Frequent regurgitation in a newborn: causes and methods of control. Regurgitation in infants: causes, prevention and causes for concern Causes of regurgitation in an infant

The first months in a baby’s life are a difficult period for him to get used to variety. environment. At this time, the final adjustment takes place internal organs. In this case, specific problems associated with feeding the baby may arise.

Young parents are especially afraid of the phenomenon of regurgitation, mainly because it is similar to the unpleasant pathological process called vomiting. However, the causes of regurgitation in newborns are completely different and are rarely associated with any disease.

Regurgitation after feeding - pathology or not?

Regurgitation in a baby after feeding is the throwing out of a small amount of food out through the oral cavity from the stomach. Usually the amount of food is small and does not bother the baby, which cannot be said about his parents. Let us note right away: most often this phenomenon is completely natural. This way, excess air comes out of the baby’s stomach, and the body makes it clear that the digestive organs are working well.

• Statistics show that about 70% of children under the age of three to six months spit up during or after feeding.
• After nine months, this feature is observed extremely rarely.
• This is often observed in children with delayed intrauterine development and those born prematurely. After all, the process of “ripening” of all functions continues for them for another five to eight weeks after birth.
• Usually, by the end of this period, the child’s body gradually adapts and all unpleasant symptoms disappear.

If this does not bother the baby, he is cheerful and sociable, and develops according to age indicators - there is no need to worry. But if the child is restless, if there is profuse regurgitation like a fountain, an in-person consultation with the supervising pediatrician is necessary. This condition may be caused by any disease that may be dangerous for the baby.

Determine: vomiting or regurgitation

It is important for parents to determine what is bothering the child:

• completely acceptable and natural regurgitation
• or vomiting, indicating pathology.

Regurgitation- In this case, food flows out without effort, contraction of the abdominal muscles does not occur. It can appear with a sudden change in the baby's position and often occurs immediately after feeding.

Vomit- And when vomiting, the child is restless and whiny. The release of food is often accompanied by spasms; the amount of vomit usually exceeds the amount of fluid released during regurgitation. Vomiting is a complex reflex act. In this case, there is an active contraction of the muscles of the abdominal cavity, diaphragm, and abs. Spontaneous release of stomach contents to the outside is observed (through the esophagus, pharynx, oral cavity). Vomiting is preceded by an attack of nausea, pallor skin, sweating, drooling and dizziness. If vomiting occurs in infants, immediate attention is required. medical care.

It is not difficult to determine whether a baby is vomiting or regurgitating. The latter happens once after feeding, immediately or after a maximum of an hour, during which water or milk is released. Vomiting is usually repeated and in addition to milk and water, bile is added to the contents, so the vomit is yellowish in color.

How do you know if this is a physiological or pathological process?

• With physiological – no vomiting
• The volume of rejected food is small
• Occurs no more than 2 times a day
• The child is gaining weight normally
• Regurgitation gradually goes away without therapy

Why does regurgitation occur in an infant?

The main “culprit” for regurgitation after feeding a newborn can be called the functional immaturity of the entire digestive system. At the same time, modern pediatrics identifies the following reasons for frequent regurgitation:

• Common overeating

Organism infant, even after being full, under certain conditions can continue to eat food. At the same time, he calms down, enjoying sucking and intimacy loved one. Well, regurgitation of food in this case is an elementary way to get rid of excess food, so as not to overload the gastrointestinal tract. That is, in this case, regurgitation serves as protection and prevention of various diseases of the digestive system.

• Aerophagia

The cause may also be aerophagia - swallowing air while eating. This can happen in a number of cases: uncomfortable position of the baby while eating, excess milk (for example, too large a hole is cut in the nipple of the bottle), the baby does not grasp the breast correctly, the baby is too excited;

• Flatulence

Increased gas formation can also provoke regurgitation, especially if the baby is breastfed (see), since it leads to a periodic increase in intra-abdominal pressure. To avoid this, mom should pay attention to her diet. Foods that cause flatulence should be excluded from her menu - brown bread, legumes, fresh apples, cabbage. You can eat stewed cauliflower and baked apples.

• Constipation

Retention of stool can also provoke frequent regurgitation in an infant. In this case, an increase in pressure in the abdominal cavity is also observed. This reduces the rate at which food moves through the gastrointestinal tract and significantly increases the likelihood of food regurgitation.

• Disorderly feeding can contribute to excessive regurgitation.
• If the baby is in an upright position, an air bubble that forms in the stomach may push some food out of it.

Prevention of physiological regurgitation

There are many effective ways to prevent this. An attentive mother, after observing her baby, can easily determine why they appear and, first of all, eliminate the negative phenomena. To help her, we provide a list of the most common prevention methods:

• It is great for the baby and mother to be in a calm state before feeding begins. You can lay the baby on his tummy, or stroke the baby’s tummy with your palm, and do a light massage in the navel area. Make sure that the baby's head is not thrown back and his nose is breathing freely. This is important. Since when the nose is stuffy, the baby is forced to gasp for air, and this will be accompanied by subsequent regurgitation;
• If the baby is fed mother's milk, then it is necessary to monitor that he takes the breast correctly. The baby should grab the nipple along with the areola, and his lower lip should be slightly turned out;
• If the child is artificial, it can be useful to use anti-colic nipples and bottles for feeding, which prevent the swallowing of excess air. It is useful to learn how to hold a bottle correctly when feeding: the milk should cover the base of the nipple, the angle of the bottle should be 40 degrees (for a baby in a lying position) and 70 degrees (for a baby sitting in his arms);
• Do not touch the baby immediately after feeding, do not swaddle him tightly. To facilitate burping, gentle patting on the baby's back helps. The baby needs to be placed on your lap. Hold it with one hand and lightly slap it on the back with the other;
• If your baby is prone to frequent burping, place him in his crib on his side. This will help prevent vomit from entering the respiratory tract. If the baby burps while lying on his back, lift him up and turn his face down;
• If regurgitation is caused by overfeeding, then you should try to reduce the feeding time. And to determine whether the baby has eaten enough, you can weigh him before and after meals;
• To correct regurgitation in babies, the use of an antireflux mixture is effective. This is a non-digestible carob supplement. It consists of natural fibers, which, when entering the baby’s ventricle, form a clot that prevents regurgitation.

In most cases, functional regurgitation can be easily corrected and then goes away on its own. Moms and dads shouldn’t worry too much if the child feels normal and is confidently gaining weight. If regurgitation occurs due to pathology, then the baby’s unusual behavior and poor health will indicate that a medical consultation is urgently needed.

When to seek medical help

• Regurgitation of milk does not stop after six months of life;
• If there is profuse regurgitation in a “fountain” more than twice a day;
• Appear - refusal to eat, low temperature body, rare urination or, conversely, more than 10 times a day, weakness, drowsiness
• Accompanied by a feverish state;
• The baby does not gain weight appropriate for his age;
• The vomit has the appearance of sour milk, bad smell, changed color.

Pathological regurgitation in infants

Most children are susceptible to regurgitation syndrome, the causes of which are varied. This is not always normal and acceptable. Sometimes profuse and frequent regurgitation appears due to disturbances in the intrauterine development of the child during the mother’s pathological pregnancy (intrauterine infection).

• Perinatal encephalopathy

This collective diagnosis is often made to newborns; it can be caused by severe pregnancy and childbirth in the mother. It includes a disruption of the central nervous system, which can be manifested by excessive regurgitation, including a fountain, sleep disturbance, the child may be restless, maybe. The risk increases significantly with prolonged fetal hypoxia during pregnancy, as well as in children who at birth had less than 5 points on the Apgar scale or had a short-term respiratory arrest.

• Hydrocephalus

• Other pathologies of the central nervous system

In case of birth injuries, circulatory disorders of the brain or underdevelopment of the central nervous system due to prematurity, regurgitation of undigested milk or formula occurs, usually after each feeding, accompanied by belching.

• Pathologies and developmental anomalies gastrointestinal tract

Diaphragmatic hernia or pyloric stenosis can cause frequent, persistent regurgitation. With pyloric stenosis, symptoms appear on the second day after birth. Regurgitation of cottage cheese may indicate this pathology. The child loses weight because food does not pass beyond the stomach and is not absorbed. The child also has no stool, even after an enema.

• Infections - food poisoning, sepsis, hepatitis, meningitis of various etiologies

They are accompanied by a rise in temperature, lethargy, pallor or yellowness of the child’s skin. Regurgitation with mucus may indicate the presence of a gastrointestinal tract infection or intestinal dysbiosis (see,).

• Hereditary pathologies - adrenogenital syndrome, phenylketonuria.

• Kidney failure is often accompanied by occasional regurgitation after eating.

Fountain regurgitation in infants

This may indicate a serious pathology of the brain or problems in the gastrointestinal tract. This may be a symptom of serious poisoning. In such a process, you must contact your pediatrician immediately. Since this threatens the child with dehydration and weight loss, which can lead to very serious consequences.

It is important to note that if a child experiences excessive belching or burping, there is a high risk that the baby may choke while sleeping or lying on his back. Therefore, even with occasional regurgitation, you only need to put him to sleep on his side and secure the position with bolsters.

If a child suffering from pathological regurgitation is on artificial feeding, then you need to select a special mixture for it (anti-reflux mixture). Formula should not be given to breastfed children.

Children under one year of age react to any trouble in the upper gastrointestinal tract by vomiting or regurgitating. Pediatricians call this phenomenon regurgitation and vomiting syndrome (SVR). It occurs in more than 80% of children of this age, which is due to the anatomical and physiological characteristics of the digestive tube at the junction of the esophagus and the stomach.

What is the difference between vomiting and spitting up?

Vomit– this is a complex neuro-reflex act, during which involuntary evacuation of the contents of the stomach occurs through the esophagus, pharynx and oral cavity to the outside. During this time, the esophagus shortens and widens, the fundus of the stomach relaxes, and the pylorus contracts.

At the same time, the gap between the vocal cords closes and the soft palate rises. And the muscles of the stomach, abdomen and diaphragm, contracting abruptly and repeatedly, empty the stomach. In infants, especially those born ahead of schedule, due to the physiological immaturity of the body, this is not always the case. Therefore, there is a risk of vomit entering the respiratory tract and causing suffocation.

Not always, but often, vomiting is preceded by nausea - an unpleasant sensation accompanied by weakness, sweating, paleness, and excessive salivation. But only a child who has begun to speak, but not a newborn, can tell adults about such discomfort.

Regurgitation- this is also the entry of stomach contents into the pharynx and oral cavity, but only passively, occurring without the participation of the abdominal muscles.

Anatomical and physiological features of the transition of the esophagus to the stomach in children under one year of age:

A healthy adult has everything defense mechanisms, preventing gastric contents from entering the esophagus, work clearly and harmoniously. In a child under one year of age, these mechanisms are imperfect and incomplete.

Causes of spitting up and vomiting in children under one year of age

Vomiting and regurgitation can have different origins. If they are associated with diseases or pathological conditions of the gastrointestinal tract, then they are considered primary, and their reasons are divided into functional And organic. If there is no connection with diseases of the digestive system - secondary.

Functional causes of primary vomiting and regurgitation

1. Overfeeding and violation of feeding regime. Everything here is extremely simple: when the stomach is overfilled with breast milk (formula), which often happens with disordered feeding, a disorder of the innervation of the organ occurs. As a result, the contents of the stomach are thrown into the esophagus and pharynx.

1. Aerophagia- This is the child swallowing air during feeding and getting it into the stomach along with food. According to the laws of physics, air will definitely come out - this is an air burp. But the air bubble often carries along the gastric contents, and the baby spits up milk (formula).

1. Cardiospasm- this is a gain motor activity the lower third of the esophagus, with its upper parts functioning normally. Because of this imbalance, the cardiac (lower) part of the esophagus does not relax after swallowing food, which should not normally happen. As a result, food cannot enter the stomach, accumulates in the esophagus and immediately returns back during feeding. Regurgitation or vomiting of undigested food that has just been eaten occurs. Causes of cardiospasm: disorders of the autonomic and central nervous systems, disruption of the hypothalamic part of the brain.

1. (GER)- this is the flow (reflux) of stomach contents into the esophagus, due to the immaturity and incompetence of the digestive system of the newborn baby. Reflux can be physiological and pathological. Physiological GER is observed in more than half of babies under the age of 3 months. It manifests itself as infrequent belching (regurgitation) after feeding, which can also occur during sleep. There are no clinical symptoms of damage to the mucous membrane of the esophagus, the child’s general condition has not changed, he is gaining weight normally.

With pathological GER, vomiting and regurgitation are almost always persistent. As a result, clinical signs of irritation of the mucous membrane of the esophagus by the acidic contents of the stomach appear - reflux esophagitis (inflammation of the esophagus) develops. The child's appetite worsens, he is capricious, and sleeps poorly. In severe cases, ulcers of the esophagus, persistent narrowing of its lumen, and pathology of the respiratory system that develop as a result of gastric contents entering the respiratory tract are diagnosed.

1. Pylorospasm- this is a spasm (contraction) of the pylorus, that section of the stomach where it passes into the duodenum. The reason for this phenomenon lies in the disruption of the neuromuscular system. From birth, a child with pylorospasm experiences regurgitation and periodic vomiting. Vomit (sometimes with bile) has a sour odor, and its volume does not exceed the volume of food eaten. The child eats well, but after several months signs of malnutrition appear and there may be constipation. Children with pylorospasm are often observed by a neurologist with a syndrome of increased neuro-reflex excitability.

1. and duodenitis In infants, it occurs with repeated, random vomiting and regurgitation of curdled milk, sometimes combined with diarrhea. Inflammation of the mucous membrane of the stomach or duodenum may be the result of a sudden transfer of a child from breast milk to formula or a violation of the formula preparation technology. Infectious gastritis develops when a child swallows infected amniotic fluid, when feeding him infected breast milk or formula contaminated with microbes. Drug-induced gastritis is a consequence of prescribing to a baby medicines in tablets.

1. Flatulence(accumulation of gases in the intestines) is accompanied by an increase in pressure in the abdominal cavity, which prevents the contents of the stomach from moving into the intestines. The stomach becomes full, the cardiac sphincter relaxes, and the baby burps. With an even greater increase in gas formation, regurgitation is replaced by vomiting. The causes of flatulence can be intestinal dysbiosis, improper feeding, constipation, lactase deficiency.

1. Perinatal encephalopathy (PEP), namely, the syndrome of vegetative-visceral dysfunctions, which sometimes begins to dominate in the PEP clinic when neurological symptoms fade into the background. It consists in disruption of the functions of internal organs. If we talk about the gastrointestinal tract, then the work of the sphincters is disrupted, the motor skills of the organs are disrupted, which in babies under one year of age is manifested by the syndrome of vomiting and regurgitation.

Organic causes of primary vomiting and regurgitation

This group includes congenital diseases, anomalies and malformations of the gastrointestinal tract, such as:

Symptoms of almost all of these diseases appear in the first days or even hours after the birth of the child:

• the child spits up during feeding or immediately after eating;
• burps profusely in a horizontal position, especially during sleep;
• vomiting during feeding or immediately after it, in a fountain or stream, of just eaten food or curdled milk;
• the volume of vomit equals or exceeds the volume of food eaten,
• the frequency of vomiting increases, the volume of vomit increases;
• admixture of bile or blood in vomit;
• the child chokes, swallows hard, wheezes or coughs during feeding;
• bad breath, bloating, tendency to constipation;
• The baby is not gaining weight well and urinates sparingly and sparingly.

Any of these symptoms should alert parents and prompt immediate medical attention.

Causes of secondary vomiting and regurgitation in children under one year of age

1. Infectious diseases: intestinal infections, pneumonia and bronchitis, urinary tract infections, neuroinfections (,), etc. In these cases, vomiting is one of the symptoms of the disease.

1. Brain pathology: perinatal encephalopathy, abnormalities of brain development, volumetric process in the cranial cavity, etc. This type of vomiting is called cerebral (cerebral), it occurs suddenly, and has nothing to do with feeding the child. As a rule, such a child has neurological symptoms: tremor (shaking) of the limbs, increased excitability, impaired muscle tone, nystagmus (involuntary movements of the eyeballs), etc.

1. Diseases manifested by metabolic disorders: salt-wasting form of adrenogenital syndrome, galactosemia, fructosemia, etc. If a child immediately after birth experiences persistent vomiting with increasing frequency, he is examined to exclude metabolic pathologies.

Possible complications of SSR:

• asphyxia (suffocation) or aspiration pneumonia, which develops as a result of vomit entering the respiratory tract;
• esophagitis, which occurs as a result of exposure of the acidic contents of the stomach to the mucous membrane of the esophagus;
• dehydration (dehydration) and acid-base imbalance due to the loss of large amounts of salts and fluid by the body.

Pediatrician Dr. Komarovsky talks about the causes of regurgitation in children:

Examination of a child with vomiting and regurgitation syndrome

1. At the initial stage of diagnosis, the doctor finds out the following:

1. The pediatrician examines the child: assesses physical and neuropsychic development, identifies neurological symptoms, if any. Examines the digestive organs, palpating and examining the abdomen.

1. Based on the information received, the doctor chooses individual tactics for further diagnosis, depending on the nature of the suspected pathology. The examination involves consultations with specialists (children's neurologist, endocrinologist, surgeon, ophthalmologist, etc.), laboratory and instrumental studies.

Laboratory tests, according to indications, include clinical and biochemical blood tests, coagulogram, urine and stool tests (pH, carbohydrates). The intestinal biocenosis is studied and the acid-base state of the body is determined.

Instrumental examination (according to indications) is ultrasound of the abdominal organs, pH-metry, fibroesophagogastroduodenoscopy (FEGDS), radiography of the gastrointestinal tract, electroencephalography (EEG), echo-EG, neurosonography, computed tomography (CT), lumbar puncture.

Treatment methods for children with vomiting and regurgitation syndrome

1. Parents of a baby with SSR should carefully follow the recommendations on the feeding regimen and method given by the pediatrician:

1. Drug therapy for SSR caused by functional reasons is aimed at normalizing the functioning of the sphincters and muscles of the stomach and esophagus through the prescription of special antireflux drugs. For flatulence, enzymes, adsorbents, and biological products are prescribed; for spastic conditions, antispasmodics are prescribed. In case of metabolic disorders, the doctor adjusts the child’s nutrition and normalizes the acid-base balance of the body. Physiotherapeutic procedures (ozokerite, UHF inductothermy, etc.) accelerate the maturation of neuromuscular structures.

New parents are wondering what the main causes of regurgitation in newborns after feeding are. Doctors, given their constant workload and limited appointment time, are not able to answer this question. Let's try to figure out why the condition occurs and how to prevent it.

Regurgitation or vomiting: where is the line?

An infant does not know how to talk and explain what is bothering him. He conveys his negative emotions, discomfort and pain through crying. And if he is accompanied, then the inexperienced mother is ready to call an ambulance. And this is not always correct.

Regurgitation is a natural reflex process in a baby that does not cause him suffering., and in some situations makes you feel better. It is based on partial emptying of the stomach. In this case, the cerebral cortex is not involved in the process, and there is no tension in the abdominal muscles.

This condition is not accompanied by pathological symptoms - pale skin, sweating, twitching of the legs.

Contents volume does not exceed 3 tablespoons. Regurgitation occurs after feeding in infants immediately or within an hour.

Vomiting is a multi-reflex process, due to the activation of a center in the cerebral cortex, accompanied by complete emptying of the stomach. Serves as a symptom of many pathologies and abnormalities in children of the first year of life.

If a child regurgitates more than 30 ml of milk or formula, then this is a suspicion. The child is also restless or lethargic, crying, and pounding his legs. If it occurs repeatedly, an ambulance is called.

Crying in infants is also observed when regurgitation due to fright or choking.

We present the distinctive features in the table.

Thus, you need to more closely monitor the child’s well-being so as not to miss the disease. Regurgitation in newborns after fountain feeding should alert doctors and parents. This is a consequence of pathology.

Shaeva M.R., consultant breastfeeding, St. Petersburg

The prevention of many intestinal ailments in children of the first year of life is rational breastfeeding. It is important for the baby to grasp the nipple and areola. The lips are turned out. Feeding on demand should be done within reason.

With incomplete latching and frequent breastfeeding, regurgitation occurs. A breastfeeding specialist can help you avoid this. In many cities, home visits are possible. He will explain and show how to set up the process correctly.

If a child spits up, but feels well, gains weight, there is no lag in physical and mental development, then there is no reason to worry. This is due to the immaturity of the gastrointestinal tract and is not life-threatening.

Reasons

The leading factors leading to physiological regurgitation are:

1. Incorrect feeding technique (how to properly feed a newborn baby):

1. Restlessness or increased excitability of the baby, leading to greedy sucking movements and additional swallowing of air (aerophagia).
2. Laying on the stomach after eating.
3. Various manipulations with the baby immediately after feeding - change, games,.
4. No belching of air.
5. Random, frequent breastfeeding. This main reason overeating.
6. Intolerance to the mixture used.
7. Chronic.

We invite you to watch the video that will complement our article if you still have any questions about regurgitation:

Vomiting and pathological regurgitation in newborns after feeding are caused by:

1. Cerebral palsy (CP).
2. Encephalopathy due to jaundice. There is a separate section on jaundice in newborns.
3. Infectious and inflammatory diseases of the stomach, intestines, and brain.
4. Fever.
5. Anomalies in the structure of the gastrointestinal tract.
6. Enzyme deficiency with damage to the liver and pancreas.
7. Diabetes mellitus.
8. Kidney failure.
9. Heavy birth defects hearts.

Vomiting is accompanied by a violation of the general condition, dehydration and weight loss. With pathological regurgitation, increases are noted that do not correspond to age norms. What other factors are there for weight gain in newborns, see.

Treatment of young patients in such cases occurs inpatiently due to the risk of severe complications.

Karnukhov S.I., pediatric gastroenterologist, Tver

Regurgitation an hour after feeding occurs due to lactase deficiency. Most people develop it due to overeating!

Children have few stomach enzymes; they do not have time to completely break down formula/milk in a short time. And at the next feeding, the body gets rid of the excess by regurgitation.

The only thing that helps is the selection of a feeding regimen at equal intervals. Enzyme preparations are prescribed for diagnosed pathology!

12 effective preventive measures

To prevent regurgitation in newborns after feeding, provoking factors are excluded. Such events include:

A large percentage of the reasons why a newborn spits up after feeding is attributed to overeating and improperly organized breastfeeding. Having eliminated these factors, parents forget about this condition.

Oleg Evgenievich advises first of all to consult a doctor. Among the causes of regurgitation in newborns after feeding, Komarovsky assigns a large role to overeating.

Reducing the sucking time or reducing the volume of formula used will help relieve parents of a lot of worries. Komarovsky suggests calculating the approximate volume that a child can eat in one feeding and not regurgitate. This portion is given to the newborn, and not what is prescribed according to the recommendations.

Even regurgitation after each feeding is not a deviation from the norm if the baby is active, sleeps well and gains weight. However, you should always talk to your doctor about the situation. He will prescribe an additional examination to exclude pathology.

What to do when spitting up and vomiting

After feeding, the baby is kept in an upright position (in a column) until the air comes out. If at the same time the baby begins to burp, then you should not panic.

Actions are limited to preventing choking or aspiration(entry into the respiratory tract of vomit).

This is achieved by holding the child in a column with the body tilted forward (on the shoulder). Then lay the baby on his side, securing the position with pillows. This will ensure a clear airway and mouth when repeating the process.

Malyukova E.S., Moscow, pediatrician

All parents experience regurgitation after feeding. There are different reasons for regurgitation in newborns after feeding. And parents try to alleviate the baby’s condition with medications (Bobotik,), which do not affect the process.

The result is an abundance of allergic reactions, with which people go to the clinic. It is important to explain during initial patronage that physiological regurgitation is not a disease. It cannot be treated with drugs.

Conclusions

Numerous causes of regurgitation in newborns after feeding frighten parents. Most of them can be eliminated without the help of medications. And the main way to prevent its occurrence is a properly organized feeding process.

The topic of spitting up in babies is one of the most discussed, most exciting and most difficult for young parents to understand. Firstly, regurgitation in a baby is very frightening for an inexperienced mother. Secondly, different doctors sometimes express diametrically opposed points of view regarding the cause of regurgitation and methods of dealing with it. Thirdly, even after seemingly applying all the tips and recommendations, many parents still fail to solve the problem.

The difficulty also lies in the fact that in reality, only the mother who spends almost all the time with him is able to understand whether there is a problem if a newborn baby spits up. A visit to the doctor will be very useful, and sometimes extremely necessary, but, admittedly, often pediatricians, neurologists and surgeons intimidate parents when everything is actually fine with the child. And the treatment begins, or rather, the crippling... The main goal is to prevent this. And regurgitation will go away sooner or later if there are no real violations. How to determine this? Let's talk below.

Regurgitation in infants, infants, and newborns

Not all infants experience regurgitation. However, they occur in most of them: according to statistics, in the first weeks of life, on average, every 8 out of 10 babies burp. By three months this happens less often, and by about a year (for some a little earlier, for some a little later) stops completely.

Doctors believe that premature babies, babies with intrauterine growth retardation (IUGR), and those with overweight or underweight at birth burp more often, but practice and statistics confirm that among healthy babies this phenomenon occurs quite often.

It happens that the mother did not observe anything like this with the first child, but the second newborn spits up, often, and sometimes even profusely, like a fountain. Therefore, this question may concern even experienced parents.

Regurgitation in infants is a frequent phenomenon and, as a rule, quite normal, that is, it is of a physiological nature. The reason lies in the imperfection of the structure and functioning of the gastrointestinal tract and brain centers:

• the newborn has not developed the lower esophageal sphincter (an elastic muscle ring that contracts after eating and holds it in the stomach). Therefore, as soon as you put the baby down after feeding, the contents of the stomach pour out;
• the baby's esophagus is short;
• The baby spends most of the time in a horizontal position. Due to the previous reasons, the contents of the stomach pour out of it, as if from a vessel placed horizontally;
• the baby’s stomach is small and spherical, which is also the reason for poor retention of food in it;
• the brain centers responsible for food intake are also still imperfect; the baby eats more than he needs, and therefore the excess food taken is eliminated through regurgitation;
• the peristalsis of a newborn is also not very active, the movement of food down the esophagus occurs slowly - and some of it can “pouring out” back;
• Many newborns swallow air during feeding. Air bubbles rise upward, and along with the swallowed air, part of the food taken also comes out.

All these factors lead to the fact that the newborn often burps. As the baby's organs and systems develop, normal regurgitation will gradually disappear. It is for this reason that healthy adults do not regurgitate - this is exclusively an infant feature.

Regurgitation after feeding in infants

Typically, regurgitation occurs during, immediately after, or a short period of time after feeding, that is, it is directly related to the baby's food intake. And taking into account the reasons described above, it becomes clear why.

If regurgitation has a physiological cause and is not associated with pathology or disorders in the child’s health, then the baby does not experience any discomfort. He can burp and smile, because not only does he not experience any unpleasant sensations, but sometimes he even feels relief after belching air or an extra portion of food, which creates pressure inside the stomach and a feeling of fullness from the inside.

If a child cries hysterically after regurgitation, and especially if he wriggles and screams shrilly, then you need to consult a pediatrician about the problem: most likely, there are some disorders, in particular, this indicates irritation of the esophagus with gastric juice.

Regurgitation of cottage cheese in newborns

Regurgitation is the release of a portion of the contents of the baby's esophagus or stomach in an undigested or partially digested form (slightly curdled). The more time passes after feeding, the more curdled the milk belched by the baby has. From time to time, a newborn may spit up curds, but if this happens quite often or constantly, between feedings, and not immediately after them, then you should consult a pediatrician or surgeon. Surely they will confirm that this may be a variant of the norm, but it is still better to play it safe.

Newborn spits up like a fountain

When discussing this issue, it is important to understand that there is a difference between regurgitation and vomiting - both in manifestations, and in reasons, and in tactics of action on the part of parents.

Regurgitation usually occurs soon after feeding and is infrequent, in small quantities. But it also happens that a newborn spits up a lot and profusely.

Vomiting can occur regardless of feeding, and can be repeated over and over again, which does not happen with regurgitation. Also, when regurgitating, unlike vomiting, the child usually feels good and behaves calmly.

If the child vomits everything he has eaten, then you should not feed him right away. Offer the breast or bottle only when he asks. In the meantime, if the baby does not require food, let the digestive system rest a little.

If the contents of the stomach are pushed out sharply, like a fountain, high and over a long distance, then the most likely cause of this phenomenon is a spasm of the pylorus. In some cases, this is acceptable, but if fountain vomiting is repeated frequently, then medical consultation is required.

Yellow regurgitation

In addition to the fact that vomiting is always profuse (it seems to the mother that the child is spitting up like a fountain), it can also be yellow in color and have a sharp sour smell, because gastric juice and even bile are mixed with the contents of the stomach during vomiting. Therefore, if a mother observes yellow regurgitation in her newborn, she should tell the doctor about this: most likely, she will need a consultation and examination by a specialist - a surgeon or gastroenterologist. Gastroesophageal reflux may be present.

IMPORTANT: Brown or green regurgitation may be a sign of intestinal obstruction and requires immediate medical attention!

Excessive regurgitation in newborns through the nose

Frequent, profuse regurgitation in newborns should also be a reason to contact a pediatrician or surgeon. Although in some cases even such manifestations do not pose a danger if the child feels well and there is a positive trend in weight gain.

It happens that with excessive regurgitation, liquid is released even through the nostrils. Many mothers are scared when a child spits up through the nose, but if such cases occur infrequently and the baby behaves calmly, then there is no need to worry. The main thing is to make sure that the child does not choke (if necessary, turn it upside down and knock very lightly) and that the nasal passages remain unclogged; if necessary, you can use a nasal aspirator.

Be prepared for the fact that the baby may be frightened by the delay in breathing that occurs during profuse regurgitation through the nostrils: he may begin to cry. This is normal - calm the baby down, pet her.

Norm of regurgitation in newborns

Various experts are trying to establish certain standards that parents could follow if they infant burps. There are, for example, tables that indicate the norms of regurgitation in newborns. On average, this norm is proposed to take the volume of regurgitation to be no more than a fifth of the portion eaten and the frequency of such episodes to be no more than 5 per day.

But in practice, it is not always possible to be guided by these standards, because it is actually almost impossible to measure how many grams a child burped. In addition, it matters how much he ate and how he behaves and feels.

We recommend focusing on the following norms for regurgitation in infants: if the baby does not regurgitate very much and does not express obvious anxiety, then most likely everything is fine. Not very much - no more than 10 ml. To understand what this looks like in reality, pour 2 tablespoons of liquid onto the diaper. If your newborn regularly spits up more, you may need to see a doctor.

However, the most important role In this situation, the dynamics of weight gain plays a role. Even if your newborn spits up after every feeding, but does not scream, does not cry, and most importantly, gains weight, then it is better to leave the baby alone.

Regurgitation in infants: causes

We have already partially clarified this issue at the beginning of our article. In particular, we were talking about physiological reasons determined by the anatomical and functional characteristics of the body of a newborn child. Let's briefly count them again:

• swallowing air during feeding; overeating;
• muscle weakness, that is, poor contraction of the esophageal sphincter and slow movement of food through the esophagus;
• enzyme immaturity;
• anatomical features of the stomach of a newborn baby;
• slow process of coordinating the acts of breathing, sucking and swallowing (up to approximately 2 months of age);
• intolerance to certain products (for example, those included in formula).

Occasional regurgitation also occurs during teething.

There is another reason why a child may burp - this is a lack of enzymes necessary for digesting food. Usually they begin to be produced in the required quantities quite quickly a few weeks after birth. But it also happens that enzyme deficiency is a pathology that requires correction, in particular the introduction of their analogues into the body.

In addition, some infants experience problems with the gastrointestinal tract or central nervous system. Among the pathological causes, doctors identify the following:

• congenital anomalies of the gastrointestinal tract;
• malformations of the development and functioning of the gastrointestinal tract or diaphragm;
• increased activity of the nervous system;
• infectious diseases or poisoning (the child in this case will be lethargic, capricious, pale;
• hereditary metabolic disorders - in extremely rare cases.

Such conditions require referral to specialized pediatric specialists - a surgeon or neurologist. Intestinal colic and excessive gas formation can also accompany regurgitation in infants.

A newborn spits up: what to do?

If the cause of regurgitation in a newborn baby is pathological disorders, then, depending on the diagnosis, drug treatment. In rare cases, surgical correction is required.

But most often, as confirmed by reviews, forums, medical and parental practice, there are no serious reasons There is no regurgitation. Sometimes it seems to parents that the child is spitting up a lot, profusely, very often, but in reality there are no problems in his health. Many mothers share their experience that despite their fears, frightening medical diagnoses, and multiple efforts made to combat this phenomenon, regurgitation in their infants went away on their own as soon as the child began to spend more time in an upright position (that is, at least sit and walk) and eat thicker foods.

Doctors say that regurgitation in newborns goes away by 6-10 months, sometimes by a year. Practicing pediatricians claim that normally they can manifest themselves up to a year and a half, especially in children with IUGR and premature babies. And then they just disappear on their own.

However, this does not mean that you need to wait until the child grows up. Again, parental experience confirms that the cause of regurgitation in babies is most often overfeeding. Experiment with this. When overfeeding, a child often burps immediately after feeding uncurdled or partially curdled milk.

If the baby hangs on the breast all the time, do not offer him another breast every time: let him suck everything completely from only one, and only after a while, when he is definitely hungry, does he start on the other. Firstly, this way he will suck out the hind milk, the most valuable milk, which, among other things, does not cause disturbances and problems with the intestines and stomach. Secondly, if the child has already eaten, but has not yet satisfied the need for breastfeeding, then this technique will help avoid overeating.

When mixed and artificial feeding, try giving your baby a few milliliters less formula than usual, or change the number of feedings - and monitor the reaction. Typically, to determine how much a bottle-fed baby should eat at one time, the following simple formula is used:

1 + age in months (4) + 0 = 140 ml.

It may be worth feeding more often, but in smaller portions, adhering to the daily amount of food according to age.

Next is the prevention of air swallowing. Attach your baby to the breast correctly and make sure that he grasps not only the nipple, but also the areola. Try not to feed your baby while he is crying, as he will swallow air. Interrupt feeding sessions by lifting the baby vertically soon after the start of feeding, because it is in the first minutes that he eats most greedily and swallows most of the air. This will facilitate the release of air bubbles that sink deepest. After the burp, continue to feed, and after some time the break can be repeated again. Among other things, such tactics can serve as a prevention of overeating, because signals of satiety arrive in the brain centers late, and with interruptions, the baby will quickly understand that he is full.

When feeding from a bottle, it is important to choose the right nipple (with the appropriate size hole) and keep the bottle in such a position that the pacifier is completely filled with the mixture - this will prevent air from entering the baby’s mouth and stomach. Many mothers like special anti-colic bottles.

It is necessary to select a mixture to which the baby’s gastrointestinal tract will react calmly, that is, if he begins to spit up from the new mixture, he needs to change it. Consult your pediatrician; it may be worth trying an anti-regurgitation (anti-regurgitation) mixture, which is labeled AR (Antiregurgitation) - it has a thicker consistency, due to which it is better retained in the stomach. You can thicken the formula you use using corn, rice or potato starch in the proportion of 1 tablespoon of thickener per 60 ml of finished formula or breast milk.

The release of air is facilitated by carrying the newborn in an upright position each time after feeding for 10-20 minutes (or until the air leaves with a burp): in a column, on the shoulder, in other positions comfortable for mother and baby. Before feeding, the baby should be placed on the tummy, massage the tummy, stroking it clockwise with the palm of your hand.

Please note that difficult nasal breathing forces the baby to breathe more through the mouth, including during feeding. For this reason, he can also swallow air and burp. To avoid such troubles, it is necessary to maintain an optimal microclimate in the children's room (with an air temperature no higher than 22 o C and a humidity of 50-70%), preventing the nasal mucus from drying out. If crusts have formed in the newborn’s nose, they should be removed before feeding.

If the baby spits up every time, as soon as you put him in the crib, then raise the head of the crib by 5-10 cm (for example, by placing a stand under the legs). By the way, parents often claim that if after feeding the baby is not touched (not picked up or carried in a column), then he does not spit up. But you need to make sure that the baby’s head is turned to the side, because he can burp the air swallowed during feeding and choke.

Try not to put pressure on the baby's stomach area: do not fasten the diaper tightly, swaddle loosely, do not use pants with an elastic band. Provide your baby with peace after feeding - do not change clothes, bathe him, or disturb him. The baby should be fed in such a position that the head is higher than the level of the legs. It is also important to ensure that your baby has regular bowel movements.

Of course, a favorable psychological atmosphere in the family, including during pregnancy, prevents increased excitability of the baby’s nervous system and reduces the likelihood of regurgitation in infancy. Factor increased risk Passive smoking also contributes to the excitability of the nervous and muscular systems of a newborn: this factor should be excluded in any case!

Regurgitation in newborns: when to see a doctor

And everything seems clear, but when the problem concerns our children personally, we are not always able to think objectively: doctors do not find any violations, but the situation seems serious to us. It also happens the other way around: the child exhibits obvious gastrointestinal or central nervous system disorders, but the mother prefers to think that everything is normal. How to understand that you need to see a doctor:

• the child regurgitates the entire amount of food eaten in the first days of life;
• regurgitation first appeared after 6 months of age;
• against the background of regurgitation, the child loses weight, there is no dynamics in weight gain;
• at the moment or immediately after regurgitation, the child arches, wriggles and cries hysterically;
• the child regurgitates more than a fifth of the entire portion of food eaten more than five times a day;
• the baby spits up like a fountain after each feeding;
• along with heavy or frequent regurgitation, other signs of the disease appeared - elevated temperature, diarrhea, etc.;
• in combination with frequent or heavy regurgitation, signs of dehydration appear.

Otherwise, the recommendations outlined in this article on what to do if an infant regurgitates can significantly reduce the frequency of regurgitation, and often, if overfeeding is eliminated, eliminate this problem altogether. But we once again want to emphasize that if the baby feels well, is cheerful and calm, is gaining weight, and the pediatrician has not found any abnormalities, then you should not treat him for regurgitation. Everything will work out - let him just grow a little, and his systems and organs will fully mature.

Especially for -Ekaterina Vlasenko

When a child is born, all his organs and systems are not yet fully formed, and therefore do not work very well. The consequence of this is various troubles that cause parents a lot of anxiety. Moms and dads are especially frightened by conditions related to the functioning of the baby’s nervous system and gastrointestinal tract, including regurgitation.

Parental fears sometimes cannot be dispelled even by consulting qualified doctors and reading specialized literature: the symptoms can be so contradictory, and the line between normality and pathology is so unclear that mothers and fathers, unable to distinguish a serious illness from a non-dangerous condition, can seriously panic .

Such manifestations also include regurgitation in newborns, which can frighten inexperienced parents, but is not always dangerous. To determine when a child needs a doctor, and when - nothing but observation and prevention, you should know how regurgitation occurs, what causes it, and what measures should be taken to reduce the frequency of this not very pleasant phenomenon to a minimum.

The reasons for regurgitation in infants lie in the imperfection of the digestive system, which continues to form in a newborn baby, but for quite a long time differs from the gastrointestinal tract of an adult. The baby's stomach is not elongated, but spherical in shape, the esophagus is still too short, and the sphincter (the muscle that opens the passage for food from the esophagus to the stomach and closes it during digestion and at rest, and also prevents the release of hydrochloric acid into the body) is quite weak.

As a result overfeeding The sphincter cannot hold back large amounts of food. It opens and some of the undigested or incompletely digested milk is pushed back out. The result is what experts call gastroesophageal reflux. Don't be alarmed - this is a professional term for regurgitation in infants or digestive problems in adults.

Another phenomenon that provokes regurgitation is the baby swallowing too much air during feeding. It's called differently aerophagia . An air plug of impressive size forms in the stomach, which puts pressure on its walls, and in order to get rid of excess pressure, the stomach contracts sharply, pushing the plug into the esophagus.

As a result, the air comes out with a characteristic sound and is accompanied by regurgitation of a small amount of milk, which left the stomach along with the plug. It can be unchanged or partially digested (the so-called regurgitation of curds in infants). Despite the volume of the sound and even spitting out milk, the child does not experience any particular discomfort.

Thus, the causes of regurgitation in a newborn can be anything that provokes pressure on the baby’s digestive and abdominal organs, namely:

• overfeeding;
• improper attachment to the breast or too wide a hole in the bottle, which leads to excessive swallowing of air;
• problems with the intestines - flatulence, colic, which creates excess pressure in the abdominal cavity and impedes the movement of milk from the stomach;
• excessive activity of the child: rolling over or crawling immediately after feeding;
• prenatal developmental delay or prematurity: in this case, the baby’s gastrointestinal tract has a long way to develop, and both breathing and the sucking reflex are not yet coordinated, which can lead to aerophagia;
• serious disturbances in the development of the digestive organs: displacement of the stomach upward towards the diaphragm, a defect in the valve that regulates the passage of food from the stomach to the intestines (pyloric stenosis), insufficient development and weakness of the sphincter between the esophagus and stomach (chalazia), excessive narrowing of the esophagus (achalasia).

As a rule, it is enough to comply correct mode feeding and breastfeeding, and also hold the baby upright for 15–20 minutes after eating, so that the food sinks into the stomach and the air rises and comes back out. However, if, despite all the measures taken, the frequency and volume of regurgitation increases, and the child feels unwell and loses weight, this is a reason to immediately consult a doctor.

Vomiting and regurgitation: how to distinguish one from the other?

The main question that worries most parents is whether regurgitation is normal in a newborn? In fact, this is an absolutely natural phenomenon caused by the immaturity of the baby’s digestive system - as the child grows and the internal organs improve, the problem will disappear by itself. However, regurgitation should not be confused with vomiting, a dangerous condition that is a sign of serious health problems.

If a child regurgitates a small amount of milk that is practically odorless and unchanged (or looks like white curd), this does not cause him discomfort, he is healthy, cheerful and gaining weight well, there is nothing to worry about. In this case, even frequent regurgitation in a baby can be considered as normal.

When vomiting, the picture is a little different: the child forcefully spits out what he has eaten immediately after feeding (in particularly difficult cases, almost everything he ate before) - this phenomenon is also called fountain regurgitation. In this case, the baby feels discomfort, gets scared, cries, and may also experience paleness, sweating, and in the case of regular episodes of vomiting, sudden weight loss. If such manifestations are repeated regularly, and the milk regurgitated by the child has a pronounced yellow tint (which is typical for pyloric stenosis), it is necessary to show the baby to a specialist as soon as possible.

Pathological processes

If regurgitation is, in principle, considered normal, then is excessive and frequent regurgitation in a newborn a pathology? Depends on what is considered frequent and abundant. As a variant of the norm, a child can burp 5–30 ml of milk (up to 2 tablespoons) after each feeding, or a total of up to 3.5 tablespoons of milk per day.

Of course, you can’t measure regurgitation with spoons, so many parents, seeing a wet spot of impressive size on their clothes or diaper, are very worried. In fact, everything may not be so scary. To get an approximate idea of ​​the amount of food regurgitated by a child, you should conduct a simple experiment: pour one tablespoon and one teaspoon of water onto the diaper in different places. By roughly comparing the size of the spots with traces of regurgitated milk, you can determine how much food the baby has “rejected.”

Even if the child regurgitates a lot at first, after 3-4 months this happens less and less frequently, and by the time the baby begins to sit and eat more solid and dense food, regurgitation stops almost completely, finally disappearing by 10-12 months.

True, there are exceptions: if a child begins to actively crawl before sitting, he may begin to spit up again, since the stomach will constantly be under pressure. This can be avoided if you do not allow the baby to roll over after feeding and carry him in an upright position until he burps air.

However, if the baby spits up very often and more than normal(in some cases - the entire portion eaten during feeding), becomes pale, lethargic and tearful, and as he grows, nothing changes; we are most likely talking about pathology - disorders in the development of the digestive and nervous systems.

The causes of frequent pathological regurgitation in infants, as a rule, are:

1. Lesions and developmental disorders of the central nervous system - hydrocephalus, perinatal encephalopathy, etc.
2. Problems with the development of the gastrointestinal tract - achalasia, pyloric stenosis and other diseases.
3. Poisoning and infectious diseases.
4. Kidney disease – in some cases.

In addition to frequent regurgitation, these abnormalities are accompanied by fever, pallor, delayed growth and weight, rare urination and lack of stool, tearfulness and increased excitability. With successful treatment or correction of the underlying disease, regurgitation gradually disappears.

What to do when regurgitating

If after feeding the baby does not burp air in an upright position, this does not mean that he will not burp later. However, if you lay him on his back, there is a risk that when he burps, the baby will begin to choke. To avoid this, it is necessary to place the baby strictly on its side after feeding, placing a small diaper under the cheek: this way the regurgitated milk will be quickly absorbed.

Another trouble - regurgitation through the nose . This happens if, when feeding or further laying down, the baby’s legs are slightly higher than the head or the baby has swallowed too much air. Milk that gets into the nose can irritate the mucous membrane, therefore, when laying the child down, it is necessary to slightly raise his head with the help of two or three folded flannel diapers.

If the child burps while lying down, you should immediately pick him up and hold him in an upright position for a while: it is possible that the air did not come out completely. If the baby burps during feeding, he should also be held in a “column” and under no circumstances should he be fed additionally, for fear that he has not eaten enough: most likely, everything is just the opposite. But in any case, you should not leave the baby alone immediately after eating, since regurgitation is an unpredictable phenomenon: its appearance and intensity are difficult to predict.

How to deal with the problem?

To get rid of regurgitation or reduce it to a minimum, you need to understand why this happens. If the cause of regurgitation in a newborn is overfeeding or aerophagia, it is necessary reconsider the mode and method of feeding : Correctly attaching the baby to the breast, in which he should grasp the nipple together with the areola, or narrowing the hole in the bottle can reduce the frequency of regurgitation in about half of the cases.

Feeding small portions at short intervals will help avoid overeating and promote better milk absorption. Moreover, if the child burps immediately after eating, it is better not to feed him lying down, but to choose a position that is closest to vertical. Regular massage and placing the baby on the stomach before feeding also helps: this stimulates the activity of the stomach.

If regurgitation is caused by excess pressure on the baby's stomach, it is necessary avoid tight swaddling , tight clothes and onesies with elastic bands, and also try to squeeze and cuddle the baby less for at least an hour after feeding. If the baby begins to actively turn over, you will have to carry him in your arms for 20–25 minutes after eating so that the milk “settles” in the stomach completely.

If your baby's problem is reflux or sphincter weakness, you may need to special food . Anti-reflux milk formulas with natural thickeners or high casein content promote rapid curdling of milk, which makes it difficult for it to rise from the stomach.

However, with serious pathologies of the gastrointestinal tract, the baby may well need operation . Before this, a thorough examination will be carried out with a mandatory examination by a surgeon, gastroenterologist, ultrasound examination and all necessary tests.

For pyloric stenosis and achalasia, the operations are usually simple: almost immediately after the operation, the baby begins to be fed little by little, and in the absence of complications, already on the 4th day he is put to the breast. In the future, the baby develops absolutely normally, and, most likely, will not even know that he was operated on in early childhood.

When should you call a doctor?

If the regurgitation is small in volume and does not cause discomfort to the baby, there is no reason to worry. However, you should immediately consult a doctor in the following cases:

1. Copious regurgitation “fountain” more than 2 times a day.
2. Changed color and bile in regurgitated milk.
3. Sudden weight loss.
4. Refusal to eat.
5. Lack of stool and urination.
6. Paleness, fever.
7. Moodiness, loud, prolonged crying.

All these symptoms are signs that the baby is seriously unwell and require urgent consultation with a specialist. Waiting for it to “go away on its own” or trying to treat a child on your own is extremely dangerous. Timely medical assistance will help quickly get rid of the problem and return the child wellness, healthy appetite and normal digestion.

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