The child is spitting up for 4 days. Spitting up in babies: how to distinguish what is normal and what is not. Recommendations from a pediatric gastroenterologist. Folk way for children on GV

Any responsible mother, of course, is concerned about the fact that a child has a lot. A healthy body of a newborn is designed in such a way that any physiological processes in it pass easily and do not depend on our desire. The procedure for spitting up milk or formula prevents the discomfort of overeating. If the child burped a lot after eating, it means that he simply freed the stomach from excess.

Many parents are concerned about the fact that the child (3 months old) spits up a lot. According to experts, regurgitation can continue after reaching the age of three months, the entire period until most of the baby's food is liquid.

Some mothers also wonder if their baby does not often spit up. This circumstance should worry parents only if, in addition, there are a number of other signs that indicate problems with the health of the baby.

These include, for example, poor weight gain. If there is such a problem and frequent profuse regurgitation, you should consult a doctor. If the child burped a lot, the main thing is not to confuse this process with vomiting. Having come to the conclusion that the baby is vomiting, it will be right to immediately seek help from a medical facility.

Another sign that indicates a health problem is dehydration. It can be determined by the state of the fontanel. In the case when it resembles a depression (fossa), it is quite possible that the newborn has a lack of water balance.

What else should you pay attention to? If your baby cries while spitting up or during feeding, then this is also a cause for concern. And do not forget that it is necessary to monitor the mood of the baby. His lethargy or, conversely, excessive anxiety will tell you that there is a problem. If the child has burped a lot, and his behavior differs from usual, it would be advisable to seek help from specialists.

Now let's talk about existing rules. But remember that each baby is individual, and it is wrong to draw conclusions based on standard situations. So, any pediatrician will tell you that the normal value is 5 regurgitations per day, and the amount of excess milk or formula at a time can reach a maximum of 3 tablespoons.

If you spit up a lot, for example, every time after feeding, then try changing the tactics of breastfeeding, and when artificially feeding, use a special nipple that is suitable for the baby in age and has a special air valve. When the baby stops swallowing a large amount of air during feeding, then it will spit up less often.

Now check out a few tips to help your child avoid frequent spitting up. The first thing to do is to hold him upright at the end of feeding. At the same time, you need to position the baby facing you and lightly tap on the back. Excess air will definitely come out, and you will hear the sound characteristic of this process. Do not think that this will happen instantly, sometimes this procedure takes about 20 minutes.

The position of the baby after eating can also affect regurgitation. If you put him on his stomach, then he will most likely spit up a large amount of milk.

And yet, after the feeding is finished, provide the child with peace. No need to throw it up, change diapers or clothes, and actively play or massage. All of these actions can contribute to profuse regurgitation.

Regurgitation is the reflux of stomach contents into the mouth. This syndrome is typical for children under one year old. Their stomach is still very small, unable to accommodate large portions of food, and the sphincter is a muscular ring that prevents the contents of the stomach from rising into the esophagus and above, while weak. But all this phenomenon is temporary and should not worry parents if regurgitation in newborns after feeding does not negatively affect the rate of development of the child. If the baby adds 600 grams or more every month, you don’t have to worry, this is a variant of the norm. Such physiological regurgitation is usually observed from the first or second month of life, and their frequency and strength gradually decrease by 6-8 months. Gradually fading away.

Late regurgitation in infants, when they first occur or become many times more active at 5-6 months and later, may be associated with malnutrition. So, many mothers, by the way, on the advice of pediatricians, introduce complementary foods at 4 months. It's very early, according to the World Health Organization. Up to 6 months, the baby is enough formula or breast milk. And food is overkill. Moreover, a rare mother does not try to offer her baby a little more than the norm recommended for this age. Overeating is also a variant of the reason why a child spits up about an hour after feeding.

It is worse if the baby spit up due to neurological pathology. However, it is quite difficult not to notice it. But if there is any deviation, most likely, you will have to give the child special drugs like Motilium.

With artificial feeding, even if the baby does not have any neurological problems, a problem often arises when the baby spit up 2 hours after feeding the curd mass. Such a late "reaction" may be the norm. The fact is that artificial mixtures are digested in the stomach much longer than breast milk. And the curd mass that came out is just the result of this “processing”. Spitting up after formula feeding can also be a reaction to inappropriate baby food. Perhaps it makes sense to change the mixture. Or feed the child a little less often, so that the food has time to be digested, the stomach is not overloaded.

Abundant regurgitation (fountain) an hour after feeding sometimes turns out to be vomiting. But attentive parents will be able to distinguish the first from the second. During vomiting, it is clear that the child is ill, he chokes, cries, the press is tense. Regurgitation occurs without any disturbance of well-being. Vomiting can be life-threatening for a child if mass is thrown from the stomach into the airways. And vomiting usually occurs for a reason, it is a symptom of poisoning or an intestinal infection, a foreign object entering the respiratory tract or digestive tract. Reason to see a doctor.

What to do if the baby often spits up an hour after eating

1. Raise the head end of the bed 30 degrees. It is advisable to do this already for a newborn baby. You can substitute bricks under the legs of the crib, or purchase special children's mattresses, cocoons, in which the baby will sleep in the correct, physiological position.

2. Longer to keep a column. 5 minutes to vilify a child vertically is not enough. Need 20-30 minutes. If the baby is heavy, and the parents' back is not healthy, it is better to put him in a crib or cocoon, where the child will be at least partially upright. Recall that in a vertical position, the baby quickly leaves the air from the stomach, and at the same time he does not “pull” breast milk or formula behind him. That is, the child spits up just air.

3. Do not let active play. If possible, the baby should be at rest. Do not put it on the tummy after feeding, change the diaper, if there is no special need, wear it on your hands, while pressing on the stomach.

4. Feed more slowly. With the rapid absorption of food, there is not only the risk of overfeeding, but also a large amount of air entering the stomach, due to which regurgitation occurs.
If you are bottle feeding your baby, spread out the feedings over 10-15 minutes. Do not let your child suck out the entire contents of the bottle in 2 minutes. A nipple with a very small hole will help with this. It is also useful to interrupt feeding 2-3 times and raise the baby with a column.

5. Give food in smaller portions. This applies to a greater extent complementary foods. Let the child eat not 2 times a day for 200 grams, but 4 times for 100. Most likely, his stomach will respond well to such changes.

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Regurgitation is the involuntary reflux of stomach contents into the mouth. This is a condition that very often occurs in infants and worries their mothers. Most often, this phenomenon proceeds “benignly” and resolves on its own at the age of one and a half to two years.

Spitting up should not be confused with vomiting. When a child burps, the release of food occurs without effort and tension of the abdominal muscles. Vomiting is characterized by tension in the abdominal muscles and the release of food under pressure not only through the mouth, but also through the nose. In infants, vomiting often begins unexpectedly and is not preceded by nausea. Sometimes at first there is a general anxiety, there is a blanching of the face, a coldness of the extremities. As a rule, vomiting is accompanied by fever and loose stools. In the vomit, there may be the presence of unchanged milk, an admixture of blood, bile or mucus.

Why does a baby spit up

Why do newborns and children under one year old tend to spit up? This is due to the structural features of the gastrointestinal tract in children. Their esophagus is short and straight, and the stomach is located vertically. The circular muscle is poorly developed - the sphincter between the stomach and esophagus, which, by contracting, prevents the flow of food in the opposite direction. Gradually, as the child grows, the maturation and final formation of the digestive system occurs, and then regurgitation stops. Therefore, it becomes clear that it is not possible to avoid such a condition in newborns and infants. However, you can make sure that the baby burps as little as possible. To do this, you should know the reasons that provoke regurgitation.

Regurgitation is physiological, occurring in healthy children in the norm, and pathological.

Causes of physiological regurgitation:

- Overfeeding. The situation of overfeeding usually occurs in actively suckling infants with abundant excretion of breast milk from the mother. It can also be when switching from breastfeeding to mixed or artificial, when the amount of milk formula is incorrectly calculated. Regurgitation in this case occurs immediately or after some time after feeding in a volume of 5-10 ml. Milk flows out unchanged or partially curdled.

- Swallowing air while feeding(aerophagia). This situation can arise when a child suckles greedily at the breast with a small amount of milk from the mother. The inverted, flat nipple of the mother's breast also promotes aerophagy, as the baby cannot fully grasp the entire nipple, including the areola. Artificial babies often have feeding defects when the hole in the nipple of the bottle is large or the nipple is not completely filled with milk and the baby swallows air. Children with aerophagia are usually restless after feeding, there is a bulging of the abdominal wall (the tummy is distended). Then, after 10-15 minutes, the eaten milk is poured out unchanged, accompanied by a loud sound of belching air. Basically, children with low or large birth weight are prone to aerophagia.

- Constipation or intestinal colic. Under these conditions, the pressure in the abdominal cavity increases and the movement of food through the gastrointestinal tract is disturbed, which provokes regurgitation.

Up to four months of age, the norm is regurgitation of up to 2 teaspoons of milk after each feeding or a single regurgitation per day of more than 3 tablespoons. To find out how much the child spit up, you need to take a diaper, pour 1 teaspoon of water on it, and compare this spot with the spot formed after spitting up.

What to do if the child is spitting up

Children with physiological regurgitation do not need any correction and treatment. You just need to try to eliminate the cause, if it depends on you and carry out prevention.

Prevention of frequent regurgitation in infants:

1. After each feeding, hold the baby upright (column) for 15-20 minutes. Then the air that has entered the stomach will come out. If nothing happens, put the child down and after a minute or two lift it vertically again.
2. Check if the bottle opening is too big and if the nipple is full of milk during feeding. Try other nipples - maybe another will work better.
3. During feeding, keep the baby in a semi-vertical position, check whether he completely captures the nipple with the areola.
4. Before each feed, lay your baby face down on a hard surface.
5. After eating, try to limit the child's physical activity, do not disturb him unnecessarily, and change clothes only when absolutely necessary.
6. Make sure that clothes or diapers do not squeeze the baby's abdomen.
7. With a good appetite, try to feed him more often, but in small portions, otherwise a large amount of food will cause the stomach to overflow and, as a result, regurgitation of excess food.
8. The surface in the crib, on which the child usually lies, should be with a headboard raised by 10 cm.

If spitting up becomes more frequent or more abundant, or first appears after six months of life, or does not decrease by the age of one and a half to two years, the child should be consulted by a pediatrician, and most likely, a consultation with a gastroenterologist will be required.

There is a scale for assessing the intensity of regurgitation:

5 regurgitations per day or less, up to 3 ml - 1 point,
More than 5 regurgitations per day, in an amount of more than 3 ml - 2 points,
More than 5 regurgitations per day, up to half the amount of milk eaten, but not more than half of the feedings - 3 points,
Regular spitting up in small volume for 30 minutes or more after each feeding - 4 points,
Regurgitation from half to the full volume of milk taken in half of the feedings - 5 points,

Regurgitation with an intensity of 3 points or more requires a mandatory visit to a doctor.

Pathological regurgitation occurs for the following reasons:

Surgical diseases and malformations of the digestive system;
- diaphragmatic hernia;
- pathology of the central nervous system;
- food intolerance;
- increased intracranial pressure.

Such spitting up is characterized by intensity, regularity, a large amount of milk that the child spits up. At the same time, the general condition of the child is disturbed - he becomes very tearful, loses or does not gain weight, does not eat the amount of food prescribed by age. In this case, an examination by a pediatrician, surgeon, neurologist, gastroenterologist, allergist is required using laboratory and instrumental examinations.

Milk thickeners for regurgitation

If the examinations did not reveal any diseases, the child’s mother takes preventive measures against regurgitation, and the child’s regurgitation still persists, the doctor may recommend using special thickeners that make breast milk thicker, which will contribute to prolonged food retention in the stomach and, thereby, prevent I will return it to the oral cavity. Rice or corn starch, carob flour, carob bean gluten are used as thickeners. Usually take 1 teaspoon of starch per 30 ml of breast milk. You can use "Bio - Rice Water" company Hipp.

With artificial feeding, therapeutic antireflux mixtures can be used.

Depending on the type of thickener, these mixtures are divided into two groups:

The greatest effect is observed when using mixtures containing gum. They are given to the child both in full and as a replacement for part of the feeding. In this case, the amount of the mixture needed by the child is determined by the time the regurgitation stops. The duration of the use of these mixtures is on average 3-4 weeks.

Artificial mixtures containing starch as a thickener act "softer". They can be given to children with mild forms of regurgitation (1-3 points). They are recommended to be prescribed to completely replace the previously obtained mixture. The duration of their use is somewhat longer than with the use of gum-containing artificial mixtures.

When using an anti-reflux mixture, it should be remembered that this group of mixtures is already a treatment for a child and is recommended only by a doctor, as well as medications prescribed for the ineffectiveness of diet therapy.

Pediatrician Sytnik S.V.

A young mother faces a lot of worries and worries, one of which is why the baby is spitting up. It is almost impossible to find answers to all questions in one day, but you should not leave the problem without attention. In order for the baby to be healthy, you need to properly care for him from the first minutes of life.

Probably, any mother faced difficulties when feeding a baby, basically they are typical for everyone. Especially frustrating profuse regurgitation of the baby. But you should not despair, as the child feels the emotional mood of the mother. It is imperative to look for reasons why a baby is spitting up, since perhaps the baby needs medical help.

Where to start searching

There are a lot of factors that cause regurgitation. Mothers should be aware that minor and infrequent phenomena are a variant of the norm, they are physiological and occur in most infants. But regurgitation with a fountain should alert. Sometimes they can be triggered by the same reasons that cause minor burps. These include incompetence of the gastrointestinal tract, muscle weakness, improper capture of the breast or nipples on the bottle, as well as the underdevelopment of the enzymatic system.

If the vomit has a greenish tint, this may indirectly indicate intestinal obstruction, so a visit to the pediatrician should not be postponed.

Is it possible to put the baby on his back after eating

This question is asked by many mothers, especially those who think about why the baby is spitting up milk. To avoid trouble, it is better not to leave the baby alone in this position after eating. It is better to lay it on its side so that the vomit does not enter the respiratory tract.

Variant of the norm or pathology

Many experts believe that up to three months it is not necessary to worry about why the baby is spitting up. But mothers worry about the amount of vomit. To dispel doubts, you can conduct a test: pour two tablespoons of water on the baby's blouse and evaluate the size of the stain. Perhaps after that, the mother will calm down a little and the volume of regurgitation will no longer seem so large.

Don't look for a problem where there isn't one...

Before panicking about why the baby is spitting up formula, mothers need to remember that the fundamental factor is the well-being of the baby. If he is calm, cheerful, goes to the toilet well and is gaining weight, there is no need to worry about spitting up. By the age of one, these phenomena should significantly decrease or disappear altogether. Sometimes exacerbations are noticeable during teething.

Regurgitation is a natural process that is inevitable during the development of the gastrointestinal tract. Vomit is considered a variant of the norm if their number does not exceed two tablespoons.

All mothers faced such a problem as spitting up milk. This phenomenon occurs in all infants. But sometimes the baby spit up a lot almost at the end of each feeding. Spitting up is very worrying for parents. Why is this happening? How to determine if this symptom is some kind of alarming sign? What to do to solve the problem?

During the first months of life, regurgitation is a physiological process. It is due to the following factor: the sphincter between the stomach and esophagus, which prevents the reverse movement of food eaten, is finally formed only by the year. The slightest errors in the technique of feeding, handling the child before or after feeding often cause profuse regurgitation, even a "fountain".

The main reasons why children spit up:

• too much food - everything superfluous is displayed back. It happens because of too much milk, formula, or maybe too little time has passed since the last feeding and there was still some amount of content in the stomach;
• problems with the digestive system (constipation, colic, congenital anomalies) that interfere with the proper movement of food;
• improper feeding - it is necessary to monitor the position of the child and how he captures the nipple. Otherwise, there is a high probability of the baby swallowing air with milk, a mixture;
• prematurity;
• disturbances in the work of the nervous system (a common cause of nutritional problems in children of the first months);
• incorrectly selected mixture (in infants who are bottle-fed);
• improper handling of a child, especially a newborn, after feeding: active games, rocking, turning from one side to another.

In addition, the reasons are different depending on the age of the baby:

• in newborns, regurgitation is mainly due to weakness of the muscles of the esophagus and sphincter near the stomach;
• at 1 - 2 months - with improper nipple grip, air swallowing and overfeeding;
• at 4-5 months, when the baby is already turning over well, regurgitation is often associated with increased activity of the child during and after feeding;
• from 6 months of regurgitation, recurring often, sometimes indicate diseases of the digestive system.

In most cases, the problem of frequent and profuse regurgitation is easily solved simply by observing the rules of feeding and handling the infant before and after feeding. But in some situations, you need the help of a doctor.

Signs of pathology

There are some warning signs. These include:

• regurgitation is observed with a fountain, occurs often, despite strict adherence to the rules of feeding;
• the mass that appears outside as a result of regurgitation has become unusual in texture, color, smell;
• there are problems with stools and urination (usually there is a delay or a noticeable decrease in the amount - a sign of dehydration);
• the baby does not gain, and sometimes loses weight;
• the baby spits up and then cries and bends;
• abdomen swollen, not very soft to the touch;
• after regurgitation, the temperature began to rise;
• regurgitation began at the age of 6 months;
• regurgitation is observed at the age of more than 12 months.

When assessing how normal a baby's spitting up is, it is very important to consider his age. At the age of up to a month, the phenomenon occurs in most absolutely healthy children. But with age, as the digestive system develops, regurgitation should appear less and less. For many, the symptom disappears by the age of four months, and after 10 to 12 months, regurgitation indicates the need for medical intervention.

Help

At the end of feeding, do not put the baby on his back, especially with frequent spitting up. And in order to prevent the contents of the stomach from entering the respiratory system when regurgitation, the baby should be turned over on the stomach, you can pick it up, preferably giving the body a vertical position.

The modern pharmacological industry produces drugs that help fight the problems that arise due to belching and the causes of its occurrence. If medical treatment is necessary, the doctor will prescribe them. But you should not make an appointment yourself, as the reasons are different.

Summing up

Regurgitation - the exit through the mouth of the milk or mixture eaten - occurs in all infants. But improper feeding or health problems increase the intensity of the process. When a child spits up a lot, you should try to find out the cause and methods of dealing with the problem.

When the substance that comes out has become similar to vomit, has some other unusual color, the smell is already a pathology. A very large amount of regurgitation, deterioration in the general condition of the baby, regurgitation in children older than 12 months, its frequent appearance in those who have almost reached 12 months of age - a reason to consult a doctor.

1. You should not force the child to eat if he is not yet hungry and does not ask or refuses.
2. Before feeding, it is necessary to give the baby the opportunity to lie on his stomach for several minutes.
3. When feeding occurs, the newborn should be in a reclining state, but the head is slightly raised.
4. Make sure that the child does not swallow air. It is very important to help to properly latch on the nipple, and when feeding with formula, to choose the appropriate size of the hole in the nipple.
5. At the end of feeding, any vigorous activity is contraindicated. It is best to hold the baby in your arms in an upright position for a while.
6. If there are any changes in the color, smell, volume of the mass coming out during regurgitation, or if the baby is very anxious, be sure to tell the doctor.