How is regurgitation different from vomiting?
Regurgitation occurs without effort: milk simply flows out of the mouth or nose, the baby does not tense up and is usually not upset. Vomiting is an active process involving the abdominal muscles, it is preceded by anxiety, pallor, sometimes drooling, and the contents are thrown out in a stream at a distance. The volume of regurgitation is usually small, although it seems large to parents: a spilled spoonful of milk spreads into a noticeable stain. The key difference is well-being and weight gain: with normal regurgitation, the child develops normally.
- Regurgitation - passive release without effort
- Vomiting - ejection in a stream with abdominal tension
- The volume of regurgitation is usually 1–2 spoons
- When burping, the baby is calm and active
- Normal weight gain is the main guideline
- Curdled milk - normal contents
Why do babies spit up?
The main reason is immaturity of the digestive tract, and it goes away on its own. But often regurgitation is aggravated by avoidable factors. The baby swallows air when the breast is latched incorrectly, the hole in the bottle nipple is too large, or when feeding in an awkward position. Overfeeding is another common reason: the stomach becomes full and the excess comes back out. Tight swaddling, pressure on the abdomen, active play and changing clothes immediately after eating also provoke regurgitation.
- Immaturity of the muscular valve of the esophagus
- Swallowing air during feeding
- Incorrect breast or nipple latching
- Overfeeding and too large portions
- Tight swaddling and pressure on the abdomen
- Active movements immediately after eating
- Less commonly, allergy to cow's milk protein
What helps reduce regurgitation
The first thing the pediatrician evaluates is feeding technique. When breastfeeding, it is important that the baby grasps not only the nipple, but also the areola, and when feeding from a bottle, the nipple must be completely filled with mixture. It is better to feed more often and in smaller portions, and after eating, hold the baby upright for 10–20 minutes, waiting for the air to escape. You shouldn’t immediately change clothes, stir him up and put him on his stomach. A child of the first year should sleep on his back on a flat mattress - this rule of safe sleep is more important than any padding.
- Check breast or nipple latching
- Feed more often and in smaller portions
- Hold upright for 10–20 minutes after eating
- Pause while feeding
- Do not stir or change clothes immediately after eating
- Do not swaddle tightly and do not put pressure on the stomach
- Place you to sleep on your back without pillows or bolsters
When is an examination needed?
If the child is gaining weight well and is cheerful, no tests are required. An examination is prescribed if there are alarming signs. Fountain vomiting in a boy of 3–6 weeks, increasing every day, makes one suspect pyloric stenosis, which is confirmed by ultrasound and requires surgery. An admixture of blood, green matter, bloating and lack of stool is a reason for an urgent examination by a surgeon. If a cow's milk protein allergy is suspected, the doctor may recommend a trial change in the mother's diet or formula.
- Examination by a pediatrician and assessment of weight dynamics
- Ultrasound of the abdominal cavity for suspected pyloric stenosis
- General blood test
- Coprogram and feces for occult blood according to indications
- X-ray with contrast in selected cases
- Test diet for suspected allergies
- Consultation with a pediatric surgeon for warning signs
Treatment and prognosis
In most cases, no treatment is required at all: just establish feeding and wait. Special thickened anti-reflux mixtures can only be recommended by a pediatrician, and they are not needed for a healthy breastfed baby. Medicines that reduce acidity are prescribed to infants strictly according to indications and not to “prevent regurgitation”: without indications they are useless and unsafe. Raising the head of the crib and putting the baby to sleep on his side or stomach is not recommended. By the age of one year, regurgitation usually stops on its own.
- Most often, feeding correction is sufficient.
- Antireflux mixtures - only as prescribed by a pediatrician
- Medicines are prescribed by a doctor and only according to indications
- Don't change your sleeping position to burp
- Regular weighing and monitoring
- Disappearance of symptoms by 6–12 months