Frequent regurgitation in a newborn baby after feeding

If the baby returns part of the portion after eating, then do not worry too much about this - the doctors believe that frequent regurgitation, as a rule, is a norm for newborns, and not a violation. But in any case, leave this issue unresolved should not be. It is necessary to choose the right baby food, as well as to think about a suitable diet - in this case, the problem can be quickly eliminated.

Since the digestive system of the baby is just beginning to function, it is natural that in it sometimes there are failures, manifested in the form of frequent regurgitation.

If this happens rarely, you should not experience it, but excessive regurgitation can provoke inhibition in the development of the baby, as well as poor weight gain. If such a problem arises, it is recommended to consult a doctor - he will appoint a suitable diet plan, as well as an antireflux mixture. Compliance with all medical recommendations will quickly resolve the violation.

[1], [2], [3], [4]

Epidemiology

Pediatric statistics show that about ¾ of all infants at the age of 3-6 months are observed regurgitation before and after feeding.

In children older than 9 months this phenomenon, as a rule, is almost not observed (only in isolated cases).

[5], [6], [7], [8], [9], [10]

Causes of the frequent regurgitations

Frequent regurgitation in infants can occur for several reasons. One of these is the immaturity of the sphincter located in the lower part of the esophagus. Because of this, there is a throwing of food from the stomach back into the digestive tract. After a while, the digestive system improves, so at the age of 4-5 months this disorder disappears. But in some cases this problem can be caused by other factors:

• premature babies - the body of such children is simply not yet prepared for such a meal;
• arising in the process of delivery of hypoxia - due to oxygen deficiency in a newborn can develop disorders of HC;
• the cause of such a violation may be the overfeeding of the child (more abundant portions or more frequent feeding). In particular, this is manifested in actively sucking babies with an abundant amount of mother's milk. In the case of mixed feeding, this is due to a change in diet or frequent changes in mixtures. In such situations, regurgitation occurs after portions of 5-10 ml. But in this case, the child's well-being, appetite and stool remain;
• aerophagia or ingestion of excessive air. Basically, this is observed in people who are too greedy for babies with a small amount of mother's milk. In this case, the baby can not grab the area next to the nipple or he takes it wrong (if the nipple is flat, retracted). This phenomenon can occur during feeding with a bottle - if the nipple has an excessively large opening, the bottle is positioned horizontally, or it is not completely filled with liquid. Also, regurgitation is due to the general weakness of the muscles, and together with this immaturity of internal organs. Usually, aerophagy is observed in toddlers with an excessively large or, conversely, a small weight at the time of birth;
• the disorder may be due to flatulence, but also intestinal spasms or constipation. This increases the pressure in the peritoneum, because of which the movement of fluid through the digestive tract is disturbed;
• The digestive tract has a pathological structure. Among pathologies: abnormal location of the diaphragm (part of the peritoneum organs moves to the sternum - this is called the diaphragmatic hernia), a gastric abnormality (the stomach at the site of the transition to the duodenum intestine narrows, which complicates the process of its emptying), as well as an abnormality in the structure of the esophagus (such as achalasia (the esophagus narrowing in the area of the transition to the stomach) and halazium (the weak lower part of the esophageal sphincter)). Such violations, as a rule, pass themselves, after a while, but in some cases still have to do the operation.

Symptoms of the frequent regurgitations

To find out whether there is any reason for concern, parents need to determine whether this process is a natural physiological regurgitation, or it is a question of vomiting, which, as a rule, is a sign of any disease.

Symptoms of regurgitation - the process proceeds without contraction, as well as the strains of the peritoneum muscles. The liquid in this case flows in small quantities, and the child does not apply any effort to its liberation. Mostly, regurgitation occurs after the procedure of feeding or as a result of a change in the position of the baby's body after eating.

Vomiting is easy to recognize - there is an abundant release of food, and in the process there are spasms and tension of the muscles of the peritoneum, the diaphragm, and with it the press. Thus the child becomes restless and cries. Before vomiting, the child noticeably pale skin, strong sweat and salivation. If a baby has vomiting, immediately call a doctor.

Frequent regurgitation after feeding

When regurgitation from the stomach of the baby, a small (as a rule) amount of previously consumed milk / mixture is allocated through the oral cavity. Basically, such processes are a variant of the physiological norm - they help remove air from the esophagus with the stomach, which was swallowed by the baby with food. In addition, regurgitation after feeding shows that the digestive tract functions normally.

But when evaluating the nature of such regurgitation, one must pay attention to what the general condition of the infant is. If he is cheerful, happy and does not react to regurgitation in any way - you should not worry. And if the baby is restless, constantly crying, he has problems with sleeping, there is a lot of regular regurgitation with a fountain - this is most likely the result of some disease. In such a situation, you should immediately contact the pediatrician, since the disease can be dangerous for the life of the baby.

[11], [12], [13], [14]

Frequent regurgitation of premature infants

Often, regurgitation is observed in premature babies, but also in children who have retarded intrauterine growth. The swallowing, respiratory and sucking functions in them also mature much more slowly, but as the body develops, this disorder disappears on its own.

Frequent regurgitation and cold hands of the child

Frequent regurgitation and cold hands of the baby can be observed with hypotrophy of the 2nd degree. In addition, he has a lag in growth (about 2-4 cm) and lack of weight (20-30%). There is also sluggishness, sadness and low mobility, but also refusal to eat. Motor and mental development of the child lags behind the norm, there is a bad dream. The skin is pale and dry, inelastic, collected in wrinkles and scaly. Together with this you can see the thinness of the baby in the limbs and abdomen, the outlines of the edges are noticeable. There is a sharp swing of the stool - alternating constipation with diarrhea.

Complications and consequences

Regurgitation can be dangerous because it can provoke the appearance of various complications in the child - such as weight loss, metabolic disorders, inflammatory process in the esophagus (esophagitis). Persistent vomiting can lead to severe dehydration of the child's body.

Gastric contents may irritate the baby's skin, which can subsequently cause dermatitis. Due to the flowing of regurgitated food into the area of skin folds (behind the ears, on the neck), there may be diaper rash.

The most dangerous consequence of this disorder is aspiration (penetration of vomit into the airway), at which asphyxia with sudden infant death syndrome or aspiration form of pneumonia (pulmonary inflammation due to aspiration) can develop.

[15], [16], [17]

Diagnostics of the frequent regurgitations

With the development of any type of reflux, you should consult a pediatrician or a gastroenterologist as soon as possible to diagnose a possible disease.

In the process of determining the cause of the disorder, the baby takes an analysis of feces for the presence of dysbiosis.

To diagnose the cause of the development of reflux, you may need such instrumental methods of examination:

• Ultrasound of the digestive system, as well as the brain;
• Fibrogastroduodenoscopy;
• coprogramme;
• procedures for MRI and CT of the brain.

[18], [19], [20], [21]

Treatment of the frequent regurgitations

There are a lot of ways to help get rid of regurgitation. All of them are quite simple - you only need to carefully follow the baby to determine the cause of this phenomenon. Usually pediatricians give mothers such recommendations:

• the best option before feeding - mom and toddler should stay in a calm state. Regurgitation sometimes arises because of psychosomatic factors - a baby who is in an excited or nervous state will swallow air more often when sucking. You can put the baby on the stomach before feeding and perform a small massage - to remove the gases. During feeding, the baby's head can not be thrown back, and his nose must breathe without interference, since with a cold it will swallow the air stronger than usual;
• if breastfeeding is carried out, it is necessary to ensure that the baby takes the breast correctly - for the nipple and a small part of the areola. His lower lip should be slightly turned in the process of sucking;
• If the child is fed with the help of mixtures through a bottle - you need to choose the right capacity. Most preferred are anti-bulb bottles, since they prevent the risk of swallowing excess air. It is also very important to keep the bottle correctly during the feeding process - in the correct position, the milk is poured under the nipple base;
• You can not "shake" the baby immediately after eating. It should also exclude a tight swaddling - to prevent increased intra-abdominal pressure. It is allowed to help the child to regurgitate - slightly slapped him on the back;
• if the infant is prone to frequent regurgitation, put it into the crib in a position on its side - thus preventing the penetration of food into the airway. But if it still happened, you should raise the baby and hold it down with your face;
• although the weighing does not provide exhaustive information, it allows us to understand whether there was a sufficient intake of food. This should be determined in order to avoid overfeeding. The way to prevent overeating is also to reduce the time for the procedure of feeding.

In cases when regurgitation arises from illness, etiotropic treatment of the pathology that caused the disorder is performed. For example, a neurologist treats a disease of the National Assembly, and from a congenital anomaly of a baby, one gets rid of by performing a surgical operation.

To eliminate the disorder, it is possible to use curative antireflux mixtures. Today, there are many tools that help get rid of regurgitation. Among them - Samper Lamolak, Humana and Frisov, as well as Nutrilon AR and Enfamil AR.

Another way to prevent regurgitation is the folk method - adding to breast milk or a mixture of rice powder (in a ratio of 60 ml 1 tablespoon of powder). This method allows you to make the fluid for feeding thicker. Allowed to use infants for 3 months.

Mixtures with frequent regurgitation

Frequent regurgitation can be effectively eliminated with the help of special antireflux mixtures that exert a thickening effect on gastric contents due to a change in the number of special supplements in their composition:

• casein-like mixtures have a high content of casein relative to whey proteins. This is due to the fact that, under the influence of gastric secretion, casein capsules much faster, transforming into a viscous mixture;
• fat - a high fat content in food inhibits the function of the lower sphincter, because of which regurgitation can become more frequent. That is why their content in special antireflux mixtures is slightly reduced;
• thickeners - such mixtures contain corn or rice starch, which has the property of quickly thickening inside the stomach, which prevents regurgitation. Starch can also be replaced with gum.

Prevention

To reduce the frequency of regurgitation, you should adhere to the correct technique when feeding your baby, and also observe the day regimen and avoid overeating. If this phenomenon causes anxiety, you should consult a pediatrician to find out the possible cause of regurgitation.

With frequent regurgitation at night, you should slightly raise the headboard of the baby's crib - the elevation will prevent food from escaping from the stomach.

Before the procedure of feeding, you must put the baby on the stomach for 5-10 minutes, or instead, a little to wear it in an upright position - in order to remove air from the stomach.

[22], [23], [24], [25]

Forecast

Frequent regurgitation has a favorable prognosis. Often, this disorder occurs due to non-pathological reasons, so the problem is solved by changing the feeding pattern or disappears with age on its own. In the presence of a pathological cause, timely adequate treatment is necessary - under this condition the prognosis is also good.

[26], [27], [28]