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In the first months after birth, the child finds himself in a difficult situation. Aggressive environment, many tests for the body.
All this takes time to adapt to new conditions. During this period, the final “tuning” of all organs and systems of the child takes place. The digestive system is no exception. Therefore, there may be some problems associated with feeding the baby.
Young parents are baffled and frightened by such a phenomenon in children as regurgitation. Inexperienced mothers usually associate regurgitation with vomiting, thinking that the child is sick with something.
In fact, regurgitation has nothing to do with vomiting and occurs for completely different reasons. Accordingly, it does not pose a danger to the life of the child.
Regurgitation after feeding – a pathology or not?
Regurgitation is a process in which some (usually small) amount of previously consumed food is evacuated from the child’s stomach through the oral cavity. As a rule, regurgitation is a physiological norm. In this way, the air that the baby swallowed along with food is removed from the stomach and esophagus. Also, regurgitation indicates the normal functioning of the organs of the gastrointestinal tract.
According to medical (pediatric) statistics, about ¾ (about infants under the age of 3-6 months regularly spit up before or after feeding).
After 9 months, such a physiological phenomenon as regurgitation is practically not observed (isolated cases).
Sometimes regurgitation may indicate the immaturity of organs and their systems. Often we are talking about children who were born before the due date. Since they did not have time to develop sufficiently in the womb, the “ripening” of the body occurs already in natural conditions. The process of this “ripening” lasts exactly as long as the time the child should have been in the womb before birth, i.e. 5 to 8 weeks.
At the end of the period of “ripening” of physiological systems (including in children born on time), the unpleasant phenomenon disappears, and everything returns to normal.
When assessing the nature of regurgitation, it is important to pay attention to the general condition of the child. If the baby is happy, cheerful and does not pay any attention to spitting up, there is no reason to worry. But if the child behaves restlessly, often cries, there are problems with sleep, frequent and profuse regurgitation with a fountain, most likely there is a pathology that can be life-threatening for the newborn. In this case, do not hesitate to consult a pediatrician.
Determine: vomiting or regurgitation?
To determine if there are grounds for concern, it is important for parents to establish:
Is it a natural physiological process of regurgitation
Or about vomiting, indicating a particular disease.
Regurgitation – occurs without tension and contraction of the muscles of the abdominal cavity. Food flows out in small quantities without any effort. Spitting up usually occurs immediately after feeding the baby and / or when the baby’s body position changes.
Vomiting is relatively easy to recognize. The allocation of food masses is plentiful, accompanied by spasms and tension of the abdominal muscles. The child cries, shows anxiety. Vomiting is a complex process. With vomiting, there is an active contraction of the abdominal muscles, as well as the press, the diaphragm. Before the onset of vomiting, there is pallor of the skin, a feeling of nausea, increased sweating, dizziness, increased salivation. If vomiting is observed, urgent medical attention should be sought.
It is also easy to determine whether the manifestation is natural or pathological:
There is no urge to vomit with natural physiological regurgitation.
The volume of allocated masses is scarce.
Regurgitation occurs rarely, no more than 1-2 times a day.
Regurgitation with age goes away on its own, without any treatment.
The child is developing normally, gaining weight.
Why does a baby spit up?
Spitting up can have many causes. All of them, one way or another, are united by a single factor: the immaturity of the functional systems of the child, in particular, the digestive system.
Pediatricians identify several causes of regurgitation:
Binge eating. For natural reasons, a child can continue to consume milk even when he is full. This is especially common in breastfed babies. For an infant, suckling at the breast is not only a way to satisfy its nutritional needs, but also a way to get maternal attention. Regurgitation in this case is designed to get rid of excess food so as not to overload the digestive system. Thus, in this case, regurgitation serves as a protective mechanism that prevents the development of diseases of the gastrointestinal tract.
Swallowing air (or aerophagia). Often regurgitation is due to swallowing air during feeding. Aerophagia can be caused by incorrect position of the baby, too large diameter of the hole in the nipple, too much milk, improper grip on the breast, etc.
Increased gas formation. Another cause of regurgitation is the increased production of intestinal gases. With flatulence, there is an increase in intra-abdominal pressure, which becomes the culprit of regurgitation. In this case, the mother needs to change her diet (if the baby is breastfed). To exclude the development of flatulence, you need to limit the use of foods that promote the formation of gases: beans, apples, fresh bread, cabbage. They should be discarded completely or cooked only by baking.
Constipation. Regurgitation with constipation occurs for the same reasons as with flatulence: intra-abdominal pressure increases. With constipation, the speed of movement of food through the gastrointestinal tract is disturbed. This becomes an additional cause of regurgitation.
Feeding should be streamlined. The erratic nature of feeding contributes to regurgitation.
In the vertical position of the body, the child spits up more often. The fact is that an air bubble forms in the stomach. Passing through the digestive tract, it can carry along a certain amount of food masses.
Prevention of physiological regurgitation
There are many ways to eliminate regurgitation. It is not difficult, it is enough to carefully observe the child, then the reason will become clear.
In general, pediatricians make the following recommendations:
Ideally, both the baby and the mother should be calm before feeding. Spitting up can have psychosomatic causes, also in a nervous, excited state, the child often swallows air. Before feeding the baby, you can put it on your stomach, make a light massage so that the gases go away. The head of the child during feeding should not be thrown back. The baby’s nose should breathe freely. If a child has a runny nose, he will swallow much more air.
If the baby is breastfed, it is important that he properly latch on to the breast: nipple and part of the areola. In this case, the lower lip should be slightly twisted.
If the baby is bottle-fed, it is important to choose the right bottle. Preference should be given to anti-colic bottles (although they do not relieve colic, they still perfectly prevent the swallowing of excess air). It is important to hold the bottle correctly when feeding. The milk should flow to the base of the nipple. The bottle should be kept at 40 ° C for a lying child and under 70 for a seated child.
Immediately after feeding, the child should not be “shaken”. Tight swaddling is also excluded so that intra-abdominal pressure does not increase. The baby can be helped to burp by lightly patting him on the back.
If the child is prone to frequent spitting up, it is necessary to put him in bed on his side. This will help prevent food from entering the respiratory tract. If this still happens, you need to raise the child and lower him face down.
Weighing a child is not informative enough, but it will still help to understand whether the child has eaten enough. It is necessary to determine this in order to avoid overfeeding. Another way to avoid overfeeding is to reduce feeding times.
There is a safe way to avoid spitting up. For this purpose, a special anti-reflux mixture is used. It is based on an additive from the carob tree. It is not digested and when it enters the stomach, it creates a dense clot that prevents food from leaving the stomach.
When should you seek medical help?
There are a number of cases when you should be wary:
There is a regular (more often than 2 times a day) regurgitation with a fountain.
The process of regurgitation does not stop after 6 months of life.
The child has an increase in body temperature.
The baby shows signs of dehydration and intoxication: weakness, headache, rare or frequent urination, etc.
Weight disorders. The child is not gaining weight.
The released food masses have a brown or yellowish tint, have the texture of sour milk, and an unpleasant odor.
Pathological regurgitation in the baby
Babies are extremely prone to spit up due to natural causes. But far from always the source of regurgitation lies in physiology.
Often, the root of the problem may lie in the development of a particular pathology associated with increased intra-abdominal pressure, a mother’s illness during the period of gestation:
Perinatal encephalopathy.This is a kind of classic diagnosis. It is put regularly to a huge number of children. The reason for the development of pathology is a complicated course of pregnancy, difficult childbirth. The main symptom of the disease is disturbances in the functioning of the central nervous system. These disorders can have various external manifestations, including regurgitation with a fountain, sleep disturbance, tremor (trembling) of the hands and chin, restlessness and anxiety. The group at increased risk of birth with encephalopathy includes infants who have experienced hypoxia, are prone to short-term respiratory arrest, and have less than 5 points on the Apgar scale at birth.
Hydrocephalus. It is also a common cause of regurgitation by the fountain. At the same time, almost all the milk eaten comes out. Children with hydrocephalus are prone to delayed mental and physical development, increased muscle tone in the limbs, and disrupted development of the step reflex. With hydrocephalus, the child is anxious, does not sleep well. Tilts head back during sleep.
Other pathologies of the central nervous system. The reasons for frequent regurgitation with a fountain can be birth trauma, cerebrovascular accident, underdevelopment of the central nervous system, for example, in premature babies. In this case, regurgitation of undigested food is observed immediately after each feeding. Diseases are accompanied by belching.
Pathologies of the development of the gastrointestinal tract. The main pathology is pyloric stenosis or diaphragmatic hernia. This is a rather formidable disease, the essence of which is the inability of food to pass beyond the stomach. The food is only half processed, then the curdled, semi-processed mass is regurgitated. There is no stool even after an enema.
Infectious diseases: hepatitis, meningitis, poisoning, sepsis.Accompanied by symptoms of general intoxication, as well as, with liver diseases, yellowness of the skin. In the structure of the isolated food masses, there may be mucus impurities, which indicates dysbacteriosis or an infectious lesion of the gastrointestinal tract.
In addition, regurgitation can be in the presence of hereditary diseases: phenylketonuria, adrenogenital syndrome.
Regurgitation may develop in renal failure.
Fountain regurgitation in infants
This phenomenon may indicate significant problems in the functioning of the brain, or pathology of the gastrointestinal tract. It could also be poisoning. In this case, you should immediately seek medical help, because. poisoning is fraught with dehydration and serious consequences.
When spitting up a fountain, there is a risk of aspiration when food masses block the airway. To prevent this, it is better to put the child on its side.
A formula-fed baby should be given an anti-reflux formula. It should not be given to breastfed children.