reflex occurs.

What is the difference between regurgitation and vomiting?

The difference lies in the volume and kinetics (movement) of the gastric contents expelled to the outside. When regurgitation occurs, leakage occurs without the participation of the diaphragm and abdominal muscles, i.e. passively. There is little content, up to about 10-15 ml. If the child does not swallow it, it quietly expires from the oral cavity. When vomiting, a wave-like bending of the upper half of the body occurs as a result of contraction of the muscles of the diaphragm and the anterior wall of the abdomen, the volume of vomit is greater, and they are erupted with pressure from the oral cavity with an ejection trajectory of up to 50 cm. In children of the first year of life, this is defined by the term "fountain vomiting" . nine0003

Regurgitation is observed only in children of the first year of life and, mainly, up to 6 months. Contribute to this anatomical and physiological features of the esophagus and stomach of the baby. Their esophagus is short and wide, the angle of connection of the esophagus with the stomach is less pronounced, and its obturator function is weak. These regurgitations are physiological. They can be after each feeding, up to 15 ml, do not affect the well-being and weight gain of the baby. They can also be caused by excessive feeding, aerophagia (swallowing air while sucking), straining during intestinal colic. The frequency and volume of such regurgitation decreases with the growth of the child. With the introduction of complementary foods, and this is a thicker food, regurgitation stops or becomes much less frequent. nine0003

If regurgitation persists in a child older than 1 year, then this is a sign of a pathological process.

Vomiting, unlike regurgitation, is accompanied by vegetative symptoms - increased salivation, pallor of the skin, palpitations. This is due to the fact that next to the vomiting center there are additional centers of autonomic regulation, which are reflexively excited, and active biological substances such as serotonin, dopamine, histamine and others are released into the blood. nine0003

Regurgitation and vomiting, from the moment of eating, may occur during feeding, after feeding for the first 20-30 minutes or delayed, sometimes after several hours.

Regurgitation and vomiting that occurs immediately after feeding unchanged breast milk or formula may be due to narrowing of the esophagus. If they persist until the next feeding, and the milk / mixture is curdled, has a sour or musty smell, then this is the result of a long standing food in the stomach. The reason for this may be the low tone of the muscle layer of the stomach and, as a result, its peristalsis or narrowing of the output section due to an anomaly in the development or high tone of the sphincter of the lower stomach. With narrowing of the duodenum, bile is present in the regurgitated masses. nine0003

Gastroesophageal reflux is a common cause of regurgitation in infants. It is likely that there is a complex problem here, starting with the immaturity of the gastrointestinal tract and disorders of the central nervous system. Perinatal injuries of the central nervous system accompany every second child. Their manifestations are varied. Regurgitation and vomiting can be facilitated by an increase in intracranial pressure, disorders in the segment of the cervical spine, and so on. Therefore, quite often, when carrying out rehabilitation measures for neurological dysfunctions, a positive effect is manifested in the form of a decrease or cessation of regurgitation. A hernia of the esophageal opening of the diaphragm will also manifest itself in a similar way. nine0003

We should not forget about allergic gastrointestinal reactions in the form of regurgitation and vomiting. The most common cause of this is cow's milk protein. With intolerance to cow's milk protein, inflammation of the mucous membrane of the esophagus, stomach and intestines occurs. And, as a result of this, regurgitation and vomiting, pain and increased gas formation, diarrhea or constipation.

Rare endocrine disorders (adrenogenital syndrome) are manifested by vomiting in children from the first weeks of life. In such cases, vomiting is frequent, there may be an admixture of bile, the child loses weight due to loss of fluid and nutrients, and severe metabolic disorders develop. nine0003

Vomiting can also be caused by an intestinal infection. Viral gastroenteritis is now common. It must be remembered that the younger the child, the more severe the disease. Within a few hours, the child's condition can go from satisfactory to extremely serious.

As you can see, the causes of regurgitation and vomiting in children of the first year of life are quite diverse, but most often these are transient conditions that disappear with the growth of the child.

Prevention of regurgitation in children of the first months of life is quite simple. Don't overfeed your baby. If he cries, it does not always mean that he is hungry. Excess feeding leads to increased gas formation and colic, during which the child is worried, straining, thereby increasing the likelihood of spitting up. After feeding, hold the baby more upright so that he can burp the swallowed air. This will take 15-20 minutes. If the child is bottle-fed, do not change his formula milk without the recommendation of a pediatrician. nine0003

If the child has frequent regurgitation and vomiting, it is necessary to consult a pediatrician or gastroenterologist to diagnose the cause. To make a diagnosis, it is sometimes enough to carry out simple and affordable diagnostic methods in a polyclinic. These include an ultrasound of the stomach and, if necessary, stool tests. However, the approach in each case is individual. Examination and treatment will be assigned to your baby, depending on the diagnosis. Perhaps it will be preventive measures or a certain milk formula, perhaps drug therapy. Rarely, but it happens that it is necessary to examine the child in a hospital and surgical treatment. nine0003

Regurgitation and vomiting in children

Regurgitation syndrome is one of the most common reasons parents of young children visit a pediatrician and a surgeon. The causes of regurgitation in children under 1 year old are different: anatomical and functional features, neurological disorders, infectious processes, malformations or other problems. The mechanism that prevents regurgitation and vomiting in children is very complex and depends on the anatomical structure and physiological processes of the child. The formation of this mechanism occurs in the last trimester of pregnancy and continues in the first months of a child's life. Although regurgitation and vomiting can be a symptom of various diseases, in themselves these processes are physiological, i.e. normal. The pathological reflux of stomach contents into the esophagus is called gastroesophageal reflux, and the mechanism that prevents vomiting is called the antireflux mechanism. nine0003

Anti-reflux mechanism in children

In children, the nervous regulation of the antireflux mechanism is very complex and easily disturbed under the influence of external and internal factors. Regurgitation and vomiting easily occur in children with an immature antireflux mechanism, if the mode or volume of feeding is incorrectly selected, as a reaction to artificial mixtures, at the slightest sign of infectious processes. This is especially often observed in children with intrauterine growth retardation and premature babies, as well as in severe pregnancy and toxicosis, caesarean section, complicated childbirth, etc. nine0003

When to see a doctor

Despite the fact that moderate spitting up in a child under 6 months is considered a variant of the norm, parents should definitely tell the pediatrician about this during a routine examination. The reason for serious concern and immediate examination of the child is an increase in the frequency or increase in the volume of regurgitation, the appearance of streaks of blood or bile impurities, a lag in recruitment or weight loss, and high temperature. In this case, it is urgent to consult a surgeon to rule out surgical causes. nine0003

Diagnostics

In most cases, an ultrasound examination (ultrasound) is necessary to establish an accurate diagnosis and select the correct treatment. An experienced doctor of ultrasound diagnostics helps to establish the correct diagnosis in more than half of the cases. Sometimes, for a more accurate diagnosis, a flexible gastroscopy, X-ray examination, or computed tomography of the abdominal organs is performed.

When surgery is required

Pyloric stenosis, or impaired patency of the gastric outlet, is the cause of the most severe regurgitation syndrome (vomiting "fountain") in children under 2 months, accompanied by severe weight loss and progressive deterioration of the child's condition. This disease requires urgent surgical care. In leading clinics, such operations are performed using a minimally invasive laparoscopic method. The current level of development of surgery and pediatric anesthesiology allows the use of endoscopic surgery techniques even in children in the first weeks of life. nine0003

There are also other causes of regurgitation that require surgical intervention, such as hiatal hernia, chalazia (gaping) of the esophagus, and others. These malformations are characterized by a violation of the formation of the antireflux mechanism and lead to constant regurgitation in a child, impaired weight gain, decreased appetite, chronic cough, bronchial asthma, and anemia. If drug therapy is ineffective, then a gastrofundoplication operation is indicated, in which an artificial antireflux valve is surgically formed. Like many other interventions, in modern children's clinics this operation is performed laparoscopically - with less trauma, minimal blood loss, minimal cosmetic defect and a quick recovery of the child after the operation. nine0003

Of course, vomiting and regurgitation can be symptoms of many other diseases and occur at any age of the child. Thus, vomiting is often observed in acute appendicitis and intestinal obstruction, it can be a symptom of an intestinal infection, intoxication, etc. In addition to the disease itself, vomiting and profuse regurgitation are dangerous because the child loses a large amount of water and salts necessary for life, which can lead to dehydration - exsicosis. The younger the child, the faster the disruption of compensatory mechanisms and the worsening of his condition. Therefore, the appearance in a child of symptoms of vomiting or severe regurgitation in young children requires immediate medical attention to identify the causes, establish the correct diagnosis and select the optimal treatment, and, if necessary, surgical. nine0003

Experienced pediatricians and surgeons are on duty around the clock at the EMC Children's Clinic, providing emergency and planned care to children of all ages, starting from the first days of life.

If surgical treatment is required, the method of choice in our clinic is minimally invasive endoscopic surgery, which in most cases allows the child to go home on the day of the operation.