Good afternoon, my dear readers! Very often, young parents wonder: why does the baby spit up and should they be concerned about this? In general, this process is absolutely normal, but again, it all depends on the frequency of regurgitation, its quantity and the condition of the baby itself. Today I will tell you everything in detail.

Every baby up to a certain age burps and this is an absolutely normal phenomenon, because in this way the small stomach is freed from an excess of food, or from air that the child has swallowed.

Why is this happening? The explanation is simple: the baby’s digestive system is not yet perfect. The baby's esophagus is short, and the stomach is spherical in shape, and not elongated, like in an adult. The sphincter muscles are also very weak to keep food well in the stomach and prevent it from entering the esophagus. By about 6-9 months, the baby’s gastrointestinal tract should be fully formed, the sphincter should become stronger, and then regurgitation will stop.

Which common reasons spitting up? Let's see:

• Overeating in infants. If a child is overfed, then the sphincter will not be able to retain the excess food, as a result of which excess contents from the stomach are released into the esophagus, and the baby seems to spit out what got from the esophagus into the mouth. This happens involuntarily.
• Aerophagia. This is the name of the process when a baby swallows air along with breast milk or formula. This causes the formation of a large air plug in the ventricle, pressing on the walls. To get rid of this plug, the stomach makes sharp contractions to push it out. Together with the air, the eaten food usually comes out like a fountain. Sometimes food may already be partially digested and look like “curd”.

Aerophagia is usually observed if the baby takes the breast incorrectly (correctly - together with the areola), or he has endured eating, and therefore greedily swallows milk, naturally along with air. To prevent this from happening, it is better to feed the baby on demand.

• Fermentation in the intestines (flatulence, colic). They manifest themselves as cramps in the tummy, the baby passes loud gases, and may cry. This increased gas formation causes intra-abdominal pressure, and this causes the baby to burp. To avoid strong fermentation, a nursing mother should not eat rye bread, apples, cabbage, beans or peas.
• During teething Copious regurgitation may occur in a fountain. So small organism gets rid of excess saliva.

The baby has artificial feeding The reasons for regurgitation may include the following:

1. The nipple on the bottle has a large hole (should be minimal).
2. Hard or too soft nipple. Here you can’t say for sure which is better, everything is very individual. You can try buying several types of pacifiers and see which one suits your baby. Also, when choosing a pacifier, you should take into account the baby’s bite. Silicone nipples are usually firmer than latex ones.
3. Unsuitable formula for feeding. If the mixture is incorrectly selected, the food eaten can come out like a fountain, even an hour or more after the meal. The baby literally vomits the mixture. If you notice such a manifestation, try changing the mixture; it is advisable to consult a doctor about this.

Regurgitation within normal limits

Let's see under what conditions regurgitation is normal and does not harm your baby:

1. Up to 4 months, the baby can regurgitate what he eats after each feeding. After this age, regurgitation should be no more than 2-3 times a day.
2. If the baby regurgitates very little milk (no more than two tablespoons is considered normal).
3. If this process does not in any way affect the baby’s well-being. The child does not cry, is not capricious, but behaves as usual. There are no other symptoms to worry about.
4. The release of food occurs within half an hour (but not more than an hour) after feeding.
5. The regurgitated food does not have an unpleasant odor or any impurities. Everything should leave unchanged.
6. If the baby continues to eat well and gain weight normally.

When to be wary

Although burping a baby is the norm, there are still cases when parents should be wary and, perhaps, even consult a pediatrician for advice.

You need to play it safe if you regurgitate:

1. Too abundant (more than half the portion that the baby ate).
2. They appear more than three times a day when the baby is more than 4 months old.
3. Occurs even when the baby has eaten very little.
4. They have an admixture of mucus, bile or blood.
5. Complemented by symptoms such as anxiety, lethargy, refusal to eat, and elevated temperature or diarrhea.
6. Occurs an hour (or later) after feeding.

The most dangerous symptom is when, along with frequent regurgitation, weight loss is observed, the baby begins to lose weight sharply. Here you need to see a doctor and the sooner the better. The reasons here could be:

1. Anomalies in the development of the digestive organs. Usually only surgery helps.
2. Intestinal infection. During infections, regurgitated food has a greenish or yellow color, this is the release of bile and gastric juice, this is how the body reacts to infection. If you notice such a change, immediately run to the doctor! Do not try to treat an infant on your own, it will only make things worse.
3. Lactose intolerance. With this diagnosis, the child spits up a lot, almost all the food comes out like a fountain. So, to make it clear to you, I’ll explain: lactose is the name given to the protein that is found in breast milk and this protein must be broken down in the stomach by special enzymes. So, when these enzymes are absent or there are very few of them, milk intolerance occurs. When this very milk enters the stomach, the latter cannot digest it and therefore the child spits up often and in large portions. In these cases, you will have to stop breastfeeding and switch the baby to lactose-free infant formula, which your pediatrician will help you choose.

How to reduce spitting up

You won’t be able to get rid of this phenomenon completely; your baby will stop burping only by about 9 months, sometimes earlier, but not later! But you can reduce the likelihood of regurgitation by simply following these recommendations:

1. Don't overfeed your baby! Babies do not yet know how to stop and can eat as much as they are given. It is important to give him the amount of food that is appropriate for his age. For example, a one-month-old baby is supposed to eat about 60 grams of milk every three hours. If the child is artificial, it is easier to measure the amount of food than when the baby is breastfed. It is in breastfed babies that overeating occurs most often.
2. After feeding, the baby should be carried in a column for 10 minutes. In this state, the air comes out better, and the amount of regurgitated food is minimal (not a fountain) than when the baby is put down immediately after feeding.
3. Be sure to swaddle (not tightly, just the arms) the baby before putting him to bed. A swaddled baby calms down faster and the pressure on the gastric walls decreases, which also reduces the likelihood of involuntary regurgitation during sleep.
4. You can give your baby a pacifier before bed, sometimes this is very useful. During sucking, the production of hydrochloric acid is stimulated and food digestion occurs faster, which means that more breast milk or the mixture will be digested and not “throw out” outside.

Walk with your baby more, do not let him become overtired. Always put her to bed on a regular schedule and feed her on demand. With this I say goodbye to you! See you soon on the pages of my blog! Ask your questions in the comments, share your life experiences, like and subscribe to updates!

My daughter is 9.5 months old. I started spitting up sometimes with the smell of vomit: about once a day, 1 teaspoon. Could this be overfeeding? The menu is as follows: at 9 am breakfast 180 ml of porridge, lunch thick vegetable soup with meat, also about 180 ml at 13 o'clock, at 16 o'clock afternoon snack 50-100 grams of cottage cheese and fruit puree 100 grams or kefir 100 grams, for dinner at 19 o'clock again porridge, 150 grams and at night I can give a mixture of 150 ml or water. After eating, she almost always screams as if from hunger and asks for more. Maybe after a serving of porridge, drink another 120 ml of water, I think that’s a lot. And he doesn’t let us eat, he also asks us, and can beg for a piece of bread, a bagel, fruit, cheese, etc. In addition to the main menu. So the child is very active, cheerful, the stool is normal. Is this overfeeding? Reduce portions and snacks?

Elena, Nizhny Novgorod

ANSWERED: 12/31/2017

Hello, no, the menu is fine. Test your stool for dysbacteriosis. You can reduce the porridge to 150 maximum. But most likely there are violations of the flora in the gastrointestinal tract.

Related questions:

A common problem for children infancy regurgitation that causes concern for parents is regurgitation. What are the reasons for this phenomenon? And in what cases should you consult a doctor and start treatment?

Regurgitation– passive reflux of small amounts of food from the stomach into the esophagus, into the pharynx and oral cavity in combination with the release of air, observed mainly in infants immediately or shortly after feeding uncurdled or partially curdled milk. These phenomena can occur in completely 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 burp at least once a day; in 23% of cases, regurgitation is considered by parents as a reason for “concern.” In most cases, regurgitation can go away 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 advisable to clarify the cause of regurgitation.

Features of the child's body

Anatomical and physiological features of the structure of the upper parts of the 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 the passage of food from the esophagus into the stomach, and does not allow gastric contents to be thrown out back into the esophagus, immaturity of the regulation of the system of moving food through the gastrointestinal tract (GIT), immaturity of enzymes) predispose to the development of regurgitation.

In newborn children, 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: first before sucking, then after it and are often 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 can cause the backflow 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 develops a feeling of false satiety and stops sucking. If this situation is repeated frequently, it can lead to malnutrition and delayed development of the child.

Causes of regurgitation

Regurgitation occurs frequently in children with intrauterine growth retardation (IUGR), as well as premature babies. Along with the above-mentioned 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 may vary. However, as the body matures, regurgitation disappears.

The cause of regurgitation may be overfeeding(increasing the frequency or volume of feeding), especially in actively sucking 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 (replacement of breast milk with an artificial formula or frequent unmotivated replacement of one adapted mixture another). Regurgitation during overfeeding occurs immediately or shortly after feeding with uncurdled or partially curdled milk, in an amount of 5-10 ml. The general condition and behavior of the baby are not affected 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) occurs: 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 grasp the nipple pigmentation (areola) along with the nipple or does not grasp correctly when the mother’s nipple is flat, inverted; when there is a large hole in the nipple of the bottle, the bottle is in a horizontal position, when the nipple is not completely filled with milk; with general muscle weakness due to immaturity of the body. More often, aerophagia develops in newborns with low or very high birth weight. Children with aerophagia are often restless after feeding, and there is bulging of the anterior abdominal wall in the stomach area. 5-10 minutes after feeding, regurgitation of unchanged milk is observed with a loud sound of escaping air.

Regurgitation in a newborn may occur when flatulence(bloating), intestinal colic (painful intestinal spasms), constipation. At the same time, pressure in the abdominal cavity increases, and the movement of food through the gastrointestinal tract is disrupted. The intensity of regurgitation can also vary.

Malformations of the gastrointestinal tract, for example, anomalies of the esophagus ( chalazia– weakness (insufficiency) of the lower esophageal sphincter; achalasia- narrowing at the junction of the esophagus with 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 part of the abdominal organs into the chest cavity), etc.

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

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

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

Assessing the intensity of regurgitation

Table 1

*Spitting up with an intensity of 3 points or higher also always requires seeing a doctor.

What to do?

To find the cause of regurgitation and help the child, you should contact a 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 child’s condition and 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. Instrumental methods include X-ray examination of the upper gastrointestinal tract (esophagus, stomach) 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 there is a miniature video camera).

Treatment of regurgitation

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

Treatment by position. When feeding a child suffering from regurgitation, it is important to create a position in which the upper body is raised at an angle of 45-60 degrees to the horizontal plane. For example, the baby can be placed 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 release of swallowed air.

Tight swaddling is not recommended, the abdominal area should not be squeezed; instead of onesies with an elastic band, it is better to use onesies that fasten on the baby’s shoulders or overalls. The child should sleep on a small pillow made from 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 place the child on his stomach or right side. Organization therapeutic nutrition This includes, first of all, feeding the baby more frequently and 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 above the prescribed norm.

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

Another approach is to add a thickener to the mixture. Rice, corn or potato starch can be used as such, as well as gum - gluten from carob seeds, which grows in Mediterranean countries. The gum thickens under the influence of the acidic contents of the stomach, but unlike starch and casein flakes, it is not digested by enzymes of the gastrointestinal tract. As a result, the thick consistency of the gastric and, subsequently, intestinal contents is maintained for a longer time. In addition, gum stimulates peristalsis, promoting faster movement of food from the stomach to the intestines.

Specialized milk formulas that prevent regurgitation

Table 2

At natural feeding medicinal mixtures can be added to the baby’s diet before breastfeeding.

If there is no effect from the above measures, the issue of drug treatment . It includes the prescription of prokinetics - drugs that improve intestinal contractile function. For this purpose it is used motilium, coordinax. An antispasmodic drug can be used to eliminate regurgitation and intestinal spasms. riabal.

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

Prevention

A complex and multifaceted problem. A favorable pregnancy and childbirth, a friendly, calm environment in the home - all this reduces the risk of developing 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 during feeding the baby grasps both the nipple and the areola, then the likelihood that the baby will swallow air will be less. If you bottle feed 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, hold the baby's tummy close to you and hold it in an upright position for 15-20 minutes to allow the air to escape. Before each feeding, place the baby on his stomach, stroke the tummy around the navel with your palm clockwise, all this facilitates the passage of gases and reduces the likelihood of regurgitation after eating. Clear your baby's nasal cavity of mucus and crusts in a timely manner, then when feeding he will not experience difficulty breathing through his nose and a lot of air will not enter the stomach. From the same point of view, it is important to ensure that when feeding the baby does not rest his nose on the chest. It is also necessary to remember about 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 Childhood Diseases No. 2 of the Russian State Medical University, Doctor of Medical Sciences.

Any child is born with certain innate reflexes that help him adapt to new conditions that differ significantly from the conditions of intrauterine life. Some of these reflexes - breathing, sucking, swallowing - are very important, without them the child will not be able to survive on his own in the absence of medical care. Eating self-regulation reflexes are also innate and protect the baby from overeating. Thanks to them, a healthy child himself “knows” how much to eat and when. One of the manifestations of these reflexes is excess food.

A characteristic feature of regurgitation is that it appears suddenly, without any warning signs and occurs without noticeable involvement of the abdominal muscles. Regurgitation in children up to 7-9 months is physiological (normal). Moreover, they should not occur later than 1 hour after feeding, and should not be in the form of a “fountain” (that is, go under pressure, a stream, over a distance). During normal regurgitation, the child’s well-being does not suffer, behavior, appetite and mood do not deteriorate.

After feeding, you need to hold the baby upright for at least 20 minutes: during this time, the air pocket will burp, and a small amount of uncurdled or partially curdled milk may flow out of the corner of the mouth. Regurgitation may recur when the baby's position changes or even without apparent reason. It may seem to you that the amount of regurgitated food is quite large, but if the nature of the regurgitation corresponds to its physiological description, and the child is gaining weight well, this is not a problem, but a variant of the norm. At approximately 7 months, the regulatory mechanisms of the valve apparatus of the esophagus and stomach mature, old reflexes are replaced by new ones and regurgitation stops.

The following manifestations should alert you.

• Regurgitation "fountain"- this is most often a consequence of neurological disorders ((PEP), intracranial hypertension). In this case, it is necessary to show the child to a neurologist. Less commonly, the cause of such regurgitation is spasms of the digestive tract (they are treated by a gastroenterologist).
• Late regurgitation- an hour or more after feeding, until the next one. In such a situation, they say that the child has a “lazy stomach,” and constipation often occurs. In this case, you need to contact a gastroenterologist.
• Frequent regurgitation . If a child spits up every 5-10 minutes, this is also abnormal. You should also contact a gastroenterologist with this problem.
• Regurgitation accompanied by restlessness and crying. These are manifestations of spastic. A pediatrician or gastroenterologist can recommend remedies for them.
• Regurgitation after drinking or eating small amounts of food, accompanied by anxiety and a decrease in weight gain up to a complete lack of weight gain. They may be a sign of an anatomical defect called pyloric stenosis (a sharp narrowing of the digestive tube, due to which practically nothing enters the intestines). Such defects are most often detected in the first days after birth and are operated on almost immediately, but sometimes the detection of pyloric stenosis occurs in more advanced stages. late dates(1-3 months). If regurgitation is of this nature, be sure to consult a pediatric surgeon (usually such specialists work in hospitals).

For non-physiological (atypical) regurgitation, doctors may suggest choosing a mixture that has an anti-reflux effect (reflux is a movement in the opposite direction, that is, regurgitation is, in fact, reflux). Usually the description of such a mixture contains the word “antireflux”.

For physiological regurgitation, there is no need for such mixtures. Do not administer the medicinal mixture without a doctor's recommendation. And, of course, it should not be completely replaced with this mixture.

Discussion

The question is probably the consequences of regurgitation. If you are gaining weight normally, then there is no need to worry.
We also burped a lot and often until we changed bottles. our pediatrician said that regurgitation could be caused by swallowing air and advised me to try bottles with an air vent tube. when I started feeding from these (Dr. Browns), I almost stopped spitting up

If you regurgitate almost everything you eat and as a result do not gain weight.
If the baby is artificial, then, most likely, the mixture was poorly chosen. Replacing the mixture can solve the problem.

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MariLana

09.04.2011, 13:57

Girls, tell me, is this normal or should I urgently go to the doctor??? The fact is that my daughter is almost 10 months old; she stopped spitting up completely 2 months ago. And on Monday evening she fell and didn’t hit her hard, but a hematoma immediately formed on her forehead. We were taken to the hospital, where they did an ultrasound and an X-ray of the head, then we saw a neurologist two more times, had another ultrasound, and all the results showed everything was fine, not even a slight concussion. BUT since then, my daughter began to burp every day (((And not immediately after eating, but about an hour later. As I understand it, at this age a child should NOT burp. The neurologist shrugged her shoulders to my question and said: “Watch.”

09.04.2011, 14:19

They said “I understand”)))))

Marjari

09.04.2011, 15:13

09.04.2011, 16:01

Yes, when the new complementary foods were introduced, we regurgitated in the evening what we ate in the first half...
It's true) It really was like that)))) but it hasn't been like that for a long time)
But our cheeks usually turn red... allergies...

MariLana

09.04.2011, 16:46

We also had falls... Ultrasounds, etc. at 2 months - spit up....
about 3 weeks ago I fell off the sofa... nothing like it, but sometimes I also spit up, rarely though)
We visited a neurologist (we are 8) - she asked about regurgitation... she said that sometimes...
They said “I understand”)))))
If not often, it will pass....
And if it bothers you, then be sure to see a doctor... or better yet, several, as our experience with a neurologist has shown)))
Some say one thing, others another.
By the way, we started taking glycine...

And we were prescribed neuromultivitis, so I think maybe it’s because of it that he’s spitting up: 016: although it’s unlikely, it’s more likely because of the blow:(

MariLana

09.04.2011, 16:49

Have you introduced any new complementary foods? in an hour - most likely the stomach does not accept it.
No, I didn’t give anything new.
This is not regurgitation, this is vomiting, if an hour after eating. What's the smell?

09.04.2011, 22:29

No, I didn’t give anything new.

Vomiting??:001: Yes, there is no special smell, as before when regurgitating... it smells a little like soap. The main thing is that my daughter behaves as usual - cheerful, cheerful... she burped and didn’t even pay attention to it: 005: And if this is vomiting, then what does this mean???

In general, vomit smells like vomit, I don’t know how to explain it. I'm afraid to lie, but I read that regurgitation occurs immediately after eating, and an hour later it's vomiting, because... the food in the stomach had already been digested for an hour, but this is another matter and for other reasons. This happened to us only a couple of times and the doctor said that it might be due to the immaturity of the valves, well, those that hold food. Remember, the child spit up/vomited out of the blue? Or maybe he jumped up, jumped before, did you pick him up? Well, in general, was there any movement before this?