The child often spits up afterwards. The child spits up: normal options and cause for concern

Spitting up is a common problem in infants that parents worry about. What are the reasons for this phenomenon? And in what cases you need to see a doctor and start treatment?

regurgitation- passive throwing of small amounts of food from the stomach into the esophagus, pharynx and oral cavity, in combination with the discharge of air, is observed mainly in infants immediately or shortly after feeding with uncurdled or partially curdled milk. These phenomena can be in perfectly healthy children (but not often, and the volume of regurgitated contents is small - up to 3 ml). According to statistics, up to 67% of children aged 4 months spit up at least once a day, in 23% of cases spitting up is considered by parents as a cause for "worry". In most cases, regurgitation can resolve on its own within the first year of life, but in some cases, serious therapy may be required. In addition, against the background of long-term regurgitation, secondary disorders can form, primarily inflammatory changes in the esophagus. Therefore, it is always desirable to clarify the cause of regurgitation.

Features of the child's body

Anatomical and physiological features of the structure of the upper digestive tract in newborns (spherical shape of the stomach and its small volume, delayed emptying, relative weakness of the lower esophageal sphincter (LES) - a circular muscle that closes after passing food from the esophagus into the stomach, and does not allow gastric contents to be thrown back to the esophagus, the immaturity of the regulation of the system for moving food through the gastrointestinal tract (GIT), the immaturity of enzymes) predispose to the development of regurgitation.

In newborns, sucking movements occur in short series of 3-5 suckings, creating negative pressure in the oral cavity, and contractions of the esophagus (peristaltic wave) during swallowing appear inconsistently: either before sucking, or after it, and often it is incomplete along its length. At the same time, in newborns, in response to the peristaltic wave, a sharp contraction of the fundus of the stomach is observed, which leads to an increase in intragastric pressure and may cause the return of food and air into the esophagus and the occurrence of regurgitation. In addition, due to the fact that during the act of sucking a certain amount of air enters the stomach, the baby has a feeling of false saturation and he stops sucking. If this situation is repeated frequently, it can lead to malnutrition and delayed development of the child.

Reasons for regurgitation

Spitting up often occurs in children with intrauterine growth retardation (IUGR), as well as premature babies. Along with the above anatomical and functional features of the gastrointestinal tract, there is also a slow formation (maturation) of the process of coordinated sucking, swallowing and breathing - it lasts about 6-8 weeks. The intensity of regurgitation can be different. However, as the body matures, regurgitation disappears.

The cause of spitting up may be overfeeding(increase in the frequency or volume of feeding), especially in actively suckling newborns with a sufficient amount of milk from the mother. With artificial or mixed feeding (breastfeeding + formula supplementation), overfeeding is possible due to a change in the nature of nutrition (replacing breast milk with an artificial mixture or frequent unmotivated replacement of one adapted mixture with another). Regurgitation during overfeeding occurs immediately or shortly after feeding with uncured or partially curdled milk, in the amount of 5-10 ml. The general condition, the behavior of the baby does not suffer in any way, there is a good appetite, normal stool, normal weight gain.

Aerophagia(swallowing a large amount of air at the time of feeding) happens: in excitable, greedily sucking children from 2-3 weeks of life in the absence or small amount of milk from the mother; when the child does not capture the areola along with the nipple or incorrectly captures with a flat, inverted nipple in the mother; with a large hole in the nipple of the bottle, the horizontal position of the bottle, when the nipple is not completely filled with milk; with general muscle weakness due to the immaturity of the body. More often, aerophagia develops in newborns with low or very large body weight at birth. Children with aerophagia are often restless after feeding, and there is a bulging of the anterior abdominal wall in the stomach area. After 5-10 minutes after feeding, regurgitation of unchanged milk is observed with a loud sound of outgoing air.

Spitting up in a newborn may occur when flatulence(bloating), intestinal colic (painful spasms of the intestines), constipation. This increases the pressure in the abdominal cavity, disturbed the movement of food through the gastrointestinal tract. The intensity of regurgitation is also possible different.

Gastrointestinal malformations, such as anomalies of the esophagus, can also lead to regurgitation and vomiting ( chalazia- weakness (insufficiency) of the lower esophageal sphincter; achalasia- narrowing at the junction of the esophagus to the stomach), anomaly of the stomach ( pyloric stenosis- narrowing at the junction of the stomach into the duodenum, preventing gastric emptying), anomaly of the diaphragm ( diaphragmatic hernia- movement of a part of the abdominal organs into the chest cavity), etc.

Fortunately, in most children, regurgitation is a non-pathological condition that spontaneously resolves by 12-18 months of a baby's life.

The intensity of regurgitation can be approximately estimated on a five-point scale (Table 1).

Intense regurgitation, with a large volume, after each feeding, causing concern to the child, leading to weight loss, requires a visit to a doctor and a thorough examination of the child to exclude congenital pathology.

Estimation of the intensity of regurgitation

Table 1

0 points	Absence of regurgitation
1 point	Less than 5 regurgitations per day, the volume is not more than 3 ml
2 points	More than 5 regurgitations per day, volume more than 3 ml
3 points	More than 5 regurgitations per day up to half the amount of formula or breast milk eaten in one feeding; no more than half of feedings
4 points	Small volume regurgitation for 30 minutes or more after each feed
5 points	Regurgitation of half to full volume of formula or breast milk eaten for one feeding; at least half of feedings

*Regurgitation of intensity 3 or more also always requires a visit to a doctor.

What to do?

To search for the cause of regurgitation and help the child, you should contact the pediatrician, it is possible that the baby may need to consult a pediatric surgeon if a congenital pathology is detected or if there is no effect from drug treatment and surgery. In other cases, the need for treatment is determined by the condition of the child and his weight gain.

The question of where to conduct the examination, in a clinic or in a hospital, is decided individually, depending on the severity of the process, the age of the child and the capabilities of the diagnostic institution. Of the instrumental methods, an x-ray examination of the upper gastrointestinal tract (esophagus, stomach) can be performed using a contrast agent and esophagogastroscopy (examination of the upper gastrointestinal tract using an optical device that looks like a rubber hose, at one end of which a miniature video camera is placed).

Regurgitation treatment

In accordance with the recommendations of the working group of the European Society of Gastroenterology and Nutrition, the treatment of regurgitation is carried out in several successive stages: treatment with position, clinical nutrition, drug therapy; surgical methods of treatment.

Position treatment. When feeding a child suffering from regurgitation, it is important to create a position in which the upper body would be raised at an angle of 45-60 degrees to the horizontal plane. For example, the baby can be put on a large, not very soft pillow. After feeding, it is important to keep the baby in an upright position for at least 20-30 minutes to ensure the unhindered exit of swallowed air.

Tight swaddling is not recommended, the abdomen should not be squeezed, instead of sliders with an elastic band, it is better to use sliders fastened on the shoulders of crumbs or overalls. The child should sleep on a small pillow made of 1-2 folded diapers, or the legs of the head of the crib should be raised by 5-10 cm. During sleep, in order to reduce the intensity of the reflux of gastric contents into the esophagus, it is preferable to lay the child on the stomach or right side. Organization medical nutrition includes, first of all, more frequent feeding of the child in smaller portions than usual. At the same time, the daily amount of food should not decrease. The number of feedings can be increased by 1-2 in excess of the norm.

The second component is the use of therapeutic mixtures. Medicinal products that prevent regurgitation (regurgitation) are labeled with the letters AR (from the English. Antiregurgitation). Of great importance is the protein composition of such a mixture, namely, the ratio of whey proteins to casein (complex milk protein). In mother's milk, this ratio is 60-70:40-30, in cow's milk - 20:80, in most adapted milk mixtures - 60:40. An increase in the proportion of casein in the diet prevents regurgitation, because. this protein is easily curdled in the stomach under the influence of hydrochloric acid, forming first flakes, then a thick mass that prevents regurgitation.

Another approach is to introduce a thickener into the mixture. As such, rice, corn or potato starch can be used, as well as gum - gluten from the seeds of the carob tree, which grows in the Mediterranean countries. Gum thickens under the action of the acidic contents of the stomach, but unlike starch and casein flakes, it is not digested by the enzymes of the gastrointestinal tract. As a result, the thick consistency of the gastric and, in the future, intestinal contents is maintained for a longer time. In addition, gum stimulates peristalsis, helping to move food from the stomach to the intestines more quickly.

Specialized milk formulas that prevent regurgitation

table 2

With natural feeding, therapeutic mixtures can be added to the baby's diet before breastfeeding.

In the absence of the effect of the above measures, the issue of drug treatment. It includes the appointment of prokinetics - drugs that improve the contractile function of the intestine. For this purpose, it is used motilium, coordinatex. An antispasmodic drug can be used to eliminate regurgitation and intestinal spasms. riabal.

Surgical treatment is performed for severe congenital anomalies of the gastrointestinal tract (for example, pyloric stenosis - a narrowing at the junction of the stomach into the duodenum, preventing gastric emptying, etc.), which caused regurgitation.

Prevention

A complex and multifaceted problem. A favorable pregnancy and childbirth, a friendly, calm atmosphere in the house - all this reduces the risk of regurgitation, as well as many other diseases and pathological conditions in a child in the first year of life. If the baby is breastfed, make sure that the baby captures both the nipple and the areola during feeding, then the likelihood that the baby will swallow air will be less. If you are bottle feeding your baby, make sure that the nipple is completely filled with milk and there is no air in it. The hole in the nipple should not be large. You can feed your baby intermittently, for example, for five minutes, then turn him to face you and hold him in an upright position. After a few minutes, continue feeding. After feeding, press the baby with your tummy to you and hold it in an upright position for 15-20 minutes to let the air out. Before each feeding, lay the baby on his stomach, stroke the tummy around the navel with the palm of his hand in a clockwise direction, all this facilitates the passage of gases and reduces the likelihood of spitting up after eating. Cleanse the baby's nasal cavity from mucus and crusts in a timely manner, then when feeding, he will not experience difficulties with nasal breathing and a lot of air will not enter the stomach. From the same positions, it is important to ensure that when feeding the child does not rest against the breast with his nose. It is also necessary to remember the pathological effect of passive smoking on the tone of the muscles of the esophagus and stomach in an infant. Smoking in the immediate environment of the baby is strictly prohibited.

Belmer Sergey Professor of the Department of Children's Diseases N 2 of the Russian State Medical University, MD

In the first weeks and months of life, the body of a newborn baby adapts to new conditions and does not always function the way it should be. It is with this that the emergence of many problems that cause concern to parents is connected.

One of them is regurgitation, in which part of the food is not digested, but is thrown from the stomach back into the esophagus and flows out through the baby's mouth immediately after feeding. This phenomenon is a bit like vomiting, so it often makes parents worry about the health of the baby. It is important to know that regurgitation can be associated with both physiological and pathological causes. Consider what to look for, what are the differences from vomiting and what measures to take for parents.

Physiological causes of regurgitation

Physiological regurgitation is usually associated with the immaturity of the organs of the digestive system. In a newborn child, the stomach is very small in volume, and its shape is not the same as in adults; the esophagus is thickened and shortened, and the obturator muscle (sphincter), which is supposed to prevent backflow of gastric contents, is still weak. As a rule, physiological regurgitation is observed in babies up to 4-6 months, and then disappears as the digestive tract matures. This condition is not a sign of a disease and does not require special treatment. Parents do not need to worry about the health of a baby under the age of six months if:

he burps up to two times a day;
while a small amount of food is released (about a teaspoon);
no vomiting;
the child is steadily gaining weight.

Pathological causes of regurgitation

Perinatal encephalopathy

Abundant regurgitation may be one of the signs of damage to the central nervous system during fetal development. With perinatal encephalopathy, the baby often spits up a fountain, sleeps poorly, and behaves restlessly.

congenital hydrocephalus

Regurgitation, along with other symptoms, can be a sign of CSF accumulation in the brain. With hydrocephalus, the baby often cries and worries, throws back its head in a dream, spits up almost the entire amount of food eaten.

Other diseases of the central nervous system

Constant regurgitation may be the result of impaired blood supply to the brain, underdevelopment of the central nervous system or its pathologies associated with birth injuries. With such diseases, the child spits up after each feeding.

Pathologies and anomalies of the gastrointestinal tract

Frequent regurgitation may indicate the presence of a diaphragmatic hernia or pyloric stenosis, a condition in which the opening between the stomach and duodenum is excessively narrow.

Infectious diseases

An infant may often spit up with hepatitis, meningitis, sepsis and other diseases caused by an external pathogen. This adds symptoms such as fever, drowsiness, pallor, etc.

hereditary diseases

Regurgitation can be observed with phenylketonuria, adrenogenital syndrome.

How to distinguish regurgitation from vomiting

Signs of regurgitation

When the baby burps, the muscles of the abdominal cavity do not contract: there are no spasms characteristic of vomiting. Undigested breast milk or formula flows in a thin stream from the mouth. This is usually observed immediately after feeding, especially if the position of the baby's body changes dramatically.

Signs of vomiting

When a child vomits, the amount of mass released is greater than when spitting up. The baby is uncomfortable with cramps in the stomach, he becomes whiny and restless. Usually vomiting a fountain is repeated several times. In addition to food, bile comes out, so the masses can acquire a yellowish tint. Immediately before vomiting, there may be severe sweating, frequent breathing. If the baby vomits during the first months of life, you should immediately call a doctor.

Hiccups when spitting up

Sometimes with regurgitation in infants, hiccups are also observed. Usually this only means that the baby swallowed air. Hiccups that occur from time to time are not a cause for concern. However, if the baby hiccups often or almost constantly, a pediatrician should be consulted.

Why does my baby spit up after formula feeding?

Due to the characteristics of the bottle nipple used. Regurgitation during artificial feeding may be due to the shape of the nipple that is not suitable for the baby or the presence of too large a hole in it (as a result, the child swallows air).

Due to improperly selected baby food. Frequent spitting up sometimes indicates that the selected mixture is not suitable for the baby. Before switching to another diet, it is important to consult with your doctor.

Babies often spit up after breastfeeding

If we are not talking about organic pathology, frequent regurgitation during natural feeding may be due to the following reasons.

Binge eating. Often the baby remains at the breast, even when he is full. Thus, he calms down and enjoys closeness with his mother. By regurgitation, excess food is removed from the stomach, which prevents the overload of the digestive organs.

Aerophagia. If the baby is in an uncomfortable position during feeding, he may swallow air. This usually happens when the nipple is not latch on properly. Air bubbles, rising up, literally push part of the food out of the stomach - this is how regurgitation occurs.

Flatulence. With increased gas production, excess pressure is created in the abdominal cavity. As a result, the baby may begin to spit up. Flatulence in infants is often observed with errors in the diet of a nursing mother. That is why during lactation it is not recommended to eat legumes, cabbage, black bread, fresh apples - foods that cause flatulence not only in women, but also in children.

Constipation. With the accumulation of feces in the intestines, food slowly moves through the digestive tract. Because of this, regurgitation can be observed, and not only immediately after eating, but also after some time.

No feeding schedule. If the mother feeds the baby too often, there is a high risk of overeating, and if rarely, a hungry baby suckles too hard and may swallow air.

Prevention and treatment of regurgitation

How to prevent physiological regurgitation

Before feeding the baby, it can be laid out for a few minutes on the tummy.
If the baby has difficulty in nasal breathing, it is recommended to remove mucus and crusts from the nasal cavity (when the nose is blocked, the baby will swallow air with his mouth).
It is important to make sure that the baby takes the breast correctly, and that his head does not tilt back too much when feeding.
If the infant is receiving infant formula, anti-colic nipples with a small opening are recommended. It is necessary to hold the bottle correctly: it should be at an angle of about 40 degrees if the baby is lying down.
It is recommended to refuse tight swaddling of the child before and after feeding. Immediately after eating, the baby can be easily patted on the back, vilified with a column.
If overeating is suspected to be the cause of spitting up, try shortening the feeding time.

How to treat regurgitation in children

Regurgitation can be associated with many reasons, so only a doctor can assess the need for special therapy and select it. In some cases, it may be necessary to administer an anti-reflux mixture, such as Bellakt. These foods for children with special dietary needs contain thickeners that increase the viscosity of the contents in the stomach and thus prevent regurgitation. Therapeutic mixture and drugs, if necessary, should be prescribed by a specialist.

In what cases you need to see a doctor

The child spit up profusely more than twice a day.
Regurgitation persists in a baby older than 6 months.
The child refuses to eat, it is difficult for him to swallow.
In the allocated masses there is an admixture of blood.
The baby's temperature rose above 37.5 °C.
There were signs of dehydration: drowsiness, weakness, rare (less than 10 times a day) urination.
The body weight of the child does not correspond to the age norm.
The baby spits up an unpleasantly smelling curd mass.

This material is for informational purposes only and does not replace medical advice.

Spitting up after every meal is completely normal in babies. But often parents notice that the nature of the discharge is changing - the baby begins to spit up like cottage cheese or even mucus - and, of course, they begin to worry. Why does the baby spit up breast milk? What volumes of reflux are considered normal, and is it necessary to sound the alarm if the infant has a change in the consistency of the discharge? Until how many months will the baby spit up?

Regurgitation (reflux) in infants is the expulsion of small amounts of food or saliva up the esophagus from the stomach. This phenomenon is normal and occurs in 85% of newborns. In a 3-4-month-old baby, the stomach becomes stronger, the muscles of the esophageal valve close tightly and do not allow food to be thrown up, therefore, by this age, the percentage of such “emergency emissions” decreases, and at 12-14 months should stop completely.

Breast milk and the mixture begin to be processed in the baby's stomach almost immediately, so it's normal if, after eating, the baby burps with cottage cheese - this means that the gastric juice has already begun its work and oxidized the food received, changing its consistency.

Why does the baby often spit up?

Despite the normality of this phenomenon, there are still cases when a baby can spit up too often. Experts have identified several stages in the subsidence of reflux, determining at what age valve strengthening and thickening of nutrition begin.

Regurgitation in newborns after each feeding is normal and physiological;
from 3-4 months, the baby should burp no more than once a day for 5-10 ml, in other periods he should have an empty eructation;
after 12-14 months regurgitation should stop.

If your baby continues to spit up after each sucking of the mother's breast or drinking from a bottle, you should think about whether you have organized his diet correctly and whether the baby is healthy.

Air

Most often, babies continue to frequently spit up after eating if a lot of air enters their stomach along with food due to an incorrect sucking process:

The baby may not completely capture the mother's nipple with his lips and because of this, a lot of air enters his esophagus along with milk. After the baby finishes eating, the swallowed gas tends to rise, and a small amount of food is sent along with it. Normally, food should remain in the stomach, and only belching should come out. So that the baby does not spit up after feeding, it is important to ensure that the entire areola is in his mouth, and the nipple rests against his sky.
Artificial babies can swallow air due to improperly selected nipples, the wrong position of the bottle when feeding. Another reason why the baby does not burp, but reflux is that if the retaining ring is not fully tightened, then when sucking, the nipple sticks together due to the pressure difference, and the baby releases it from the mouth so that it puffs up again. To prevent the baby from spitting up after feeding, check that the bottle is well screwed up and make sure that the nipple is filled only with formula.

Weak valve muscles

The stomach of an adult is separated from the esophagus by a special valve that opens and closes when eating. In newborn babies, the muscles responsible for bringing this valve together are not yet developed. They get stronger by about 3-4 months. But there are babies in whom this muscle does not have time to develop properly, and therefore, even by six months, they continue to burp after eating.

Overfeeding

The baby may spit up after eating when he has simply overeaten, and his stomach seeks to get rid of the excess, throwing them into the esophagus.

Not that kind of food

Often children spit up profusely due to the fact that food is not suitable for them. Such cases happen if the nursing mother ate something for which the crumbs had a food allergy. Artificers are also prone to frequent reflux, whose parents change mixtures too often or introduce a new powder into the baby's diet not according to the rules.

Diseases

If the baby is growing, but still continues to spit up profusely, tell the pediatrician about it. Strong and frequent emissions of stomach contents can be a symptom of a number of diseases and pathological conditions:

developmental delay;
malformations of the gastrointestinal tract;
flatulence;
intestinal colic;
constipation against the background of dysbacteriosis;
anomalies in the development of the stomach and diaphragm;
neurological pathologies.

When should you be concerned?

If your baby spit up often and in large volumes, be sure to contact your pediatrician, because, as mentioned, this phenomenon can be a symptom of a number of diseases.

Spitting up in a fountain after feeding is considered a consequence of neurological disorders (encephalopathy, hypertension), as well as stomach cramps.
Reflux separated from a feeding episode for a long time - more than an hour - requires consultation with a gastroenterologist. This phenomenon is called a "lazy stomach", it consists in the long assimilation and promotion of food through the system, as well as in the unstable operation of the closing valve. In this case, the infant, in addition to delayed reflux with curdled milk, may suffer greatly from constipation.
Regurgitation in newborns, accompanied by crying, indicates that the child suffers from intestinal colic and needs your help.
If, after reflux, the crumbs have a prolonged belching, then the matter is high acidity, and you should contact a gastroenterologist.

Spitting up or vomiting?

Sometimes spitting up in newborns can be so intense that they can be confused with vomiting. Both of these phenomena are indeed similar. The food thrown out of the stomach is already being oxidized by the gastric nipple, the food leaves the stomach curdled, and for many parents it begins to seem that the baby did not burp, but vomited.

Since vomiting is a symptom of diseases and requires a lot of attention from parents, you need to be able to distinguish

her from the usual but profuse regurgitation. Both vomiting and reflux can be a "fountain", so it's important to take a closer look at the crumbs and look for other signs.

The baby will burp only after eating or 10-15 minutes after the end of feeding. Vomiting can start at any moment.
Normal reflux occurs once, vomiting episodes, on the contrary, often follow one after another.
The color and texture of reflux is almost indistinguishable from food, sometimes it comes out curdled, while vomiting, as a rule, has an admixture of bile and a yellowish tint or comes out with mucus.
After spitting up, the baby will behave as usual, and after an episode of vomiting, it will change dramatically, become lethargic and painful. Since the cause of vomiting is usually an infectious disease of the gastrointestinal tract, after a while the child's stool will also change - it will become greenish with mucus.

Consequences of regurgitation

If the baby spits up often, this will negatively affect his health:

along with the food eaten, gastric juice enters the oral cavity through the esophagus, which has a certain acidity and irritates the mucous membranes. Often spitting up babies because of this, they cannot lie on their backs.
frequent regurgitation in newborns is the cause of irritation of the respiratory tract, as well as the occurrence of inflammatory processes in the ENT organs, especially if reflux occurs in a fountain.
abundant regurgitation with a fountain leads to the fact that the baby does not eat enough, gains weight poorly and develops at a slow pace.

Therefore, you should make every effort to ensure that the baby does not spit up too often, and in case of heavy episodes of reflux, consult a doctor to find the causes and eliminate them.

How to help the baby?

To prevent reflux episodes, you need to follow certain rules:

Do not overfeed the baby, if he greedily clings to the breast, take him away when, according to your calculations, the baby should be satiated.
Monitor the infant's nipple latch at breastfeeding, and nipple filling at IV.
Change positions during feeding and make sure that the head of the crumbs is higher than his torso.
Before feeding, constantly lay the baby on the tummy - this will reduce the soreness of colic.
At the end of feeding, take the baby in your arms and, holding it in an upright position, walk like this for about 10 minutes until a burp occurs.
It is recommended to raise the head of the baby's bed by 20 degrees so that belching can come out of the esophagus. This can be done by placing two diapers under his head and shoulders, or by placing boards under the legs of the bed.
The baby should sleep in a position on its side or half-side.
After feeding, babies are not recommended to actively move and change the position of the body, it is better to choose calm activities for the first half hour or hour after eating.

If preventive measures do not help to avoid episodes of reflux, you can find a solution to the problem by consulting with your pediatrician.

It helps to reduce the percentage of regurgitation by adding rice powder to milk or a mixture, which effectively thickens the liquid;
in some cases, the pediatrician may recommend that you feed your child with special anti-reflux mixtures until the valve separating the stomach from the esophagus is strengthened;
if the doctor deems it necessary, he will prescribe medication to reduce stomach acid, improve bowel function, or eliminate spasms.

Regurgitation is a normal physiological process for newborns, which is associated with the characteristics of the baby's body. It represents the involuntary discharge of breast milk or formula along with air from the stomach into the mouth. This phenomenon is typical for every child in infancy. Regurgitation begins spontaneously and occurs within 15-30 minutes after feeding.

Regurgitation in newborns occurs about three times a day, while the volume should not exceed 5 ml of food taken. In most newborns, they pass 4-7 months after birth, in some they do not end up to a year.

Sometimes babies have profuse regurgitation and regurgitation with a fountain. The reasons for this process are different. It can be ordinary overeating, and digestive disorders, and even a malformation of the gastrointestinal tract. In any case, when spitting up a fountain, you should consult a doctor.

The reasons

The main cause of regurgitation is the failure of the digestive tract in infants. In the first months of life, the body of newborns only adapts to new conditions and new food, which leads to various reactions. However, in this case, regurgitation should not exceed the above volume norms.

Another common cause is aerophagia, or swallowing air when eating. This is due to improper feeding organization, when the baby does not grasp the nipple or bottle correctly. It is important for a nursing mother, since an improperly organized process leads to problems. And it's not just spitting up. With such feeding, the child does not receive the necessary amount of breast milk and does not eat up.

Regurgitation is typical for premature babies with undeveloped sucking reflex, swallowing and breathing. The problem disappears as the body develops and gets used to new conditions.

Violation in the work of digestion, pathology in the development of internal organs and the central nervous system are the causes of regurgitation by the fountain, which are combined into one group called dysphagia. Dysphagia manifests itself in various ways:

Bloating, increased gas formation and colic in newborns. Increased formation of gases and colic is a common occurrence for infants, especially in the first months of life. The reasons still lie in the underdevelopment of digestion. However, if flatulence is observed often, and colic in a baby causes severe pain, you should consult a doctor;
Anomalies in the development of the central nervous system. As a rule, this is increased intracranial pressure. In this case, the problems are not in the work of the digestive organs, and it is necessary to undergo a thorough examination by a neurologist;
Pathology of the development of the digestive organs, including the esophagus and stomach, including intestinal obstruction, stenosis and other diseases;
Digestive disorders - diarrhea or constipation in infants. Indigestion in newborns often appears due to malnutrition of a nursing mother. Many products, especially in the first two or three months of a baby's life, negatively affect well-being.

Regurgitation is caused by overfeeding, eating too much, and feeding too often. Pediatricians advise to feed the child on demand and not force him to eat.

Profuse regurgitation or vomiting?

It is important to distinguish pathology from the norm. Many nursing mothers exaggerate the problem, while others, on the contrary, do not notice developmental disorders. In newborns, it is quite difficult to distinguish between strong regurgitation and vomiting, but these phenomena indicate different problems. Let's look at the distinctive features of these phenomena:

The volume of regurgitation should not exceed 5 ml at a time, vomiting can occur in an unlimited amount;
Regurgitation occurs only once after feeding, vomiting may be repeated;
When regurgitation, food comes out in its original form, while vomiting milk undergoes partial digestion. Curdled milk or food with a sour smell are signs of vomiting;
When spitting up, the baby's well-being does not worsen. If a child vomits, he often refuses food, sleeps restlessly and feels unwell;
Regurgitation occurs only within half an hour after feeding, vomiting can be at any time;
Only vomiting can go like a fountain!

Thus, regurgitation with a fountain is vomiting. The causes of such an ailment often lie in the malnutrition of a nursing mother, too fatty, spicy or salty foods, poor-quality foods. In addition, newborns often have an allergic reaction, which can manifest itself in the form of vomiting. In this case, it will help with breastfeeding.

If a nursing mother has adjusted the diet and excluded foods that irritate the baby from the menu, and vomiting with a fountain continues, you should urgently consult a doctor. Frequent and profuse vomiting may indicate an abnormal development of the internal organs of the baby.

When to sound the alarm

We offer a table of regurgitation intensity, the readings of which will help a young mother determine the degree of danger of the process.

With an intensity of three points inclusive, it is necessary to consult a doctor and start treatment!

There are other signs that indicate developmental disabilities. First of all, it is a loss or shortage in weight. How to correctly calculate the weight of newborns up to a year, see. Frequent and profuse regurgitation, vomiting with a fountain are accompanied by screaming and crying, violation of the stool, smell from the mouth. Particular attention should be paid if regurgitation continues after a year.

How to help a baby

With signs of pathology, be sure to consult a specialist. Only he will determine the problem and prescribe the right treatment. Do not self-medicate, it can only worsen the situation!;
Do not leave the baby lying down when vomiting or spitting up! Take the child upright and hold for about 15 minutes. Do this after every feeding. This will make it easier for the air to escape;
Organize your baby's food. Make sure that the baby captures both the nipple and the areola. Incorrect latch on the nipple causes problems for the mother as well. As a result, there are cracks and abrasions on the nipples, which cause pain and sometimes cause infectious diseases!;
If your baby is formula- or formula-fed, hold the bottle correctly at a 45-degree angle. Do not hold the bottle horizontally! Make sure that the nipple is full, and as little air as possible passes through the hole in the bottle;
Proper nutrition of a nursing mother is the key to good health, normal growth and development. Read more about nutrition while breastfeeding at the link /;
Constant monitoring of the newborn by doctors. Get regular check-ups and check-ups;
Place your baby on your tummy before feeding. Periodically, you can massage the tummy with light stroking movements;
Try to breastfeed only. Breastfeeding will provide the child's body with vitamins and elements necessary for full development and growth. Breast milk will strengthen the immune system, protect against diseases;

Sometimes, to fix the problem, you need to take medications and special therapeutic mixtures. Medicines and a suitable mixture are prescribed by a doctor! In extreme cases, if other methods have not had the desired effect, surgical intervention is required.

Why does a child spit up and should I be worried about it? In most cases, no. However, there are a number of situations when regurgitation in newborns may indicate a disease or malfunction of the gastrointestinal tract.

Spitting up after feeding is normal

Causes of spitting up in babies

A child can spit up for one reason, or for several at once. Up to six months, regurgitation in children is considered the norm, and it is due to the peculiar structure of the gastrointestinal tract. The causes of regurgitation in infants up to six months are called physiological. These include:

short esophagus;
insufficiently pronounced narrowing of the esophagus;
the muscular sphincter (part of the body that regulates the passage of food from one organ to another) is not sufficiently developed;
insufficiently formed system for moving food along the gastrointestinal tract.

It is also normal for a baby to spit up after each breastfeed, from two months of age to one year of age.

From the age of four months, the child should spit up no more than once a day. There are a number of reasons that are caused by mistakes in child care. In these cases, you need to quickly correct the mistakes and then the regurgitation will stop. These reasons include:

Swallowing air with food. It happens when a child suckles incorrectly: does not completely wrap his lips around the nipple or breast, eats in the wrong position, a bad nipple is picked up, the bottle cap is not screwed enough. To avoid these causes, you need to make sure that the baby completely wraps around the mother's nipple, so that his bottle is always tightly closed, and there is nothing but formula in it.
Binge eating. Another common reason. This can lead to feeding the baby on demand, and not on schedule. Such experiments should be curtailed immediately.
Colic and gas. Gas bubbles press on the walls of the stomach and intestines, causing rejection of food.
Intolerance to breast milk. A rare cause caused by maternal malnutrition. In this case, you need to go to the doctor, they are assigned a suitable mixture.
Excessive activity. Do not touch the child immediately after he has eaten.

Physiological regurgitation after feeding

Types of regurgitation

There are several of them. All of them are caused by different reasons, some indicate the danger of diseases, and some are natural for the body of the baby. Each of them is better to know in more detail, because a nursing baby can go from one type to another. Such a transition can be caused by both natural and dangerous changes in the digestive tract.

Vomiting "fountain"

This type of regurgitation is very dangerous. If a mother notices this in her baby, she should immediately consult a doctor. It is believed that the baby can suffer up to death (he can simply choke). By the way, Komarovsky denies the danger of even such types of regurgitation, arguing that a child is able to choke only if he lies on his back. One way or another, only a specialist can help in such cases. Causes of regurgitation by the fountain include:

serious problems with the gastrointestinal tract;
birth trauma;
poisoning or infection.
dysphagia (indigestion).

Fountain spitting is dangerous for the baby

Spitting up through the nose

It also happens that a newborn burps through the nose. This is also not the norm. This type of regurgitation leads to the development of polyps. Violated the integrity of the mucous membranes of the nose. In order to help the newborn, you need to consult a doctor.

The cause of regurgitation through the nose often lies in improper feeding. It is necessary to ensure that the child eats in the correct position and exactly on the clock, correctly clasping the nipple. In order to help the baby, you can put him on your stomach, or make a special massage. This will help the baby stop hiccuping.

How to reduce spitting up in a child after eating

The easiest thing to do is just wait. A newborn should stop burping at six months of age. There is no way to stop this process artificially - there are no universal cures for regurgitation. All that a mother can do for her child is to try to reduce this process, to make it painless. To do this, there are a number of specific measures, especially them, should be taken into account by mothers whose children behave restlessly both day and night.

You don't need to feed your baby too much. Nutrition should be balanced and consistent with the schedule.
It is not recommended to feed the baby in a horizontal position. The ideal position would be at an angle of sixty degrees.
You need to make sure that the baby is completely clasping the nipple. With IV, it is important to monitor the quality of the mixture and the correct filling of the bottle.
When eating, it is necessary to monitor the posture of the baby, his head should be located above the body.
Before feeding, you can give the child a light massage of the abdomen. You can let the child lie down on his stomach a little, this will reduce gas formation and colic.
After feeding, the child is carried in the arms in an upright position until he burps.
You can put several diapers under the baby's head during sleep, thereby raising his head and facilitating spitting up.
Milk mixture should be warm. You need to feed the baby at the same time. It is necessary to ensure that the mixture does not turn out to be curtailed, do not heat it for too long.
Don't feed a crying baby. Avoid activity after eating.
You can give your baby a pacifier before bedtime, this relieves colic a little, stimulating the bowels.

Correct posture while feeding

Massage before feeding

Light massage should be done before meals constantly. This takes about five minutes. First, the stomach is stroked with light soothing movements, while during the massage the area of \u200b\u200bthe right hypochondrium should not be touched, there, the baby has a liver. Then make slightly pressing movements with your hands from right to left. The following movements are made from top to bottom along the central part of the abdomen. Then one hand is left on the stomach, and the second is stroked first on the left, then on the right side.

Now stroking with one hand down and the other up at the same time. Then the baby's tummy is stroked in a circle. First with one hand, then with two hands. You can massage the child and "P" figurative movements. First left from bottom to top, then corner left to right, then top to bottom, and so on.

The massage itself should be done in a clockwise direction. For each movement you need to spend about 1.5 minutes.

Massage before feeding - lie on the tummy

How to behave after feeding

The fact that the child will burp after eating is completely inevitable. So you gave the child food. The regurgitation should occur after about twenty minutes. After this happens, change your baby's clothes. Reassure the child, let him lie down on his side for a while. If hiccups have begun, boiled water in a small amount will help. If there is an increase in temperature or the rejected milk has a strange color, you need to call a doctor.

Hold baby upright after feeding

Causes of pathological regurgitation

These include diseases of the gastrointestinal tract, infections, poisoning, injuries and others. In general, the causes of pathological regurgitation are presented in a list based on the ICD:

developmental delay;
pathology of the gastrointestinal tract;
colic or flatulence;
constipation, dysbacteriosis;
abnormal development of the stomach;
neurological abnormalities.

It is about such pathologies that we can talk about when it comes to frequent, profuse, and strong regurgitation in children. Now in more detail.

Digestive disorders

Dysbacteriosis can cause regurgitation at an early age. It can be caused by antibiotics, or malnutrition of the baby. As a result, the intestinal microflora is disturbed, an imbalance of beneficial and harmful microorganisms occurs.
Various infections are accompanied by fever, lethargy, anxiety, diarrhea, severe colic. Mucus impurities may be observed in the rejected masses.
Food allergy, when it comes to IV, occurs on cow's milk protein. In this case, the baby serum must be replaced with another one. If the baby is breastfeeding, then the mother needs to better monitor her diet.
Lactase deficiency is caused by a deficiency of lactase in the child's body. In such a situation, doctors prescribe special mixtures and vitamins to the child.
Flatulence and constipation. Can be avoided when it comes to GW. Mothers simply need to exclude everything sweet and gas-forming from their diet.

Digestive disorders - causes of regurgitation

Congenital pathologies of the gastrointestinal tract

Pyloric stenosis. Narrowing of the passage between the stomach and part of the intestine, leading to stagnation of food. As a result, the child begins to burp profusely for the first two weeks, then with a fountain, and after another time, vomiting begins. The mass regurgitated by the child often has a curd-like consistency. Pathology belongs to the group of dangerous and the child needs inpatient treatment.
Pylorospasm. The same narrowing as in pyloric stenosis, but caused by spasm of the pyloric muscles. In this case, you need to consult a doctor, switch to the mixtures and additional drugs prescribed by him.
Sphincter expansion. Too wide opening between stomach and esophagus. The doctor prescribes vitamins and calcium, additional drugs. Food is taken in fractional portions. It is acceptable to eat a small amount of cottage cheese.

The structure of the esophagus and stomach in a baby

Neurology

The child was born prematurely. In such children, the sphincter is less developed, in this case the child will continue to burp up to six months, until he catches up with his peers in the development of the gastrointestinal tract.
Pathologies formed during fetal development. These are disorders of the central nervous system, and sleep disturbances, increased intracranial pressure, high excitability of the vomiting center, and more.
Injuries in the cervical spine. The child could be injured during childbirth, proceeding with complications. Treatment here is prescribed by a neurologist, it is a special massage, physiotherapy, medications.

What examinations are needed if there is concern?

In order to make sure that spitting up is not dangerous, it is necessary to undergo the following examinations: X-ray, ultrasound, blood test and stool test. All these procedures are prescribed by a neurologist or pediatrician. In some cases, other tests may be needed.