Neonate regurgitation, sometimes called physiological or uncomplicated reflux, is common in babies and is usually (but not always) normal.

Most young babies spit up occasionally because their digestive systems are immature, allowing stomach contents to return to the esophagus.

Many newborns and infants spit up some of their mother's milk or formula during or shortly after feeding. Some babies spit up only occasionally, while others spit up after every feeding.

As long as the baby is growing, gaining weight well, and regurgitation is not accompanied by pain or discomfort, there is no reason to worry.

The baby often spits up after feeding when he receives a lot of milk in a short period of time. This happens when the baby suckles very quickly and forcefully or when the mother's breasts are too full.

When a baby is often distracted (pulling the breast to look around) or fussing at the breast, he swallows air and therefore will burp more often. Some babies spit up more when they start teething, crawling, or eating solid foods.

• The child vomits curdled milk immediately after eating. But it happens that the baby spits up an hour after feeding;
• half of all children under 3 months burp at least once a day;
• regurgitation usually peaks at 2 to 4 months;
• many children outgrow this condition by 7–8 months;
• Most babies stop spitting up by 12 months.

When a baby spits up milk, this is not a cause for concern. The fact that the baby regurgitates a curdled mass is explained by the action of an enzyme contained in the stomach juice. The enzyme is responsible for preparing food for the next stages of digestion.

Why does a child burp often?

Periods of development

During certain periods, for example, when teeth are cutting through, children learn to crawl or begin to eat solid food, the child spits up a lot after feeding.

Incorrect mixture

This is a possible reason why a baby spits up after formula feeding. It may happen that the selected formula is not suitable for your baby.

Why does a child spit up like a fountain?

If your baby spits up frequently and a lot, he may have the following conditions that require medical attention.

If your baby spits up like a fountain, he may have a condition called gastroesophageal reflux disease (GERD).

Symptoms:

• frequent regurgitation or vomiting;
• discomfort when regurgitating.

It happens that the child does not burp in the full sense of the word, but quiet reflux occurs. This is a phenomenon in which the contents of the stomach only reach the esophagus and are then swallowed again, causing pain.

Signs of severe reflux:

• the child cries a lot during feeding, it is impossible to calm him down;
• poor weight gain or loss;
• refusal to eat;
• difficulty swallowing, hoarseness, chronic nasal congestion, chronic ear infections;
• regurgitation that is yellow or mixed with blood.

Research has shown that breastfed babies have less severe episodes of reflux than formula-fed babies. The baby spits up the formula more often than mother's milk, since human milk is easier to digest and leaves the baby's stomach twice as quickly. The less time milk spends in the stomach, the less opportunity it has to get back into the esophagus. Any delay in emptying the stomach can make reflux worse.

Pyloric stenosis

A condition in which the muscles at the bottom of the stomach harden and prevent food from passing into the small intestine. Fountain regurgitation in newborns in combination with underweight are clear signs of pyloric stenosis.

And it affects more boys than girls. This usually occurs in infants at about 1 month. requires surgical correction.

Intestinal obstruction

If there is green bile in your baby's regurgitation, this is one sign of a blockage in the intestines, which will require an emergency room visit, a scan, and possibly emergency surgery.

Disorders of the central nervous system

Disturbances in the functioning of the central nervous system are also the answer to the question of why a newborn spits up like a fountain.

Rotaviruses are the leading cause of regurgitation in infants and young children, with symptoms often progressing to fever.

Rotavirus is one viral cause, but other types of viruses such as noroviruses and adenoviruses can also cause this condition.

Sometimes infections outside the gastrointestinal tract cause regurgitation. These are infections of the respiratory system, ear infections, and urinary system.

Some of these conditions require immediate medical treatment. So be vigilant no matter your child's age and call your pediatrician, if they appear:

• blood or bile in vomit and regurgitation;
• severe abdominal pain;
• persistent, repeated fountain regurgitation;
• swollen or visually enlarged abdomen;
• lethargy or severe irritability of the baby;
• signs or symptoms of dehydration - dry mouth, lack of tears, recessed fontanel and decreased number of urinations;
• prolonged vomiting for more than 24 hours in a row.

Sometimes spitting up like a fountain does not mean the presence of a pathology, but if the child spits up like a fountain once or twice every day after feedings, you should contact a specialist.

What to do if a child spits up?

1. If your baby spits up frequently, change your feeding position to a more upright position. Gravity will play a role in retaining milk in the stomach if the baby is held upright for about half an hour after feeding.
2. Avoid any vigorous activity immediately after eating. This may cause the baby to burp.
3. Provide a calm and relaxed atmosphere during feeding. Don't leave your baby very hungry before you start feeding him. A hungry and anxious baby may swallow a lot of air, increasing the chances of breast milk reflux.
4. Feed your baby in small portions, but more often, to avoid an overfilled tummy.
5. Avoid overfeeding your baby.
6. Have your baby burp as often as possible to get rid of any air that might be absorbed from the food. If you don't see a burp after a few minutes, don't worry. Your baby may not need this.
7. The child should be placed to sleep on his side or back, and not on his stomach. If your baby spits up during sleep, keep his head elevated.
8. Don't put pressure on your stomach. Loosen any tight clothing, and do not place your baby's stomach on your shoulder so he can burp.
9. Eliminate certain foods from your diet to see if the problem of frequent spitting up resolves.

When does a baby stop burping?

Parents are often interested in the question, until how many months does a baby spit up? When all the elements of the digestive system develop and become stronger, the baby will be able to hold food in the stomach, and regurgitation will stop.

Most babies stop spitting up around 6 or 7 months or when they learn to sit up on their own. But for some of them, regurgitation will continue for up to a year.

If the baby spits up a lot, but generally feels well, no special treatment is required other than the feeding methods mentioned.

Frequent regurgitation in newborns is a process that almost any mother can cope with. But in some cases treatment is necessary.

If the child constantly burps or the amount, smell or color of the regurgitation has changed, contact a specialist. First of all, visit your pediatrician. Then he can refer you to a gastroenterologist, neurologist, or surgeon.

Do not delay a visit to the doctor if the child spits up heavily and then screams or squirms. This behavior may mean that the baby's esophageal walls are irritated.

Increased attention is required if the regurgitation looks like a fountain, occurs after each feeding, or looks like vomiting and after it the body temperature rises.

Don’t take unnecessary risks, show your child to a specialist.

Regurgitation after a year is an alarming signal. At this time, this unpleasant process should already stop. Otherwise, this indicates a pathology in the child’s body, the nature of which can only be determined by doctors.

Sometimes regurgitation is so frequent that the child does not gain as much body weight as necessary. This is much more important and may require special tests and more aggressive treatment. If testing confirms gastroesophageal reflux, treatment may include gentle feeding techniques and possibly medications.

Some medications, such as ranitidine, help neutralize stomach acids and protect the sensitive lining of the esophagus, which is exposed to stomach acid due to regurgitation. Others, such as Omeprazole or Lansoprazole, stimulate the stomach to move food into the intestines more quickly.

Baby spitting up is one of the most important and sometimes confusing issues you will face as a parent. The recommendations in this article are general in nature and apply to infants in general. Remember that your child is unique and may have special needs. If you have questions, ask your pediatrician to help you find answers that apply specifically to your baby.

The first months in a baby’s life are a difficult period of getting used to the diversity of the environment. At this time, the final adjustment of its internal organs occurs. 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 intrauterine growth retardation and in 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, pale skin, sweating, salivation and dizziness. If infants vomit, seek immediate medical attention.

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 causes of frequent regurgitation:

• Common overeating

The body of an infant, even when full, under certain conditions can continue to eat food. At the same time, he calms down, enjoying the sucking and closeness of his 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: the baby’s uncomfortable position while eating, excess milk (for example, a hole in the bottle’s nipple is too large), the baby does not latch onto the breast correctly, the baby is too excited;

• Flatulence

Increased gas production 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, or 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. It 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 him 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 body temperature, 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;
• Vomit has the appearance of sour milk, an unpleasant odor, and a 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 of the 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 bottle-fed, then a special formula (anti-reflux mixture) must be selected for him. Formula should not be given to breastfed children.

Regurgitation is a natural physiological process for a newborn. It is common for a baby to spit up some food after feeding, whether breastfed or bottle-fed. Regurgitation of excess food is an innate reflex that helps the baby regulate the amount of food.

If a child regurgitates a little food within 30-40 minutes after feeding, while his health, mood and appetite are good, then this is considered normal. After feeding, hold the baby vertically, “in a column” for about 10 – 15 minutes, the air will come out and the baby will feel better. After burping, a little curdled milk may come out. After a change of position, for example, when turning from the back to the tummy or when actively tucking and straightening the legs, the baby may still regurgitate some amount of food. To find out whether the baby’s regurgitation process is normal, let’s look at in what cases you should worry and consult a doctor.

Burping up like a fountain

If the baby spits up after eating like a fountain - a strong stream, far from itself, then you need to contact a neurologist. Such regurgitation can occur with neurological disorders. Also, fountain regurgitation can occur due to spasms in the digestive tract, in which case you need to consult a gastroenterologist.

If the baby burps like a fountain once, then you don’t have to worry and monitor the condition during the day; this may be a variant of the norm.

The baby spits up frequently

If a child burps too often and profusely, approximately every 5 to 10 minutes, or later than an hour after feeding, you should see a gastroenterologist. This is definitely not the norm.

The child cries and arches

If, when regurgitating, the baby is restless, cries and arches, then he probably has spastic colic, it is recommended to consult a gastroenterologist.

Increased temperature and fever

Frequent regurgitation with an increase in temperature may actually be vomiting. In this case, you must immediately consult a doctor or call an ambulance.

Color change

If you spit up milk or formula mixed with yellow, brown or green, you need to call an ambulance. The same applies to mucus impurities.

The child is not gaining weight

If you experience frequent regurgitation and little or no weight gain, you should definitely consult a doctor. Read about how much a child should weigh by month.

Why does a baby spit up:

1. Overfeeding - the baby eats more food than he can currently absorb. Read about how much a child under one year old should eat.
2. The baby swallows air during feeding. This can happen with an incorrect latch on the breast (read about the correct latch) while breastfeeding and with an incorrectly selected bottle when using an artificial bottle.
3. The formula is incorrectly selected for artificial or mixed feeding.
4. Colic and gassy in a baby (usually up to 3 months).
5. Baby activity: rolling over, crawling, tucking up legs, etc.
6. Poor development, immaturity of the gastrointestinal tract and sucking reflex in the baby (often occurs in premature babies).
7. Disturbances in the development of the baby’s body organs.
8. Infections and diseases (regurgitation is more like vomiting).

What to do if your baby spits up?

First of all, you need to learn how to put your baby to your chest so that the grip is deep and he does not swallow air. On IV, you need to select a special bottle to reduce the swallowing of air. The nipple should resemble a woman's nipple and the hole should be small.

After feeding the baby, you need to hold it in a column for about 10 minutes. The main thing is to wait for the air to burp.

There is no need to get rid of regurgitation, because this is a useful and necessary reflex for the baby. If regurgitation is frequent and profuse, consult a doctor. If you are formula-fed, the formula may not be suitable, then you will have to choose another one. Remember, each child is unique, formula may suit one, but the same may not suit another. It may be necessary to give the baby special bacteria for some time before eating, because often only a lack of beneficial bacteria leads to the inability of food to be digested. Frequent and profuse regurgitation while breastfeeding may indicate that you just need to change the feeding regimen and give only one breast at a time, so that the baby receives “hind” fatty milk, and not just “front” liquid milk.

If you vomit, regurgitate with discoloration, or have a high temperature, be sure to call an ambulance.

1. Place your baby to sleep on his side so he can't choke when he spits up milk.
2. Hold the baby in a column after each meal.
3. Try not to let your baby be active or move around a lot after feeding.
4. Keep wet wipes handy to quickly clean up after your baby.
5. Maintain hygiene of breasts, bottles, and pacifiers.
6. Do not overfeed the baby, do not give water/compote to drink immediately after feeding (for IV).
7. Don't overheat your baby.

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 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 horizontal vessel;
• 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!

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 afraid of the delay in breathing that occurs when 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 can follow if their infant spits up. 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 is played by the dynamics of weight gain. Even if your newborn spits up after each 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 is carried out. In rare cases, surgical correction is required.

But most often, as confirmed by reviews, forums, medical and parental practice, there are no serious reasons for 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 infants 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 the other 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, this tactic 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. Check with your pediatrician; it may be worth trying an anti-regurgitation (anti-regurgitation) mixture, which is marked with the letters 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 may 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. Passive smoking is also a factor in the increased risk of 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 to be 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 - fever, 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

Regurgitation in newborns

Regurgitation in newborns and infants is a normal and even necessary physiological phenomenon. Meanwhile, the reasons why a child spits up vary. Some of them are worth seeking help from your pediatrician.

In most cases, newborns and infants burp in a completely safe manner.
natural reasons. Completely “cure” babies from spitting up
You can not. However, it is within your power, if desired, to slightly reduce the intensity.
and the frequency of spitting.

Regurgitation in newborns and infants: main causes

To understand why a child spits up and to distinguish a physiological norm from a potentially dangerous situation, it is necessary to delve into some details of the process itself. In itself, regurgitation in infants is the involuntary throwing of stomach contents into the esophagus and higher, into the baby’s mouth. And accordingly - spitting food out. Whether a child burps “slowly” or literally gushes depends on the force with which the walls of the stomach push out food.

About 80% of all children in the first six months of life feel sick every day. But how much, how often and exactly when each of them burps depends on many factors individually: on the degree of term, on birth weight, on the dynamics of weight gain, and also on how strong the mother’s desire is to “always feed, feed everywhere." From the moment of birth, mom, dad and other relatives must understand that the principle “whatever fits, as much is useful” is more likely to harm the health and comfort of the child than to contribute to his growth and well-being.

There may be several reasons why a child spits up milk or formula:

• The baby eats more than he can digest and “hold” in his stomach. Many pediatricians believe that it is overfeeding and the “on demand” style of breastfeeding that is the main reason for frequent regurgitation, as well as the reason that the child spits up like a fountain.
• Cardiac part of the baby's stomach(that is, that part of the stomach that is located directly behind the esophagus) in the first six months of the baby’s life not perfect yet. Namely, in children after six months and in adults, the border between the esophagus and the cardiac part of the stomach is a special cardiac sphincter, which, by contracting, does not allow food to be thrown back into the esophagus. So, in the first months of the baby’s life, this sphincter is not yet developed.
• Dissonance between swallows and intestinal peristalsis. While eating, a newborn usually sucks milk or formula in series of 3-5 times. And between these series the baby takes pauses, during which he swallows what he managed to suck. Breast milk and formula are simple, liquid foods that reach the baby's intestines very quickly. As soon as “food” enters the intestines, peristaltic waves occur, during which the bottom of the stomach becomes very tense and the pressure in it increases slightly. This pressure creates a push to ensure that the food in the stomach “hurries” to exit.
• Excessive gas and colic in newborns are also the cause of regurgitation. Air bubbles press on the walls of the stomach and intestines, thereby causing pressure, which provokes spitting out food.
• “All troubles come from nerves.” With high activity of the nervous system in newborns and infants, a phenomenon such as stretching of the stomach walls is often observed, in which regurgitation is the most common symptom. However, this reason is too rare and “medical” for parents to go into it and try to “see” it themselves.

It is not so important why the child spits up, but how he gains weight at the same time

Mom, dad and other household members of a newborn baby should be concerned, first of all, not with why and how the baby spits up (this problem is always secondary!), but, first of all, with the dynamics of the baby’s weight.

If the baby is steadily gaining weight, then no matter how much and how often he regurgitates leftover food, this is considered a safe and physiological norm - his gastrointestinal system is developing, and regurgitation in this case is not considered a negative symptom. If the baby does not gain the required weight and, moreover, loses it, only in this case is it worth sounding the alarm and rushing to the doctor for advice, telling him in detail how often, how much and when exactly the child burps.

If the child’s weight is normal, and also if he is cheerful, smiling, sleeps well, and so on, then the phenomenon of regurgitation itself is not a problem with the baby’s health, it is a problem with the mother, who, seeing that the child is spitting out food, is completely beyond any concern. then there is no reason to worry too much.

Let us repeat - worrying and panicking because the baby is spitting up, as well as trying to find out exactly why the baby is spitting up, does not make any sense if the baby is gaining weight well. And only if the “newborn” kilograms suddenly begin to melt away, then the phenomenon of regurgitation becomes significant. First of all, for the doctor, to whom you are obliged to show the “losing weight” baby.

Why does a child spit up and lose weight?

When a baby regurgitates food during the day (a lot, a little, often or rarely - this is not so important) and at the same time not only does not gain weight, but also loses it - regurgitation is no longer considered as a physiological norm, but as an alarming symptom. Symptom of what?

The doctor to whom you bring your baby will answer this question. The most common and common causes of the phenomenon of “regular regurgitation of food plus weight loss” are as follows:

• Abnormal development of the digestive organs. The gastrointestinal tract system is quite complex in its organization, and not every baby at birth has the organs involved in the process of digesting food of the proper size, shape and located clearly in their places. Often something is too small, often something is twisted or jammed - there can be a lot of options for anomalies. The doctor will determine the one and only “marriage” in the gastrointestinal tract system that is preventing your baby from eating well and gaining weight.
• Lactose intolerance. In a nutshell, it is the following: breast milk of any mammal (including humans) contains a protein - lactose, which is broken down in the stomach by special enzymes - lactase. When this enzyme is not produced in sufficient quantities, or not at all, milk intolerance occurs. And, naturally, if it is impossible to digest it, the baby will burp it often and in large quantities. And as a result, lose weight. In this case, the doctor will help you choose a special lactose-free mixture.
• Infection. With any infectious disease, the gastrointestinal tract system is the first to respond to infection. In this case, the color of the baby's regurgitated food will have a yellow, or more often greenish, tint. Due to the fact that milky belching mixes with bile. If you notice that your baby is spitting up “green milk,” rush to the doctor.

Is it possible to “stop” or reduce spitting up in babies?

Even if we take into account that regurgitation in newborns and infants who are normally gaining weight in their weight category is a physiological norm (that is, it is not dangerous and will go away on its own), not every mother will like the fact that all her dresses began to smell like baby burp.

Question “How to stop or at least reduce regurgitation in a baby?” sounds very often in pediatricians' offices. And the first answer to this from doctors is to simply wait.

Babies stop regurgitating leftover food around the moment they begin to sit confidently - that is, about 6-7 months old.

What can those parents do who can’t bear to wait? Let's make a reservation right away - today there are no safe medications, means or devices that reduce the frequency and volume of regurgitation in children. The maximum that you can ask the pharmacists at the pharmacy for is remedies for excessive gas formation. Namely: products based on simethicone, or preparations based on fennel fruits. The amount of gases inside the baby will decrease - the pressure on the walls of the stomach will also decrease, and accordingly the volume of regurgitated food should also decrease.

In addition to the use of “gas masks,” all other measures to reduce regurgitation should be of an exclusively organizational and everyday nature. Namely:

• 1 After feeding, carry the newborn and baby in a column for as long as possible - let him, sorry, burp to his heart's content: the more he can release swallowed air, the less “returnable” milk or formula will pour out on you later.
• 2 Reduce the amount of food you eat for a while. If the baby is breastfed: feed for less time, but without reducing the number of feedings per day. If the baby is artificial, then simply reduce the number of grams of ready-made formula that you give per feeding. The doctor will tell you exactly how much to reduce, because this figure strictly depends on how much the child weighs and the dynamics of his gain.
• 3 When putting a newborn baby to bed, doctors advise swaddling it (just do not wrap the legs in a diaper - as a preventive measure for hip dysplasia in newborns and children under one year old). When the baby is swaddled, his nervous activity calms down and decreases. And along with it, the pressure on the walls of the stomach decreases. Which in turn reduces the likelihood that the baby will burp in his sleep.
• 4 Lead an active lifestyle - walk with your baby every day and bathe him, carry him in a sling and in a special backpack, if there is even the slightest opportunity - visit the pool, massage and gymnastics courses with him. All this will speed up the process of strengthening the baby’s muscles, including those muscles that are involved in the work of the gastrointestinal tract.
• 5 Before going to bed, give your baby a pacifier or, at a minimum, allow him to suck his thumb - this is to some extent useful. The fact is that in this situation, food no longer enters the stomach, but the sucking movements continue to stimulate intestinal activity. As a result, more food will end up “under the digestion” of the baby than will be spat out.

The use of pillows and bolsters, as well as placing the baby on his tummy face down while sleeping, is not recommended at all. All of these practices increase the risk of sudden infant death syndrome in your sleep. How then to lay the baby on his back without him choking on his own burp? Place a flat pillow directly under the mattress so that the baby lies at an angle of about 30 degrees (naturally, the head is higher than the butt). At the same time, from time to time, make sure that the child’s head is slightly tilted - to the left or to the right. In this case, even if he burps (which is unlikely), he will not choke.

Let's sum it up

So, if regurgitation in a baby does not occur in parallel with weight loss, then it is considered a normal, safe phenomenon that will go away on its own as soon as the baby grows up. If a child regularly regurgitates the food he eats every day, and at the same time “melts” before our eyes, run to the doctor and find out the reason. There are no safe medications against regurgitation in newborns and infants. But you can reduce the frequency and volume of regurgitation to some extent if you lead an active lifestyle with your baby, often carry him in an upright position, put him to sleep correctly and make sure that excessive gas formation does not interfere with the baby's comfortable existence.

That's all! Nature will do the rest itself when the baby grows up and gets stronger.