According to statistics:

• In the first weeks of life, regurgitation occurs on average in 80% of infants.
• By 3 months, this happens less often.
• Approximately a year (for someone a little earlier, for some a little later) it completely stops.

The maximum age until which regurgitation should completely stop is 1.5 years. Otherwise, it should be considered a deviation.

Up to 4 months, the rate of regurgitation of a child is no more than 2 teaspoons after each meal. Also considered normal is a condition in which the baby burps once a day in the amount of 3 teaspoons. In some cases, even regurgitation with a fountain is acceptable, but not more than 1 time per day.

Important! Pay attention to the fact that at the time of spitting up the child does not show much anxiety. The rest of the time, he should eat well, be alert and active, and put on weight based on his age.

Differences from vomiting

Spitting up is a normal process that does not require treatment. As for vomiting, it is a sign of disease. In both cases, the contents of the stomach are ejected, so you need to be able to distinguish between these 2 processes.

You can find out if a child is spitting up or vomiting by such signs:

• When regurgitation, a small amount of substances “leaves” the body, while their separation occurs without problems. After that, the baby behaves normally.
• Spitting up in a baby usually occurs after feeding, and vomiting appears at any time of the day, regardless of the meal.
• Regurgitation is often a one-time process (per day), and vomiting can be repeated again and again.
• When spitting up, unchanged or slightly curdled food comes out of the body. Attacks of vomiting are characterized by digested food and gastric juice with bile.
• When spitting up, the child's well-being should not worsen, but vomiting invariably leads to poor health.

Causes: Why does this happen to newborns?

Why does the child spit up a lot? There can be many reasons for regurgitation in the baby. We list some of them:

When should you see a doctor?

What to do if the child often spit up fountain?

What should be done if the baby vomited a fountain:

1. Massage. In the event that a child has vomiting with a fountain, abdominal massage will be an excellent help. His technique is simple - to stroke the abdominal area clockwise with light enough movements, while making light pressure.
2. Stance "column" after feeding. After you have fed the baby, you should hold it in a “column” for at least 20 minutes, and then wear it exclusively in an upright position. When all the excess air is out of the stomach, let the baby lie down and rest.
3. Portion reduction. If you can't figure out why your baby spit up often after formula feeding, make sure you don't overfeed him. It is very simple to do this - just cock the baby before and after feeding.
4. Other Methods. While feeding, it is recommended to keep your baby in the correct position. This will prevent the baby from swallowing air along with the mixture, which leads to subsequent regurgitation.

Medications

Medical treatment may include taking the following drugs:

• Antacids. This group includes drugs that adults take with increased stomach acidity and heartburn, for example, Phosphalugel and Maalox.
  1. At the age of 6 months, the child should be given 1 teaspoon after meals.
  2. From 6 to 12 months - 2 teaspoons. The drug should be taken for 3 weeks.
• Drugs that stimulate gastrointestinal motility. These drugs have many side effects, so they should be given to infants only when absolutely necessary. Motilium does the least harm. These drugs should be taken at the rate of 0.25 mg per kg of weight 3-4 times a day 30 minutes before meals. The course of treatment usually lasts from 10 to 14 days. The purpose of taking the drug is to speed up the passage of food through the stomach.
• H2 receptor blockers. Used in extreme cases: with incessant and profuse regurgitation, when there is a risk of dehydration. This group includes the drugs "Ranitidine" (5-10 mg per kg of weight) and "Famotidine" (1 mg per kg of weight). The course of treatment is up to 3 months.

Prevention

To prevent repeated regurgitation of the baby, it is necessary to carry out the prevention of this process:

1. If the baby is crying, feed him a little later.
2. When feeding your baby from a bottle, tilt the bottle so that the formula fills the nipple completely.
3. When buying a new pacifier, be sure to check that it has medium-sized holes.
4. Make sure that clothes or diapers do not press on the child's stomach. It is also not recommended to swaddle babies tightly, and instead of pants with an elastic band, it is better to dress the baby in sliders that fasten on the shoulders.
5. During sleep, the child is preferably laid on the right side. This will reduce the rate of reflux of stomach contents into the esophagus. Under the baby's head, you need to put a small pillow from a pair of folded diapers or raise the legs of the crib at the head of the bed by 5-10 centimeters.

If the baby has frequent and profuse regurgitation after feeding with the mixture, this is due purely to physiology. In such cases Parents can use a few tips:

• before eating, the child should be laid out on a hard surface with the stomach down;
• after feeding, it is necessary to limit the mobility and activity of the baby as much as possible;
• you need to feed the child more often, but in smaller portions;
• provide the child with an active lifestyle outside of feeding: bathing, walking, massage and daily gymnastics will make the muscles responsible for the digestive tract stronger.

Often these actions are enough to fix the problem.

Reference! However, if the situation does not change, the frequency of regurgitation does not decrease, you need to contact your pediatrician for advice.

The various causes of regurgitation in infants have been listed above. As already mentioned, in addition to the physiological and functional causes of regurgitation, there are also organic ones. This problem sometimes requires surgery. Fortunately, organic causes are extremely rare. If your baby has frequent spitting up, seek medical attention, even if the rest of the time the baby feels well and does not show signs of anxiety.

Useful video

We invite you to watch a video about the causes of regurgitation in a child after a mixture:

Questions regarding spitting up in babies are among the most common among young parents and experienced moms and dads. And all because there are practically no newborns who would not do this. According to medical statistics, 8 out of 10 toddlers do this. The difference is only in the frequency, volume and intensity of the process. The famous doctor Yevgeny Komarovsky tells what to do if the baby regularly “throws out” part of what he has eaten, whether it needs treatment.

About the problem

In medicine, regurgitation has a scientific name - gas esophageal reflux. For the first time, as a medical phenomenon, it was described in the 19th century. Reflux develops mainly after eating. It manifests itself in the fact that part of the contents of the stomach is passively thrown back into the esophagus, into the pharynx and into the mouth. As a result, the baby “pleases” the mother by giving back what was eaten recently, sometimes quite abundantly.

In an adult, food most often cannot go back, as a whole barrier mechanism of various sphincters of the esophagus is triggered. In newborns, especially premature babies, these "locking devices" are poorly developed. As they improve, episodes of regurgitation occur less frequently, and then completely disappear. The underdevelopment of the digestive organs is considered the main cause of gasoesophageal reflux.

In the first months of life, such a phenomenon is considered physiologically justified, normal. In a third of babies, digestion normalizes at the age of 4 months, most of the little ones stop spitting up at 5-6 months. Only in a small part of babies this is observed after 7 months, but by the year such a “late” child completely stops spitting up.

If the general condition of the child is normal: the baby is gaining weight well, the pediatrician does not see any abnormalities, and the neurologist has not made a serious neurological diagnosis, then regurgitation does not cause any harm to babies.

Treatment

There is no magic pill for this phenomenon, says Yevgeny Komarovsky. Therefore, the treatment of reflux is always a complex of psychological and pedagogical measures aimed primarily at parents. They, alarmed and panicking, need to be explained in an accessible and understandable way that there is nothing pathological in this process, the child is not sick, does not starve, does not suffer and does not need hospitalization.

If this succeeded, then mom and dad explain another important point. Spitting up is not vomiting. You should urgently consult a doctor if vomiting has opened, because this symptom is very dangerous for infants. With vomiting, in addition to the food thrown out of the stomach (its large volume), the baby will have other symptoms. With reflux, nothing else happens to the baby other than a small amount of milk or formula that has come out.

There are children with increased activity of the vomiting center, which can react with vomiting even to a slight overeating. Such crumbs need to be underfed, says Evgeny Komarovsky, that is, limit the time they spend at the breast. And if the baby eats an adapted milk formula, then dilute it in a smaller amount than the age norm requires.

The main treatment for any regurgitation should be to ensure that the child does not overeat, because he will “throw out” the excess anyway. In especially severe cases, drugs are prescribed to reduce gas formation - "Diflatil" or "Espumizan". Often and abundantly spitting up a baby, especially if his reflux does not appear immediately, but half an hour or even an hour after eating, Komarovsky advises to swaddle and put to sleep on his side so that the baby does not choke in a dream.

If the baby is outraged by the need to sleep on his side (and this is not uncommon at all!), Then you can put an adult pillow under the mattress of the crib. On this elevation should be the back, but not the head of the baby. It can be laid on the back at an angle of about 30 degrees, in this position the risk of choking is minimized.

When you need a doctor

If the child is not gaining weight well, noticeably lags behind in development, then regurgitation needs to be corrected, which the specialist will think over after the examination. You also need to consult a doctor if, after an episode of reflux, the baby behaves restlessly - it starts to cry piercingly, tighten its legs, and writhe. This can occur when the esophagus is irritated by gastric juice. As a rule, this becomes possible with some pathologies of the digestive system, with neurological problems.

Mom needs to see a doctor as soon as possible if the baby burps not just milk or a mixture, but a brownish or greenish liquid, as this can be a sign of a serious pathology - intestinal obstruction. Yellow masses from the stomach should also be the basis for a visit to the doctor, as they can indicate disorders in the work of the stomach or pancreas.

Be sure to visit the pediatrician should be mothers whose babies did not burp until six months, and after 6 months this problem has just begun. Spitting up a fountain is also a reason to seek help from a qualified specialist.

If the child often spits up, parents should heed a few simple tips:

• during feeding, babies can swallow air - this is also one of the reasons for spitting up. After eating, the baby should be held vertically, leaning against your shoulder and lightly tapping the back with your palm until the excess air leaves;
• if the child is bottle-fed, after a preliminary consultation with a doctor, you should buy him not just an adapted mixture, but a product marked "antireflux". It contains special safe thickeners such as rice starch;
• after spitting up, do not try to feed the baby, his digestive tract needs to be given a little rest;
• if the baby spits up through the mouth and through the nose, it is imperative to clean the nasal passages from the remnants of the contents of the stomach in order to prevent the development of bacterial inflammation;
• do not entertain the baby immediately after eating, but you need to leave it alone - so the likelihood of regurgitation is reduced.

Regurgitation is a problem that affects all breastfeeding mothers and their babies. What to do and how to behave mom in this situation? Tips from Dr. Komarovsky from the video below will help you figure it out.

The regurgitation that occurs in a baby after feeding is usually a normal process. However, in some cases, it is also a sign of a pathological condition in newborns.

When, against the background of belching after breast milk, some discomfort appears. In children, all these processes are regulated immediately after birth.

The newborn "knows" how much to eat, when and what. Mother's milk is intended exclusively for her baby and is produced according to his needs.

The reasons

Frequent spitting up is the result of swallowing large amounts of air during feeding that does not fit in the baby's stomach (aerophagia).

Excess air is expelled as a burp.

This happens as a result of two main factors:

• during feeding, the nipple is incorrectly applied and unnecessary gaps are formed between the newborn's mouth and breast;
• when the baby is on a mixture (artificial, bottle feeding), with a large hole in the nipple of the bottle, a similar situation develops.

Excessive regurgitation is rare.

The situation when a newborn spits up after milk, but there are no signs of dehydration (see below), should not particularly alarm the mother.

• It happens that the baby spits up breast milk 5 times a day.
• The volume of one serving is no more than two or three tablespoons.

Sometimes a child will eat more than they can handle and the excess will naturally come back.

Norm

Even too much spitting up can be completely normal.

Within the acceptable range, the frequency at which pathological signs do not develop that indicate dehydration is considered.

So notes the famous pediatrician Komarovsky.

The regurgitation itself goes away by the seventh month.

Signs of normal discharge of food and gas from the stomach in infants:

• despite regurgitation, children do not lose weight, but, on the contrary, there is a steady increase;
• the fontanel in an infant does not sink;
• regurgitation occurs once, within an hour after feeding, the color and consistency are close to mother's milk, without yellow impurities;
• the baby behaves as usual, that is, he does not have lethargy and irritability;
• after burping, the newborn does not cry.

In the case when the child has opposite signs, parents should urgently seek help from pediatricians.

Since there is a possibility of developing a pathological condition, and assistance not provided in time will lead to severe dehydration with all the ensuing consequences.

What to do

• The baby should be in an upright position after feeding.

In this position, the child spits up milk and mixtures much less often. Sometimes you have to wear a baby in your arms for up to 20 minutes.

• Before feeding, put the baby to lie on the tummy for some time.

Mom can still stroke his back and talk in a soothing voice. A light massage of the tummy also has a beneficial effect.

• If formula-fed babies, ask your pediatrician for advice on the best formula.
• A properly selected nipple plays an important role.

Take a closer look at anti-colic models. Milk should not flow freely, and it is better to choose an anatomical nipple shape.

• After feeding, the child should not play active games, it is recommended to be alone for a while.

By the way, the child does not even spit up, but he can vomit. Then you need specialized help.

It is important to remember: you need to put a baby to bed with regurgitation only on its side in order to avoid choking.

When to worry

You should be alarmed when the child spits up milk in a fountain, that is, strongly, under pressure. Then there is a plentiful yield of food - more than 2–3 tablespoons.

Most likely, the baby is vomiting, and which is quite a symptom of some pathological condition.

Causes of vomiting after feeding are as follows:

• Viral infections in children, which often show signs of dehydration.

The child is lethargic, the temperature is lowered (increased), problems with urination.

• Perinatal encephalopathy due to severe pregnancy and childbirth.

Often accompanied by vomiting fountain and poor sleep.

• In premature babies due to underdeveloped gastrointestinal tract, central nervous system.
• Food poisoning that develops from the use of harmful, expired food.
• Food intolerance of a certain class.

Often the reaction manifests itself in cow's milk, which is recommended to be replaced with goat's.

• Kid with intestinal dysbacteriosis.
• Allergic reaction.

Newborns react with vomiting to any products taken by the mother and present in her milk.

Help for young mothers.

Regurgitation in newborns and infants is well known to almost every family.

How to reduce the frequency of regurgitation in children and the amount of spewing milk?

Regurgitation/belching.

First you need to calm down and understand that this phenomenon is completely normal., happens to every baby, because his nervous system is still weak, and the structure of the digestive tract is such that it facilitates the penetration of food in the opposite direction - from the stomach into the short esophagus, pharynx, mouth and out.

As the child grows, his gastrointestinal tract is gradually rebuilt and regurgitation stops.

Experts often say that mothers worry in vain - this phenomenon does not cause trouble for the child. Often this is true. But I observe how difficult it is sometimes for a family to cope with a problem. Sometimes the baby remains hungry, loses weight, and the mother's lactation is disturbed..

Sometimes the baby spit up excess milk. This is fine. It's not worth worrying. Just organize more frequent and even feedings so that the baby does not overeat.

To check, pour 1-2 tablespoons of water on the diaper and compare the stain with how much he spit up. If not more, then everything is in order.

It happens that regurgitation occurs in a fountain, and often, even if the daughter or son eats little. This is an occasion to consult a doctor.

When spitting up, gastric juice can be thrown into the esophagus. Sour sometimes irritates the esophagus to such an extent that the baby can cry, rush about. If this trouble haunts the baby constantly, then there may be a threat of sinusitis or otitis media.

The nutrition and health of the child in the future will often depend on how the process of feeding the baby in the first week and in the first month will be established.

Trusts you and needs your help.

What to do

Tips from my own experience.

• Ask the nursing staff to show you how to properly feed your baby. With sufficient perseverance, you will definitely find those who will tell and show everything very clearly.
• If possible, take any help from family and friends to deal with initial problems as early as possible.
• Who can afford it, it is better to hire a knowledgeable nanny in order to cope with regurgitation as quickly as possible. After all, before you have time to look back, more abundant salivation and preparation of the gums for the growth of teeth will begin. In calmer children, teeth are usually calmer.

Before feeding

If possible Lay your baby on his tummy on a hard surface before each feed., you can - to your knees. Not all crumbs allow you to do this if you are hungry, but be kind and patient.

Babies literally “on the fly” seize pleasant moments and soon they themselves are waiting for the moment when the fingers and palms of mom or dad, grandmother or nanny will make an easy “run” along their tummy.

Gradually accustom the child to light massages of the abdomen in a clockwise direction around the navel with a slight pressure on the right side so that the gases come out and do not put pressure on the abdominal cavity during and after feeding. Then the baby will be saturated calmer and faster.

Accompany any of your actions with affectionate, gentle communication with the baby. It is very important. So he will quickly learn to trust you, learn the intonations of your voice and will be guided by them in the future.

Feeding

Do not start feeding the screaming baby. Sometimes the baby is just in a hurry to "shut up." It is not right. First calm down, relax, and then feed, otherwise you will swallow air.

It should not be brought to the point that the child is screaming from hunger, and it is impossible to calm him down. Hunger for a baby is a catastrophe, it should be satisfied immediately.

You can read in detail about the technique of breastfeeding, night feedings and the frequency of feedings in my article. There is also a wonderful detailed video material. And there I listed the reasons why is the baby crying. When you learn to distinguish "hungry" crying from other types of crying, many problems will go away on their own.

If feeding from a bottle, make sure that the nipple is constantly filled with milk, the baby should not “feed on emptiness”. The hole in the nipple should not be too big for your baby (and not too small).

Try feeding from Dr. Brown's anti-colic bottles (Dr. Brown). Many of them do well.

The capture of a large amount of air leads to an overflow of the baby's stomach, discomfort, and regurgitation.

Watch your newborn carefully and listen.

If he sucks evenly (evenly makes swallowing movements), and then stops and becomes worried, carefully release him from feeding and give him an upright position, putting him lightly on your chest. Perhaps he will immediately belch air.

If the air has not come out, and the baby is writhing from discomfort, then lift the child up so that his head and arms lie on your shoulder and the baby sees the room behind you.

Press the child with your palm closer to you, hold it like that and the air will definitely come out. You can lightly pat your hand on the back. The child will feel better, there will be room in the ventricle for a new portion of milk and the baby will ask to eat again. Look for positions that are comfortable for you and your baby. The feeding procedure can be divided into 2-3 stages.

Breaks in feeding are also necessary because milk does not flow in a continuous stream, but there are tides. Between hot flashes, the baby rests and waits for the next portion to appear.

How to hold a baby to burp

It is necessary to give the baby a position in which he will release all the air that has entered the stomach. Only and everything.

How to induce a burp and help release air

At the end of feeding, put the baby back on your shoulder and hold him like that until all the air bubbles and bubbles come out.

Occasionally it happens that the air does not come out. If the child is calm, then he is not there. And if he “complains”, then gently give him a horizontal position and again lift him onto your shoulder.

Under the weight of his weight, the baby will constantly go down, and you will constantly lift him up. Thus, an additional massage of the tummy and calf of the crumbs is performed. Move the baby from one shoulder to another if you get tired quickly. And it’s better to give it to dad or someone else, showing this technique.

• This method of carrying a baby frees him to a large extent from regurgitation, gas and colic; trains his vestibular apparatus; massages the abdominal and dorsal muscles, strengthening them.
• The umbilical hernia is reduced faster and the spine is strengthened. The baby will begin to hold his head earlier and more confidently.
• If you walk with him, and do not sit, then he will learn a lot of new things around him. He is both pleasant and interesting.

Very good content in this video. I advise you to study.

The first difficulties in the postpartum period.

If your baby is often bothered by regurgitation, gaziki and colic, then he may like this position and over time he will be happy to “ask” for you on your shoulder to alleviate his condition.

But what you should not do with the baby after feeding is sudden movements. Let him rest after eating.

Do not shake the baby, do not play with him, and do not try to get a generous smile so that the child does not twitch with a big sigh. Especially since laughter in older infants can turn into prolonged hiccups or tantrums. It is often difficult to stop this, especially at bedtime when the child's nervous system is exhausted.

Let the food digest a little, don't pump too hard. Motion sickness is very useful, but there should be a measure in everything.

It is important to wean the baby from any motion sickness, or rather, do not accustom to them. In the future, you will undoubtedly appreciate this advice of mine, especially in winter, even if at first you are skeptical about it.

If it becomes necessary during or immediately after feeding to urgently wash the baby or change clothes, then at least hold it a little in the way described above to cause belching, and only then do the necessary actions, but carefully.

• Clothing and diapers should not tightly squeeze the baby's body. Buy daily things a couple of sizes larger, because not only the baby grows quickly, but also natural linen after two or three washes in the machine “shrinks” a lot.
• You can slightly raise the head of the mattress on which the baby sleeps.
• You should not constantly keep the baby at the breast. So he will never be free of air.
• Learn to distinguish between the crying of a hungry baby and a full one.

Anxiety - Need a doctor

Never hesitate to ask for help, especially when it comes to the health of the smallest family member. Keep in mind that it is often impossible to predict the development of events.

At the slightest suspicion of a threat to the health of the baby, contact a specialist! After all, sometimes regurgitation is pathological.

In this article, I talked only about regurgitation, but not about vomiting. At the slightest suspicion of vomiting, immediately call an ambulance, call the doctor urgently!

With the help of this wonderful video, you can learn many useful things.

Newborn care, vestibular gymnastics. Great communication between mom and baby.

How to pick up and hold your baby

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Regurgitation. A very rare mother can boast that her baby never burps. Usually, these little incidents happen regularly during the first months of a baby's life.

Regurgitation is the passive flow of food from the stomach into the esophagus and oral cavity, due to the contraction of only the muscles of the stomach.

Observing regurgitation, we see the leakage of the contents of the stomach from the baby's mouth. Immediately after feeding, most of all it is still milk, after a while after feeding, the milk is already curdled.

Regurgitation is based on age-related anatomical and physiological features of a young child. Regurgitation occurs in babies with an increase in intragastric pressure as a result of eating with a reduced tone of the lower esophageal sphincter.

In most children, regurgitation is a variant of the normal reaction of the body, which does not cause pronounced changes in the state of health.

This is a temporary phenomenon. In the first three months, regurgitation is observed in almost 100% of children, at 4-6 months, about 60% continue to spit up sometimes, at 6-12 months, about 20%, older than a year - less than 2% of children. All babies spit up at different rates. There are quite healthy babies who have 20-30 episodes of regurgitation per day.

It is the passive outflow of stomach contents, rarely with force. Some babies never spit up a "fountain", and some do it regularly, but not more than 1 time per day. How can you distinguish regurgitation with a "fountain" from vomiting?

Unlike vomiting, regurgitation is an inactive process that does not affect the well-being of the child. With vomiting, there is always a contraction of the diaphragm and muscles of the anterior abdominal wall. Vomiting is preceded by nausea, pallor of the skin, salivation, sweating, increased heart rate, lowering blood pressure. With repeated vomiting, disturbances in water and electrolyte metabolism quickly develop. Vomiting is an active process regulated by the vomiting center of the central nervous system and performing a predominantly protective role, freeing the stomach from poor-quality food or toxic substances.

There are diseases in which abundant regurgitation with a "fountain" becomes frequent and the baby's well-being begins to suffer. In this situation, it is necessary to consult a doctor, remembering that if the babies are healthy, they do not spit up a "fountain" often and continue to feel good, gain weight and develop normally.

The development of the child is the main indicator of the health of the baby in the first months of life.

The baby is growing well, gaining weight, but spitting up regularly. Do you need to do something? Depends on the type of feeding the child.

If your baby is a breastfed baby, you do not let him suck on a pacifier, you put it on your breast as often as he asks, he gains weight well and develops well, nothing needs to be done. Spitting up will go away when the baby grows up a little, and will practically stop when, after six months, the baby begins to eat complementary foods - more solid food.

There are babies with a very strong need to suck, and some of them do this: after pumping milk, they spit up some and continue to suck. This is also a normal variant of spitting up, often found in children who are gaining weight very well.

If the baby regularly spits up after feedings, if there is often a burp of air (aerophagia), it is worth checking the correct attachment to the breast: the baby will not or almost will not suck in air, if he correctly grasps the nipple deeply during feeding. If correcting attachment does not help, expelling air and reducing regurgitation can be helped by an upright position after feeding if the baby is awake, or an elevated position at an angle of 20 to 30 degrees for a sleeping baby. The baby sleeping in his arms is in the correct position - the body is raised.

Formula-fed babies, in addition to helping with the position, are helped by an increase in the number of feedings with a decrease in a single serving, the use of mixtures with thickeners that have an increased viscosity. Be aware of the possibility of overfeeding, as well as problems associated with feeding technique (width of the opening in the nipple, position of the bottle).

Kazakova L.V.

Pediatrician of the Center for Natural Development and Health of the Child,

Head of Maternity Support Unit