Baby vomits in sleep

Child Vomiting at Night but Fine During Day: Causes, Treatment

Your little one is tucked into bed after a rambunctious day and you’re finally settling into the sofa to catch up on your favorite series. Just as you get comfortable, you hear a loud wail from the bedroom. Your child who seemed fine all day long has woken up from their slumber — throwing up.

Any time is a bad time for vomit. It can seem worse, though, when your cranky, sleepy child throws up at night. But it can happen for a number of reasons.

Often it’s just a temporary (and messy) situation for both you and the kid. Your child may feel better after vomiting — and being cleaned up — and go back to sleep. Throwing up may also be a sign of other health issues. Let’s take a look at what might be going on.

Along with throwing up after bedtime, your child might have other signs and symptoms that appear at night. These include:

• stomachache or cramps
• coughing
• headache pain
• nausea or dizziness
• fever
• diarrhea
• wheezing
• difficulty breathing
• itching
• skin rash

Food poisoning

Sometimes vomiting is simply the body saying “nope” for all the right reasons. Your child — or anyone — may consume something (through no fault of their own) that they shouldn’t have eaten, as far as the body’s concerned.

Cooked and uncooked food can both cause food poisoning. Your child may have eaten food that was:

• left out too long (for example, at a friend’s outdoor birthday party in the summer)
• wasn’t cooked properly (we’re not talking about your cooking, of course!)
• something they found in their backpack from a few days ago

It can be hard to find out exactly what the culprit food was because your child may not have any symptoms for hours. But when it hits, vomiting is likely to happen at any time — even at night.

Along with vomiting, food poisoning can also cause symptoms like:

• stomachache
• stomach cramps
• nausea
• dizziness
• fever
• sweating
• diarrhea

Stomach flu

The stomach flu is a common and contagious illness for kids. And it can strike at night, when you least expect it.

The “stomach bug” is also called viral gastroenteritis. Vomiting is a hallmark symptom of the viruses that cause the stomach flu.

Your child may also have:

• mild fever
• stomach cramps
• headache pain
• diarrhea

Food sensitivities

A food sensitivity happens when your child’s immune system overreacts to a (normally) harmless food. If your child is sensitive to a food, they may not have any symptoms for up to an hour after eating it. Eating a late dinner or a bedtime snack might lead to nighttime vomiting in this case.

Check to see if your child might have eaten anything they may be sensitive to. Some of these might be hidden in processed snacks like crackers. Common food sensitivities include:

• dairy (milk, cheese, chocolate)
• wheat (bread, crackers, pizza)
• eggs
• soy (in lots of processed or boxed foods and snacks)

A food allergy, which is more serious, would usually cause other symptoms — like rash, swelling, or breathing problems — and can be a medical emergency.

Cough

Your child might only have a slight cough during the day. But a cough can sometimes get worse at night, triggering your child’s gag reflex and making them vomit. This can happen whether your child has a dry or wet cough.

A dry cough might get worse if your child is a mouth breather. Breathing through an open mouth while sleeping leads to a dry, irritated throat. This causes more coughing, which in turn, causes your child to throw up dinner in bed.

A wet cough — usually from a cold or flu — comes with lots of mucus. The extra fluid trickles into the airways and stomach and can collect as your child sleeps. Too much mucous in the stomach causes waves of nausea and vomiting.

Acid reflux

Acid reflux (heartburn) can happen in babies as well as children from the age of 2 years and up. Your child may have it once in a while — this doesn’t mean they have a health problem necessarily. Acid reflux can irritate the throat, setting off coughing and vomiting.

This can happen in the wee hours of the night if your child ate something that may trigger acid reflux. Some foods make the muscles between the stomach and mouth tube (esophagus) relax more than usual. Other foods trigger the stomach to make more acid. This can cause occasional heartburn in some little ones and adults.

Foods that might give your child — and you — heartburn include:

• fried foods
• fatty foods
• cheese
• chocolate
• peppermint
• oranges and other citrus fruits
• tomatoes and tomato sauce

If your child has acid reflux often, they may have other signs and symptoms that don’t seem linked:

• sore throat
• coughing
• bad breath
• frequent colds
• repeated ear infections
• wheezing
• raspy breathing
• rattling noise in the chest
• loss of tooth enamel
• dental cavities

Asthma

If your child has asthma, they might have more coughing and wheezing at night. This is because the airways — lungs and breathing tubes — are more sensitive at night while your child is sleeping. These nighttime asthma symptoms sometimes lead to throwing up. This can be worse if they also have a cold or allergies.

Your child may also have:

• chest tightness
• wheezing
• whistling sound when breathing
• difficulty breathing
• trouble sleeping or staying asleep
• tiredness
• crankiness
• anxiety

Snoring, with or without sleep apnea

If your little one sounds like a freight train while snoozing, pay attention. Children can have light to pretty serious snoring for a number of reasons. Some of these causes go away or get better as they get older. But if they also have significant pauses in breathing (usually while snoring), they might have sleep apnea.

If your child has sleep apnea, they might have to breathe through their mouth, especially at night. This can lead to a dry throat, coughing — and sometimes, throwing up.

In some children even without sleep apnea, snoring can make it hard to breathe. They might wake up suddenly feeling like they are choking. This can set off panic, coughing, and more vomit.

Kids who have asthma or allergies may be more likely to be snorers because they get stuffy noses and congested airways more often.

Remember that throwing up is usually a symptom of something else not quite right. Sometimes — if you’re lucky — one vomiting episode is all it takes to correct the problem, and your child goes back to sleep peacefully.

At other times, night vomiting may happen more than once. Treating the underlying health cause can help reduce or stop this symptoms. Soothing a cough might help get rid of the vomit. Home remedies include avoiding:

• foods and drinks before bedtime that may trigger acid reflux
• allergens such as dust, pollen, dander, feathers, animal fur
• secondhand smoke, chemicals, and other air pollution

If the vomiting seems to be associated with eating certain foods, talk to the pediatrician to see if these are foods your child should avoid.

Give your child sips of water to help them stay hydrated after vomiting. For a younger child or baby, you may be able to get them to drink a rehydration solution like Pedialyte. This can be especially helpful for babies who have vomiting or diarrhea lasting longer than overnight.

You can try a rehydration solution from your local drugstore or make your own. Mix:

• 4 cups water
• 3 to 6 tsp. sugar
• 1/2 tsp. salt

Popsicles can be a good hydration source for older children.

Vomiting is occasionally linked to breathing problems. Some children with sleep apnea have a smaller jaw and other mouth problems. Dental treatment or wearing a mouth retainer can help end the snoring.

If your child has asthma, talk to your pediatrician about the best medications and when to use them to reduce symptoms at night. Even if your child hasn’t been diagnosed with asthma, talk to their doctor if they frequently cough at night. Some children with asthma seem mostly fine during the day and their primary — or even only — symptom is a nighttime cough, with or without vomiting. Your child may need:

• bronchodilators to open up the breathing tubes (Ventolin, Xopenex)
• inhaled steroid drugs to reduce swelling in the lungs (Flovent Diskus, Pulmicort)
• allergy medications (antihistamines and decongestants)
• immunotherapy

Too much vomiting can lead to dehydration. This is especially a risk if your child also has diarrhea. Vomiting along with other symptoms may also be a sign of a serious infection. Call your doctor if your child has:

• persistent cough
• a cough that sounds like barking
• a fever that is 102°F (38.9°C) or higher
• blood in bowel movements
• little or no urination
• dry mouth
• dry throat
• very sore throat
• dizziness
• diarrhea for 3 days or longer
• extra tiredness or sleepiness

And if you child has any of the following, an emergency trip to the doctor is warranted:

• severe headache
• severe stomach pain
• difficulty waking

The Healthline FindCare tool can provide options in your area if you don’t already have a pediatrician.

Sometimes the only reaction to a food sensitivity or allergy is vomiting. Your child might feel better after throwing up because the food is out of their system. In other cases, food allergies can trigger serious symptoms that need urgent medical care.

Look for symptoms like:

• swelling of the face, lips, throat
• difficulty breathing
• hives or skin rash
• itching

These can be signs of anaphylaxis, a serious allergic reaction that requires immediate medical attention.

If your child has asthma, check for signs that show they’re having a lot of difficulty breathing. Get emergency medical attention if you notice that your child:

• isn’t speaking or has to stop speaking to catch their breath
• is using their stomach muscles to breathe
• is breathing in short, rapid breaths (like panting)
• seems overly anxious
• raises their rib cage and sucks in their stomach when breathing

Your child might vomit at night even if they seem fine during the day. Don’t worry: Vomiting isn’t always a bad thing. Throwing up is a symptom of some common health ailments that can crop up at night while your little one is sleeping. Sometimes, the vomiting goes away by itself.

In other cases, nighttime vomiting may be more of a regular thing. If your child has a health issue like allergies or asthma, throwing up can be a sign that more treatment is needed. Treating or preventing the underlying problem can stop the vomit.

Vomiting (0-12 Months)

Is this your child's symptom?

• Vomiting (throwing up) stomach contents
• Other names for vomiting are puking, barfing and heaving

Causes of Vomiting

• Viral Gastritis. Stomach infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery loose stools may follow within 12-24 hours.
• Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Uncommon in infants, but main foods are eggs and peanut butter.
• Coughing. Hard coughing can also cause your child to throw up. This is more common in children with reflux.
• Serious Causes. Vomiting alone should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. An example is a kidney infection. A serious cause in young babies is pyloric stenosis. See below for more on this.

Pyloric Stenosis (Serious Cause)

• The most common cause of true vomiting in young babies.
• Onset of vomiting is age 2 weeks to 2 months
• Vomiting is forceful. It becomes projectile and shoots out.
• Right after vomiting, the baby is hungry and wants to feed. ("hungry vomiter")
• Cause: The pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
• Risk: Weight loss or dehydration
• Treatment: Cured by surgery.

Vomiting Scale

• Mild: 1 - 2 times/day
• Moderate: 3 - 7 times/day
• Severe: Vomits everything, nearly everything or 8 or more times/day
• Severity relates even more to how long the vomiting goes on for. At the start of the illness, it's common for a child to vomit everything. This can last for 3 or 4 hours. Children then often become stable and change to mild vomiting.
• The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
• The younger the child, the greater the risk for dehydration.

Dehydration: How to Tell

• The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
• Vomiting with watery diarrhea is the most common cause of dehydration.
• Dehydration is a reason to see a doctor right away.
• Your child may have dehydration if not drinking much fluid and:
• The urine is dark yellow and has not passed any in over 8 hours.
• Inside of the mouth and tongue are very dry.
• No tears if your child cries.
• Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

When to Call for Vomiting (0-12 Months)

Call 911 Now

• Can't wake up
• Not moving
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
• Stomach pain when not vomiting. Exception: stomach pain or crying just before vomiting is quite common.
• Age less than 12 weeks old with vomiting 2 or more times. Exception: normal spitting up.
• Vomited 3 or more times and also has diarrhea
• Severe vomiting (vomits everything) more than 8 hours while getting Pedialyte (or breastmilk)
• Head injury within the last 24 hours
• Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Vomiting a prescription medicine
• Fever over 104° F (40° C)
• Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• All other infants (age less than 1 year) with vomiting. See Care Advice while waiting to discuss with doctor.

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

• Bellevue
• Everett
• Federal Way
• Seattle

Care Advice for Vomiting

1. What You Should Know About Vomiting:
   • Most vomiting is caused by a viral infection of the stomach.
   • Vomiting is the body's way of protecting the lower gut.
   • The good news is that stomach illnesses last only a short time.
   • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
   • Here is some care advice that should help.
2. Formula Fed Babies - May Give Oral Rehydration Solution (ORS) for 8 Hours:
   • If vomits once, give half the regular amount of formula every 1 to 2 hours.
   • If vomits formula more than once, offer ORS for 8 hours. If you don't have ORS, use formula until you can get some.
   • ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food stores or drug stores.
   • Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
   • After 4 hours without throwing up, double the amount.
   • Return to Formula. After 8 hours without throwing up, go back to regular formula.
3. Breastfed Babies - Reduce the Amount Per Feeding:
   • If vomits once, nurse half the regular time every 1 to 2 hours.
   • If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, return to regular nursing.
   • If continues to vomit, switch to pumped breastmilk. (ORS is rarely needed in breastfed babies. It can be used if vomiting becomes worse).
   • Spoon or syringe feed small amounts of pumped milk. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
   • After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
4. Pumped Breastmilk Bottle-Fed Infants - Reduce the Amount per Feeding:
   • If vomits once and bottle-feeding breastmilk, give half the regular amount every 1-2 hours.
   • If vomits more than once within last 2 hours, give 1 ounce (30 mL) every 30 to 60 minutes.
   • If continues to vomit, give 1-2 teaspoons (5-10 mL) every 5 minutes. Only if not tolerating breastmilk, switch to ORS (e.g., Pedialyte) for every 5 minutes for a few hours.
   • After 4 hours without vomiting, return to regular feedings. Start with 1 ounce (30 mL) every 30 minutes and slowly increase as tolerated.
5. Stop All Solid Foods:
   • Avoid all solid foods and baby foods in kids who are vomiting.
   • After 8 hours without throwing up, gradually add them back.
   • If on solid foods, start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
6. Do Not Give Medicines:
   • Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
   • Fever. Mild fevers don't need to be treated with any drugs. For higher fevers, you can use an acetaminophen suppository (such as FeverAll). This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
   • Call your doctor if: Your child vomits a drug ordered by your doctor.
7. Try to Sleep:
   • Help your child go to sleep for a few hours.
   • Reason: Sleep often empties the stomach and removes the need to vomit.
   • Your child doesn't have to drink anything if his stomach feels upset and he doesn't have any diarrhea.
8. Return to Child Care:
   • Your child can return to child care after the vomiting and fever are gone.
9. What to Expect:
   • For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
   • Vomiting from a viral illness often stops in 12 to 24 hours.
   • Mild vomiting and nausea may last up to 3 days.
10. Call Your Doctor If:
    • Vomits clear fluids for more than 8 hours
    • Vomiting lasts more than 24 hours
    • Blood or bile (green color) in the vomit
    • Stomach ache present when not vomiting
    • Dehydration suspected (no urine in over 8 hours, dark urine, very dry mouth, and no tears)
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/06/2022

Last Revised: 09/21/2022

Copyright 2000-2022 Schmitt Pediatric Guidelines LLC.

Regurgitation in children of the first year of life

Regurgitation in children of the first year of life. Recommendations for young parents.

Parents have a lot of questions with the birth of a child. Moreover, it has been noted that almost all parents face the most exciting problems regarding the health of the baby, since all of them are mostly physiological, passing as the child grows and the work of all systems of his body becomes established. After all, a newborn child is not a small adult, absolutely all the organs and systems of the baby will not only grow in size, but also mature. However, even an understanding of this fact does not reduce the anxiety of parents when any deviations appear in the child's condition, even if they pass over time.
One of these exciting problems is regurgitation in children of the first year of life. According to statistics, a fairly large percentage of all infants, namely from 25% to 80%, have manifestations of the so-called regurgitation syndrome. Moreover, in half of the children, it is stubborn. What is the reason for such a high frequency of this syndrome? And what is it all about - regurgitation?
Regurgitation is the reflux of stomach contents into the mouth shortly after ingestion in infants, predominantly in the first six months of life. There are a number of reasons for the occurrence of regurgitation, both physiological and related to the care and feeding of the baby.

From the point of view of the characteristics of the child's body:

• The stomach is not elongated, as in an adult, but spherical in shape.
• Insignificant volume of the stomach.
• The sphincter (circular muscle), which opens the entrance to the stomach when food passes through the esophagus and closes it at the time of digestion, is rather weak, while the "pylorus", the same muscle, but at the junction of the stomach into the duodenum, is stronger. This feature contributes to the occurrence of regurgitation. A cavity closed on one side arises and with an increase in pressure in the cavity of the stomach, a weak sphincter opens and a reverse reflux of food into the esophagus is formed, and from there the oral or nasal cavity.
• It follows that overfeeding a child or swallowing air during feeding, contribute to an increase in pressure in the stomach, and therefore will inevitably lead to regurgitation.
• The presence of constipation in a child, increased flatulence, bloating can also cause unpleasant symptoms.

How to distinguish regurgitation from other, serious symptoms, indicating not just the immaturity of the baby's systems, but the occurrence of certain diseases that require examination by a pediatrician.

Regurgitation:

• Starts suddenly, without any previous symptoms.
• Occur without tension of the muscles of the anterior abdominal wall.
• Not accompanied by pallor, sweating, impaired well-being of the child.
• The child is still active, with a good appetite, and sufficient weight gain.

Symptoms to watch out for parents:

• Profuse regurgitation. In quantitative terms - from half to the full volume that was introduced in one feeding, especially if this situation is repeated in more than half of the feedings.
• The child has insufficient weight gain. A very formidable sign is the loss of body weight from the original and / or a decrease in the number of urination of the child less than 8 - 10 times a day.
• There are certain symptoms associated with the broncho-pulmonary system, recurrent cough, especially the occurrence of pneumonia in children of the first six months of life.
• The general condition of the child is disturbed.
• Profuse vomiting of previously eaten food with an admixture of bile (the contents of the vomit becomes yellow), especially if the child does not have a stool.

Doctors, which specialties should be consulted to rule out organic diseases that sometimes require immediate medical intervention:

• Pediatrician - Your first assistant, having assessed the condition of the child, will be able to say whether your worries were in vain or whether it is still necessary to show the baby to others specialists, as well as prescribe treatment, if necessary.
  
• A neurologist, as a number of neurological problems that occur in a small child can also be accompanied by regurgitation (hydrocephalic syndrome, perinatal damage to the central nervous system).
• Pediatric surgeon. Some of the diseases, one of the signs of which may be vomiting, require emergency surgical intervention (pyloric stenosis, intestinal obstruction).

But, now all the excitement is over, the child has been examined by all the necessary specialists, and it's time to start the question, but how, actually, to reduce the severity of symptoms or minimize them.
As usual, we start with the normalization of routine moments:

• Do not overfeed the child, it is better to reduce the single amount of food, but feed more often
• When breastfeeding, make sure that the baby has a good grip on the nipple (together with the areola). Never stop breastfeeding!
• When feeding from a bottle, try to avoid swallowing air when sucking (using special bottles, adjusting the diameter of the hole in the nipple)
• Put the baby on the tummy before feeding
• When feeding, keep the baby in a raised position (not horizontal!), as well as after feeding - the baby should be upright for about 20-30 minutes
• Do not wear clothes that tighten the baby's stomach, avoid sudden movements in relation to the baby in the first half an hour - an hour after feeding, do not put it on the stomach immediately after eating
• If the child spits up in his sleep, when putting him to bed, make sure that the head end of the bed is raised by 10-15 cm. so that the baby does not roll over in a dream on his back.
In addition to regime moments, there are other methods of treating regurgitation in children. All of them are prescribed only by a pediatrician!

• The first of these methods is the appointment of special therapeutic mixtures. These mixtures contain so-called thickeners (starch, locust bean gum), which form a denser food bolus in the stomach, and thereby prevent it from being thrown back into the oral cavity. The choice of mixture depends on many related factors, for example, frequent or rare stools in a child, whether there are signs of lactase deficiency, and so on. The pediatrician, taking into account all the individual characteristics of your baby, will select the necessary mixture. At the same time, you must understand that such treatment, and this is the treatment, will be prescribed for a certain period and in the required amount. That is, only some part of the mixture that your child receives will be replaced with a medicinal one, and upon reaching the results, the baby will return to his usual diet.
• There are also drugs that promote the normal movement of food through the gastrointestinal tract, the so-called prokinetics. Most often appointed - motilium. It normalizes intestinal motility, has a minimum number of side effects and is approved for use in young children. This drug is prescribed only if all the above regimen moments are ineffective.
Remember that only a pediatrician should determine the cause in case of regurgitation in your baby, and prescribe treatment if necessary. Do not get carried away going to the pharmacy and buying up all the beautiful jars that the modern pharmaceutical industry can offer you. Indeed, one of the reasons for the appearance of regurgitation syndrome may be the irrational use of drugs, as well as the frequent change of mixtures during artificial feeding of a child.

Contact Family Clinic Alexandrovskaya and our experienced pediatricians will help you raise your baby healthy!

Author: Mikhailova Nina Vasilievna
Gastroenterologist of the highest category.

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Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation - Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day, at least 50% of babies from 0 to 3 months old can spit up, more than 60% of children 3-4 months old, and in 5% of children, spitting up continues until the year ¹ .

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

• Features of the structure of the upper digestive tract in babies
• In newborns and infants up to a year of age, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year ² .
• Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
• Normally, the lower esophageal sphincter should tightly “close” the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well ² .
• Slow movement of food through the gastrointestinal tract
• The neuromuscular apparatus of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters - if it is too large, the newborn swallows a lot of air ³ .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled ³ .

Promotes post-feeding regurgitation and baby's predominantly horizontal position during the day, combined with relatively high intra-abdominal pressure ⁴ . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be triggered by other situations in which abdominal pressure increases and stomach contents are thrown into the esophagus, in particular ³ :

• tight swaddling;
• stool disorders, in particular constipation;
• long, forced cry and some others.

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Start with a baby bottle with an anti-colic system that helps avoid common feeding problems such as colic, gas and spitting up*

How do you tell normal spitting up from vomiting?

Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation ¹ .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more ¹ .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 - 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. When the range of the jet of vomit is up to 50 cm, doctors talk about "vomiting a fountain." A variant of atonic vomiting is possible, when the contents of the stomach flow "sluggishly". It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus ¹ .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor's consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day ^1.3 .

Physiological regurgitation: symptoms

Neonatal regurgitation, which is considered a normal variant and is not of concern to pediatricians ³ :

• usually lasts for a certain period of time;
• is characterized by slow, "passive" outflow; if the baby spits up a fountain, it is better to consult a doctor;
• has a sour smell of curdled milk;
• occurs without the participation of muscles - the baby does not strain during regurgitation;
• does not affect the general well-being of the baby.

How to help a newborn who spit up often?

If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all - on demand ⁵ .