The rate of regurgitation in a month-old baby. Improper breastfeeding. Video: Frequent regurgitation in newborns and children up to a year after feeding

Good day, dear readers! How are you feeling? My friend and I recently reviewed photographs of our children, among them is a moment - a friend's daughter with milk on her lips. I immediately remembered the first six months of the baby. Constant regurgitation in newborns after feeding - the reasons may be different.

And how many experiences from ignorance! I remember the first time I got scared when the baby's milk went through her mouth. Are you familiar with this? If you are already a mother and don’t understand why this is happening, or if you are preparing for the birth of the most important person in your life, I advise you to read this article.

After birth, the baby will long haul life long. But at the initial stage, the crumbs did not even fully form and strengthen the internal organs. The same applies to the sphincter, which is located between the esophagus and the child's small ventricle.

Statistics show that regurgitation in newborns lasts up to six months, after which it disappears (since the baby's body gets used to environment organs get stronger, the child learns to eat properly).

Often, such an effect after feeding should not bother the parent. However, to replenish the baggage of your knowledge and find out why the child often spits up will not be superfluous.

2. Spitting up in a baby is normal.

An attentive mother may notice that the baby is spitting up systematically, usually this happens after each feeding. This process is quite natural for a newborn.

Also, the parent should observe the behavior of her baby and the nature of his regurgitation:

It's natural for a baby to spit up. a large number of milk (about 2 tablespoons). If the volume is much larger - it is worth worrying.
If the newborn continues to gain weight (a daily weight gain of 20 grams is considered the norm), do not sound the alarm. Does the weight stand still? It's worth being concerned.

The regurgitation of the child is different, distinguish only 2 types:

Functional.
Organic.

3. Functional regurgitation and their causes

Functional spitting up is absolutely normal and is rather physiological in nature, which is inherent in every newborn. This type does not cause concern to the baby and is absolutely safe.

However, their reasons are different., the most common of which are:

4. Organic regurgitation is not safe

The nature of such regurgitation is manifested in their abundance. The child suffers from frequent urge to vomit, becomes restless, begins to cry and act up. Mom may notice that the child is sick of milk mixed with bile or even blood. Such signs indicate health problems and are not acceptable in newborns.

There are several common causes of organic regurgitation, let's take a closer look at each of them.

4.1. Damage to the nervous system

Have you noticed that the child vomits heavily even when he did not eat? Is he crying and unable to calm down? Weight decreases, and the activity of the child fades away? The child has problems with the nervous system.

The reasons may be different:

4.2. Infection

Because of infectious disease the child may change behavior. But the most basic signs of the disease that has appeared are:

profuse regurgitation (thick);
incessant vomiting (even during sleep, the baby is sick);
fever;
diarrhea.

All of these symptoms point to possible dehydration. Therefore, it is extremely important to seek medical help as soon as possible.

4.3. Problems with the gastrointestinal tract

Even the smartest mother will not be able to diagnose the baby on her own (if she is not a doctor by profession). Only a doctor can diagnose pathologies associated with the gastrointestinal tract. If you are concerned about the frequency of belching, their abundance and concern for the child, consult your doctor.

The pediatrician Komarovsky spoke a lot about the syndrome of regurgitation. He clearly explains what signs are acceptable, and what symptoms indicate pathology:

5. How to help the baby

As soon as a parent is faced with the problem of spitting up crumbs, a lot of questions arise in the head: what to do, how to help the baby, how to prevent vomiting, where to go, what to give from medicines, etc.

Also, the doctor will prescribe plenty of fluids for the child to restore water balance.

6. Preventive measures

If the newborn burps not because of the disease that entailed such consequences, but for physiological reasons, it is quite possible to prevent them:

set a feeding schedule for your baby and stick to it;
try not to overfeed the newborn;
you should not put the baby to the chest as soon as he starts to sob - this can lead to the development of a reflex (ate - burped, kissed the chest - burped);
do not squeeze the newborn immediately after feeding.

Being close to the baby, try not to be nervous and behave with restraint, children often take over their internal state from their parents (since the child's connection with mom and dad is quite strong).

And remember, mothers, the health of your baby is primarily in your hands. A parent is the first to notice any deviations in the well-being of their child. Don't be afraid to call your doctor or just ask your pediatrician for advice - it's always easier to prevent a disease than to cure it.

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The topic of regurgitation in babies is one of the most discussed, most exciting and most difficult for new parents to understand. Firstly, regurgitation in infants is very frightening. inexperienced mom. Secondly, different doctors sometimes express diametrically opposed points of view regarding the cause of regurgitation and methods of dealing with it. Thirdly, even after applying, it would seem, all the advice and recommendations, many parents still fail to solve the problem.

The difficulty also lies in the fact that in reality, only a mother who spends almost all the time with him is able to understand whether there is a problem if a newborn baby burps. A visit to the doctor will be very useful, and sometimes extremely necessary, but it must be admitted that often pediatricians, neurologists and surgeons intimidate parents when everything is actually fine with the child. And the treatment begins, or rather, the mutilation ... The main goal is to prevent this. And regurgitation will pass sooner or later if there are no real violations. How to define it? Let's talk below.

Regurgitation in an infant, in infants, in newborns

Not all babies 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 spit up. By three months, this happens less often, and by about a year (for someone a little earlier, for some a little later) stops completely.

Doctors believe that premature, delayed babies are more likely to spit up prenatal development(IUGR), with excess or underweight at birth, but practice and statistics confirm that this phenomenon is quite common among healthy babies.

It happens that the mother did not observe anything like this in the first child, and the second newborn burps, and often, and sometimes even abundantly, with a fountain. Therefore, this issue can excite even parents with experience.

regurgitation infants- the phenomenon is frequent and, as a rule, quite normal, that is, it has a physiological nature. The reason lies in the imperfection of the structure and work of organs. gastrointestinal tract and think tanks:

the newborn does not have a lower esophageal sphincter (an elastic muscle ring that contracts after eating and holds it in the stomach). And therefore, it is worth putting the baby after feeding, as the contents of the stomach pour out;
the baby's esophagus is short;
Most of the time the baby spends in a horizontal position. In view of the previous reasons, the contents of the stomach pour out of it, as if from a vessel laid horizontally;
the stomach of the crumbs is small and spherical, which is also the reason for poor retention of food in it;
the centers of the brain responsible for food intake are also still imperfect; the baby eats more than he needs, and therefore the excess of food taken is excreted through regurgitation;
the peristalsis of the newborn is also not very active, the movement of food down the esophagus is slow - and part of it can “poured out” back;
many newborns swallow air while feeding. Air bubbles rise up, 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 spit up. As the organs and systems of the baby develop, regurgitation will normally gradually disappear. It is for this reason that regurgitation does not occur in healthy adults - this is an exclusively infantile feature.

Spitting up after breastfeeding

Typically, regurgitation occurs during, immediately after, or a short time after feeding, that is, it is directly related to the infant's food intake. And given the reasons described above, it becomes clear why.
If regurgitation has a physiological cause and is not associated with pathology, disorders in the health of the child, then the baby does not experience any discomfort. He can burp and smile, because not only does he not experience discomfort, but sometimes he even feels relief after he burps air or an extra portion of food, which creates pressure inside the stomach and a feeling of fullness from the inside.

If the child, after regurgitation, cries angrily, and especially if he wriggles and screams piercingly, then the problem should be addressed to pediatrician: most likely, there are some violations, in particular, this indicates irritation of the esophagus by gastric juice.

Regurgitation in newborns with cottage cheese

Regurgitation is the ejection of a portion of the contents of the esophagus or stomach of the child in an undigested or partially digested form (slightly curdled). The more time passes after feeding, the more curdled the consistency of the milk burped by the child. From time to time, a newborn may spit up cottage cheese, but if this happens quite often or constantly, between feedings, and not immediately after them, then it is worth consulting with a pediatrician or surgeon. Surely they will confirm that this may be a variant of the norm, but it is better to play it safe.

Newborn spitting up a fountain

Discussing this question, it is important to understand that there is a difference between regurgitation and vomiting - both in manifestations, and in causes, and in the tactics of actions on the part of parents.

Regurgitation usually occurs shortly after feeding and is infrequent, in small amounts. But it also happens that a newborn burps a lot and profusely.

Vomiting can occur regardless of feeding, and be repeated over and over again, which does not occur with regurgitation. Also, when spitting up, unlike vomiting, the child usually feels good and is calm.

If the child has burped up everything he has eaten, then do not feed him immediately. Offer a breast or bottle only when he asks. In the meantime, if the baby does not require food, let the digestive system rest a bit.

If the contents of the stomach are pushed out sharply, in a fountain, high and for a long distance, then the most likely cause of this phenomenon was the spasm of the pylorus. In some cases, this is acceptable, but if the vomiting of the fountain is repeated often, then medical advice is required.

spitting up yellow

In addition to the fact that vomiting is always profuse (it seems to the mother that the child is spitting up in a fountain), it can also be yellow color, 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 a newborn, then the doctor should be told about it: most likely, a consultation and examination by a narrow specialist - a surgeon or a gastroenterologist - will be needed. Possibly gastroesophageal reflux.

IMPORTANT: brown or green regurgitation can be a sign of intestinal obstruction and requires immediate hospitalization!

Abundant regurgitation in newborns through the nose

Frequent, profuse regurgitation in newborns should also be a reason to contact a pediatrician or surgeon. Although in some cases even such manifestations are not dangerous if the child feels well and there is a positive trend in weight gain.

It happens that with abundant regurgitation, fluid is released even through the nostrils. Many mothers are frightened when a child burps through the nose, but if such cases are not often repeated and the baby behaves calmly, then you should not 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 do not remain clogged, if necessary, you can use a nasal aspirator.

Be prepared for the fact that the baby may be afraid of the delay in breathing, which occurs with abundant regurgitation through the nostrils: he may start to cry. This is normal - calm the baby, stroke her.

The rate of regurgitation in newborns

Various specialists are trying to establish certain norms that parents could be guided by if they infant spits up. There are, for example, tables that indicate the norms of regurgitation in newborns. On average, for such a norm, it is proposed to take the volume of regurgitated no more than a fifth of the portion eaten and the frequency of such episodes no more than 5 per day.

But in practice, it is not always possible to be guided by these norms, because it is actually almost impossible to measure how much a child has burped in grams. In addition, it matters how much he ate at the same time and how he behaves and feels.

We recommend focusing on such norms of spitting up in infants: if the baby does not spit up very much and does not express obvious anxiety, then most likely everything is fine. Not very much - it is no more than 10 ml. To see how it looks in reality, pour 2 tablespoons of liquid onto the diaper. If your newborn is regularly spitting up more, you may need to see a doctor.

However, the most important role in this situation, the dynamics of weight gain plays. Even if your newborn spits up after each feeding, but does not scream, does not cry, and most importantly, gains weight, 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, it was about physiological reasons, due to the anatomical and functional features of the body of a newborn child. Let's recap them briefly:

swallowing air during feeding; overeating;

muscle weakness, that is, poor contraction of the esophageal sphincter and slow movement of food through the esophagus;

enzymatic immaturity;

anatomical features of the stomach of a newborn child;

a 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 that are part of the milk formula).

Episodic regurgitation also occurs during teething.

There is another reason why a child can spit up - this is the lack of enzymes necessary for digesting food. They usually begin to develop quite quickly in required quantity a few weeks after giving 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 disorders in the functioning of the gastrointestinal tract or in the work of the central nervous system. Among pathological causes doctors distinguish the following:

congenital anomalies of the digestive tract;

malformations and functioning of the organs 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 disorders metabolic processes- in extremely rare cases.

Such conditions require an appeal to narrow children's specialists - a surgeon or a neurologist. Intestinal colic, excessive gas formation can also accompany regurgitation in infants.

Newborn spitting up: what to do?

If the cause of regurgitation in a newborn child is pathological disorders, then, depending on the diagnosis, medical treatment is carried out. In rare cases, surgical correction is required.

But most often, which is confirmed by reviews, forums, medical and parental practice, no serious reasons regurgitation is not. Sometimes it seems to parents that the child is spitting up a lot, profusely, very often, but in reality there are no violations 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 by itself, 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 appear 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 parenting experience confirms that the cause of regurgitation in infants is most often overfeeding. Experiment with it. When overfeeding, the child often spits up immediately after feeding with uncurdled or partially curdled milk.

If the child hangs on his chest all the time, do not offer him another breast every time: let him suck everything out of only one breast to the end, and only after a while, when he is definitely hungry, he proceeds to the other. Firstly, in this way he will suck out the back, the most valuable milk, which, among other things, does not cause disturbances and problems with the intestines and stomach. Secondly, if the baby has already eaten, but has not yet satisfied the need to suck on the breast, then this technique will help to avoid overeating.

With mixed and artificial feeding try giving your baby a few milliliters less formula than usual, or change the number of feedings - and watch for a reaction. Usually, this simple formula is used to determine how much at a time a formula-fed baby should eat:

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 swallowing air. Attach the baby to the breast correctly and make sure that he captures not only the nipple, but also the areola. Try not to feed your baby while crying, because he will swallow air. Interrupt feeding sessions by lifting the baby vertically shortly after the start of feeding, because it is in the first minutes that he eats the most greedily and swallows most of the air. This will contribute to the release of air bubbles that sink most deeply. After belching, continue to feed, and after a while, the break can be repeated again. Among other things, such a tactic can serve as a prevention of overeating, because satiety signals arrive at the centers of the brain late, and intermittently understand faster that ate.

When feeding from a bottle, it is important to choose the right nipple (with an appropriately sized hole) and hold the bottle in such a position that the pacifier is completely filled with formula - this way air will not enter the baby's mouth and stomach. Many mothers like special anti-colic bottles.

It is necessary to choose a mixture to which the gastrointestinal tract of the crumbs will react calmly, that is, if he starts spitting up from the new mixture, you need to change it. Talk to your pediatrician, it may be worth trying an anti-regurgitation (against spitting up) 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 mixture you use with corn, rice or potato starch at a ratio of 1 tablespoon thickener per 60 ml ready mix or breast milk.

The discharge of air is facilitated by wearing a newborn in an upright position every time after feeding for 10-20 minutes (or until the air leaves with a burp): in a column, on the shoulder, in other positions convenient for mom and baby. Before feeding, the baby should be laid out on the tummy, massage the tummy, stroking it with the palm of your hand clockwise.

Keep in mind that difficult nasal breathing forces the baby to breathe more through the mouth, including during feeding. For this reason, he, too, can swallow air and spit up. In order to avoid such troubles, it is necessary to maintain an optimal microclimate in the children's room (with an air temperature not higher than 22 ° C and a humidity of 50-70%), preventing the nasal mucus from drying out. If crusts have formed in the nose of the newborn, then they should be removed before feeding.

If the child spits up every time you just put him in the crib, then raise its headboard by 5-10 cm (for example, by placing a stand under the legs). By the way, parents often argue that if after feeding the baby is not touched (not picked up and not carried in a column), then he does not spit up. But you need to make sure that the head of the crumbs is turned to the side, because he can burp the air swallowed during feeding and choke.

Try not to squeeze the baby's stomach area: do not fasten the diaper tightly, swaddle loosely, do not use pants with an elastic band. Keep your baby calm after feeding - do not change clothes, do not bathe, do not disturb him. The baby should be fed in such a position that the head is above the level of the legs. It is also important to establish regular emptying of the baby's intestines.

Of course, a favorable psychological atmosphere in the family, including during childbearing, warns hyperexcitability nervous system in a baby and reduces the likelihood of regurgitation in infancy. factor increased risk nervous excitability and muscular systems the newborn is also passive smoking: this factor should be ruled out in any case!

Spitting up 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, and the situation seems serious to us. It happens the other way around: the child has obvious disorders of the gastrointestinal tract or central nervous system, but the mother prefers to think that everything is normal. How to understand that you need to see a doctor:

the child spits up the entire volume 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 spit up more than a fifth of the entire serving eaten more than five times a day;

the child spits up a fountain after each feeding;

along with abundant or frequent regurgitation, other signs of the disease appeared - fever, diarrhea, etc .;

in combination with frequent or profuse regurgitation showing signs of dehydration.

Otherwise, the recommendations set out in this article on what to do if an infant spit up can significantly reduce the episodic spitting up, and often, when overfeeding is eliminated, completely eliminate this problem. But once again we want to emphasize that if the baby feels good, 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 up a little, and his systems and organs will fully mature.

Especially for - Ekaterina Vlasenko

regurgitation - passive throwing of small amounts of food from the stomach into the esophagus, pharynx and oral cavity, in combination with the discharge of air, is observed mainly in infants immediately or shortly after feeding with uncurdled or partially curdled milk. These phenomena can be in perfectly healthy children (but not often, and the volume of regurgitated contents is small - up to 3 ml). According to statistics, up to 67% of children aged 4 months spit up at least once a day, in 23% of cases spitting up is considered by parents as a reason for "worry". In most cases, regurgitation can resolve on its own within the first year of life, but in some cases, serious therapy may be required. In addition, against the background of long-term regurgitation, secondary disorders can form, primarily inflammatory changes in the esophagus. Therefore, it is always desirable to clarify the cause of regurgitation.

Features of the child's body

Anatomical and physiological features of the structure of the upper sections digestive tract in newborns (spherical shape of the stomach and its small volume, delayed emptying, relative weakness of the lower esophageal sphincter (LES) - a circular muscle that closes after passing food from the esophagus to the stomach and does not allow gastric contents to be thrown back into the esophagus, immaturity of the regulation of the food promotion system along the gastrointestinal tract (GIT), immaturity of enzymes) predispose to the development of regurgitation. In newborns, sucking movements occur in short series of 3-5 suckings, creating negative pressure in the oral cavity, and contractions of the esophagus (peristaltic wave) during swallowing appear inconsistently: either before sucking, or after it, and often it is incomplete along its length. At the same time, in newborns, in response to the peristaltic wave, a sharp contraction of the fundus of the stomach is observed, which leads to an increase in intragastric pressure and may cause the return of food and air into the esophagus and the occurrence of regurgitation. In addition, due to the fact that during the act of sucking a certain amount of air enters the stomach, the baby has a feeling of false saturation and he stops sucking. If this situation is repeated frequently, it can lead to malnutrition and developmental delay. child.

Reasons for regurgitation

Spitting up often occurs in children with intrauterine growth retardation (IUGR), and in premature babies. Along with the above anatomical and functional features of the gastrointestinal tract, there is also a slow formation (maturation) of the process of coordinated sucking, swallowing and breathing - it lasts about 6-8 weeks. The intensity of regurgitation can be different. However, as the body matures, regurgitation disappears. The cause of spitting up may be overfeeding(increase in the frequency or volume of feeding), especially in actively suckling newborns with a sufficient amount of milk from the mother. With artificial or mixed feeding(breastfeeding + formula supplementation) overfeeding is possible due to a change in the nature of nutrition (replacement of breast milk with artificial formula or frequent unmotivated replacement of one adapted mixture another). Regurgitation during overfeeding occurs immediately or shortly after feeding with uncured or partially curdled milk, in the amount of 5-10 ml. General state, the behavior of the baby does not suffer in any way, there is a good appetite, normal stool, normal weight gain. Aerophagia(swallowing a large amount of air at the time of feeding) happens: in excitable, greedily sucking babies from 2-3 weeks of life in the absence or small amount of milk from the mother; When child does not capture the areola along with the nipple or incorrectly captures with a flat, inverted nipple in the mother; with a large hole in the nipple of the bottle, the horizontal position of the bottle, when the nipple is not completely filled with milk; with a general muscle weakness due to the immaturity of the organism. More often, aerophagia develops in newborns with low or very large body weight at birth. Children with aerophagia are often restless after feeding, and there is a bulging of the anterior abdominal wall in the stomach area. After 5-10 minutes after feeding, regurgitation of unchanged milk is observed with a loud sound of outgoing air. Spitting up in a newborn may occur when flatulence(bloating), intestinal colic(painful bowel spasms) constipation. This increases the pressure in abdominal cavity, the movement of food through the gastrointestinal tract is disturbed. The intensity of regurgitation is also possible different. Gastrointestinal malformations, such as anomalies of the esophagus, can also lead to regurgitation and vomiting ( chalazia - weakness (insufficiency) of the lower esophageal sphincter; achalasia - narrowing at the junction of the esophagus to the stomach), anomaly of the stomach ( pyloric stenosis- narrowing at the junction of the stomach into the duodenum, preventing gastric emptying), anomaly of the diaphragm ( diaphragmatic hernia - moving part of the abdominal organs into the chest cavity), etc. Fortunately, in most children, regurgitation is a non-pathological condition that spontaneously resolves by 12-18 months of a baby's life. The intensity of regurgitation can be approximately estimated on a five-point scale (Table 1). Intense regurgitation, large volume, after each feeding, disturbing child leading to weight loss, require a visit to the doctor and a thorough examination child to exclude congenital pathology. Table 1

Estimation of the intensity of regurgitation

*Regurgitation of intensity 3 or more also always requires a visit to a doctor.

What to do?

To find the cause of spitting up and get help to kid you should contact your pediatrician, it is possible that baby it may be necessary to consult a pediatric surgeon if a congenital pathology is detected or in the absence of the effect of drug treatment and surgery. In other cases, the need for treatment is determined by the condition child and his weight gain. The question of where to conduct the examination, in a clinic or in a hospital, is decided individually, depending on the severity of the process, age child and capabilities of the diagnostic institution. Of the instrumental methods, an x-ray examination of the upper gastrointestinal tract (esophagus, stomach) can be performed using a contrast agent and esophagogastroscopy (examination of the upper gastrointestinal tract using an optical device that looks like a rubber hose, at one end of which a miniature video camera is placed).

Treatment

As recommended working group The European Society of Gastroenterology and Nutrition treatment of regurgitation is carried out in several successive stages: treatment by position, clinical nutrition, drug therapy; surgical methods treatment. Position treatment. During feeding child, suffering from regurgitation, it is important to create a position in which top part the torso would be raised at an angle of 45-60º to the horizontal plane. For example, the baby can be put on a large, not very soft pillow. After feeding, it is important to keep child in an upright position for at least 20-30 minutes, to ensure the unhindered exit of swallowed air. Tight swaddling is not recommended, the abdomen should not be squeezed, instead of sliders with an elastic band, it is better to use sliders fastened on the shoulders of crumbs or overalls. Sleep to kid should be on a small pillow made of 1-2 folded diapers, or the legs of the head of the crib should be raised by 5-10 cm. During sleep, in order to reduce the intensity of the reflux of gastric contents into the esophagus, it is preferable to lay child on the stomach or right side. Organization medical nutrition primarily includes more frequent feedings child smaller than usual portions. At the same time, the daily amount of food should not decrease. The number of feedings can be increased by 1-2 in excess of the norm. The second component is the application medicinal mixtures. Medicinal products that prevent regurgitation (regurgitation) are labeled with the letters AR (from the English. Antiregurgitation). Of great importance is the protein composition of such a mixture, namely, the ratio of whey proteins to casein (complex milk protein). IN mother's milk this ratio is 60-70:40-30, in cow's milk- 20:80, in most adapted milk mixtures - 60:40. An increase in the proportion of casein in the diet prevents regurgitation, because. this protein is easily curdled in the stomach under the influence of hydrochloric acid, forming first flakes, then a thick mass that prevents regurgitation. Another approach is to introduce a thickener into the mixture. As such, rice, corn or potato starch, as well as gum - gluten from the seeds of the carob tree, which grows in the Mediterranean countries. Gum thickens under the action of the acidic contents of the stomach, but unlike starch and casein flakes, it is not digested by the enzymes of the gastrointestinal tract. As a result, the thick consistency of the gastric and, in the future, intestinal contents is maintained for a longer time. In addition, gum stimulates peristalsis, helping to move food from the stomach to the intestines more quickly. table 2

Specialized milk formulas that prevent regurgitation

At breastfeeding therapeutic mixtures can be added to the baby's diet before breastfeeding. In the absence of the effect of the above measures, the issue of drug treatment . It includes the appointment of prokinetics - drugs that improve the contractile function of the intestine. For this purpose, it is used MOTILIUM, COORDINAX. An antispasmodic drug can be used to eliminate regurgitation and intestinal spasms. RIABAL. Surgical treatment is performed for severe congenital anomalies gastrointestinal tract (for example, pyloric stenosis - a narrowing at the junction of the stomach into the duodenum, preventing gastric emptying, etc.), which caused regurgitation.

Prevention

Prevention of regurgitation is a complex and multifaceted problem. Favorably flowing pregnancy and childbirth, a friendly, calm atmosphere in the house - all this reduces the risk of regurgitation, as well as many other diseases and pathological conditions at child in the first year of life. If the baby is breastfed, make sure that during feeding child captured both the nipple and the areola, then the likelihood that the baby will swallow air will be less. If you are bottle feeding your baby, make sure that the nipple is completely filled with milk and there is no air in it. The hole in the nipple should not be large. You can feed your baby intermittently, for example, for five minutes, then turn him to face you and hold him in an upright position. After a few minutes, continue feeding. Press after feeding child with your tummy towards you and hold it in an upright position for 15-20 minutes to let the air out. Before each feeding, lay out child on the stomach, stroking the tummy around the navel with the palm of your hand in a clockwise direction, all this facilitates the passage of gases and reduces the likelihood of spitting up after eating. Cleanse the baby's nasal cavity from mucus and crusts in a timely manner, then when feeding, he will not experience difficulties with nasal breathing and a lot of air will not enter the stomach. From the same positions, it is important to ensure that when feeding child did not rest his nose on his chest. It is necessary to remember about the pathological effect of passive smoking on the tone of the muscles of the esophagus and stomach in the chest. child. Smoking in the immediate environment of the baby is strictly prohibited.

Children, compared with adults, have a number of features that at an older age can be regarded as a pathology. So, these features include increased heart rate, high frequency of respiratory movements, enuresis and regurgitation. When regurgitation occurs, the reverse movement (reflux) of the contents of the stomach into the oral cavity occurs, which, with large volumes of food, resembles vomiting. As a rule, reflux is widely presented before the age of 1 year and, in most cases, is regarded as a physiological phenomenon. In addition, the prevalence of regurgitation after eating in this period has high performance and ranges from 60 to 70% in the first 4 months and 50% in the period from 4 to 12 months.

Regurgitation, or reflux, is the reflux of gastric contents through the esophagus into the oral cavity. This phenomenon should be distinguished from vomiting, in which the activation of the vomiting center occurs with the development of spasm of the pylorus of the stomach and active contraction of the anterior abdominal wall in order to increase intra-abdominal pressure.

Generally, reflux is common among people of all ages. Symptoms of regurgitation can vary greatly and can be both practically invisible to a person and lead to unpleasant consequences. In such situations, they speak of esophageal reflux disease.

Spitting up in children

Regurgitation in children and adults occurs when smooth muscles relax to prevent stomach contents from entering the esophagus (lower esophageal sphincter). The movement of the contents of the stomach in a proximal direction in this situation is a consequence of the fact that the pressure in the stomach is much higher than the pressure in the thoracic esophagus and throat. Outwardly, regurgitation in a baby differs from vomiting in a lesser intensity and severity of this phenomenon.

Up to 6-7 months, regurgitation in children, in most cases, is normal having a physiological basis. So, there are a number of factors that increase the likelihood of regurgitation of the contents of the stomach. In most cases, the causes of regurgitation after feeding in newborns and preschool children are associated with the characteristics of the anatomical structure and life of the child (an abundance of liquid foods and a large amount of time spent in a horizontal position).

According to an international panel of experts, also called the Pediatric Rome Working Team, regurgitation in a baby is physiological when the following criteria are met:

the duration of regurgitation is at least 3 weeks;
occur at least twice a day in infancy;
observed during the first year of life;
do not lead to developmental disorders.

Regurgitation in children normally should not be accompanied by:

urge to vomit or stool;
bleeding from the digestive tract;
refusal to eat;
breathing problems.

Regurgitation in newborns (that is, during the first month of life) is observed somewhat less frequently than in children over the age of 4 months (which is the peak of the incidence). As a rule, the main causes of regurgitation in newborns after feeding are:

length of the lower esophageal sphincter;
contractile capabilities of the lower esophageal sphincter;
delayed gastric emptying.

In addition to anatomical and functional prerequisites, regurgitation in newborns is influenced by a number of factors related to the characteristics of life. So, the causes of regurgitation after feeding in newborns are often presented:

overfeeding a child;
a large amount of air swallowed during feeding;
prolonged crying or severe coughing.

Healthy newborns normally gain weight quickly. In this regard, if the regurgitation of milk in newborns is physiological, there is a correspondence between body weight and developmental level to normal indicators. At the same time, a child after pathological regurgitation in most cases has problems with weight gain and breathing. Also, esophagitis often develops due to the throwing of aggressive stomach contents.

The division of reflux into physiological and pathological is associated with the determination of indications for conservative or surgical treatment. As a rule, regurgitation in newborns and infants in most cases resolves on its own within 18 months after birth and does not bring significant discomfort.

Spitting up in babies

Directly during feeding, regurgitation of milk is not observed immediately, but after a certain period of time (15-60 minutes). It should also be noted that the rate of regurgitation is relatively low, and therefore, if vomiting occurs with a “fountain”, you should be alert and consult a specialist.

As a rule, by the age of 9 months, regurgitation in most infants goes away on its own. At the same time, it is necessary to suspect that something was wrong with the sudden occurrence or increase in regurgitation. This may be due to both a change in the diet, and pathological processes in the digestive and nervous systems, as well as severe infectious diseases.

Baby's spitting up preschool age may not be noticed by parents, as they are often masked by symptoms such as coughing and refusal to eat. As a rule, regurgitation in children over 12 months of age is much less common than in older children. early age. In this regard, in the presence of gastroesophageal reflux, regardless of the time of its occurrence, it is recommended to conduct an examination, including:

esophagoscopy;
esophageal pH - metry;
contrast (with barium) radiography.

When conducting surveys, they also pay attention to:

length of the esophagus in the abdominal cavity;
the value of the angle of His;
condition of the lower esophageal sphincter;
esophageal opening of the diaphragm and the presence of hernias in this area.

When identifying pathological changes in most cases, a change in diet is required, as well as conservative or surgical treatment.

Regurgitation in older children and adolescents

School-age children and teenagers can also have stomach acid reflux. As a rule, they experience discomfort when even small amounts of gastric contents enter the oral cavity. Also, often frequent regurgitation in a child and adults is accompanied by heartburn, which occurs due to the effect of hydrochloric acid on the esophageal mucosa. Sometimes the following unpleasant symptoms appear:

pain or discomfort in the chest;
sensation of food moving to the throat;
bad taste in the mouth.

A number of studies conducted by foreign scientists have revealed a relationship between asthma and gastroesophageal reflux disease. As a rule, common symptoms in children with these diseases are shortness of breath and wheezing. Thus, according to statistics, 45-65% of children suffering from asthma were diagnosed with gastroesophageal reflux disease.

It is assumed that this connection is based on microaspiration of gastric contents (entering the bronchial tree). However, other symptoms associated with a job change digestive system, do not always appear. If a patient has gastroesophageal reflux disease and asthma, often the therapy of the latter does not allow success.

Normally, regurgitation is not observed in healthy adults. This is due to the development of the digestive system. At the same time, since the normal activity of the gastrointestinal tract is the result of the joint work of smooth muscles and the nervous system, regurgitation occurs either when their interaction is disturbed, or when the digestive tube is obstructed (Barrett's esophagus, pylorospasm or pyloric stenosis).

Often, regurgitation in adults is combined with belching (when air from the stomach prevails instead of liquid gastric contents). As a rule, this is due to overeating, the use of gas-containing drinks, as well as a violation of the rules of eating.

Regurgitation in adults is important to distinguish from vomiting (as a rule, the most significant sign is the absence of active contractions of the abdominal wall). Obesity is a predisposing factor for the development of belching or regurgitation, as this increases pressure in the abdominal cavity.

Regurgitation in the elderly

Regurgitation in the elderly is normally very rare. As a rule, this unpleasant symptom can be one of the manifestations of the following diseases:

stroke
gastroparesis;
multiple sclerosis;
muscular dystrophy;
Parkinson's disease.

Also to one of possible causes regurgitation in the elderly include oncological processes with damage to the esophagus. As a rule, both a violation of the evacuation of liquid food from the esophagus (with paradoxical dysphagia) and a violation of the lower esophageal sphincter lead to regurgitation.

Also, regurgitation in older people is often caused by taking medications that affect the digestive tract through the autonomic nervous system.

Depending on the cause of regurgitation, there are:

physiological regurgitation (does not affect the quality of life);
pathological regurgitation (there are various complications associated with the reflux of gastric contents in the proximal direction);
secondary gastroesophageal reflux (when the reflux of the contents of the stomach in the proximal direction develops against the background of an already existing pathological process).

The causes of regurgitation in adults are usually presented:

taking medications (diazepam, theophylline and methylxanthines);
smoking;
the use of alcoholic beverages;
improper diet (overeating, eating food immediately before bedtime, as well as taking a horizontal position shortly after eating);
food allergies;
a change in the motility of the digestive tract (slow gastric emptying);
obesity (one of the main risk factors in the adult population);
diseases of the gastrointestinal tract (cholelithiasis and lead to gastroduodenitis, which is accompanied by a violation of the evacuation of gastric contents in the distal direction).

Does regurgitation depend on milk

In most cases, regurgitation of milk is noted during feeding. At the same time, it can be either unchanged or in the form of curdled milk and have a sour smell. At the same time, even if it seems that the predominant amount of regurgitated food is represented by milk, this is not so. As a rule, the liquid during regurgitation consists mainly of saliva and gastric juice, with only a small amount of milk.

At the same time, the question arises whether the regurgitation of milk during feeding depends on its qualities. In a study conducted by American scientists, it was found that the likelihood of developing regurgitation largely depends on the amount (with excessive use) and the form of (liquid) food. At the same time, the direct quality of food has a much smaller effect with regular regurgitation. However, if frequent spitting up in a child began to be observed after switching to artificial nutrition, you should consult a specialist about changing the composition, consistency and volume. nutrient mixtures. The exception is children with high risk atopy, as they may allergic reaction for milk proteins. At the same time, in addition to abundant and frequent regurgitation, diarrhea is noted.

One of the most common causes of regurgitation in newborns after feeding is a violation of the basic rules of nutrition. So, quite often the wrong feeding technique leads to incomplete capture of the nipple and swallowing air along with milk. In addition, excess milk volume, as well as turning and rocking the baby immediately after feeding, leads to spitting up.

In this regard, in order to prevent regurgitation when feeding babies

Instead, give your baby less to drink during feedings, but feed him or her more often. And don't move your baby about too vigorously after feeding.

Structural features as a cause of regurgitation in newborns after feeding

Anatomical factors that can be regarded as possible causes of regurgitation in newborns and older people include:

a large angle of His, which is formed by the axes of the esophagus and stomach (blunt in newborns, becomes more acute with age and increases the efficiency of the lower esophageal sphincter);
hiatal hernia (in this case, it is possible to shift the lower esophageal sphincter towards the chest cavity, where more low level pressure contributes to the development of reflux, but the presence of a hernia is not always accompanied by regurgitation);
violation of the outflow of gastric contents (gastric paresis, pyloric stenosis).

Other possible causes of regurgitation in newborns include:

supine position;
neurological pathology (in disabled children, including cerebral palsy, Down syndrome, as well as various processes accompanied by developmental delay).
transient decrease in the tone of the lower esophageal sphincter, which is currently considered the main cause of gastroesophageal reflux in children (in 94% of cases);

Is abundant, frequent regurgitation a fountain dangerous?

Frequent and profuse regurgitation with a fountain is primarily dangerous for the health of the child due to the high likelihood of developing dehydration. So, with the loss of a significant amount of fluid, dryness of the mucous membranes and skin, a grayish tint are noted. skin, increased viscosity of saliva, lethargy and drowsiness, increased heart rate, decreased amount of urine. Also sometimes there is increased anxiety and crying without tears.

Due to the high likelihood of developing dehydration, if a child has frequent and profuse regurgitation with a fountain, you should immediately be alert and seek help from a doctor. As a rule, compensation for dehydration in children is very difficult, so the timely provision of medical care is of great importance.

The most common causes of regurgitation in a fountain in newborns are lesions of the nervous system, which include:

perinatal encephalopathy;
hydrocephalus;
birth trauma;
prematurity.

At the same time, frequent and abundant regurgitation is observed after each attempt to feed the child. As a rule, regurgitation occurs more often than 6 times a day.

Also, the causes of regurgitation of the fountain in newborns after feeding include severe infectious processes, accompanied by severe intoxication. So, poisoning, meningitis, sepsis and other infectious diseases most often lead to regurgitation.

Despite the fact that, as a rule, during the first 12 months, physiological regurgitation is observed most often, the timing of its occurrence is not associated with age. So, if regurgitation is observed in more late age and, at the same time, it does not manifest itself in any unpleasant symptoms, it also remains physiological. However, this is quite rare and, as a rule, after 1 year of life, physiological regurgitation practically does not occur. Gastroesophageal reflux disease is much more common at this age.

Diagnosis of regurgitation

Frequent regurgitation in infants, as well as older children and adults, is an indication for an instrumental examination.

As a rule, to identify the cause of regurgitation, they carry out:

contrast (since the study is carried out for a short period of time, there is a high probability of missing pathological reflux, but this method of examination has importance to exclude diaphragmatic hernia, stricture of the esophagus, pyloric stenosis, duodenal ulcer, malrotation, volvulus and other possible causes of reflux);
pH-metry is regarded by many experts as the “gold standard” and, by determining the acidity of the environment in the esophagus, can make it possible to indirectly judge the severity of reflux (direct indications for this research method are poor response to treatment, preparation for surgery, unexplained lesions respiratory tract);
double control of pH in alkaline reflux (the study is carried out if there is a suspicion of continuous intake of duodenal contents into the stomach, which leads to an increase in pH inside it and makes it difficult to detect gastroesophageal reflux);
esophageal manometry (allows you to measure pressure in the lower part of the esophagus, however, the data obtained do not always allow diagnosing the presence of reflux with a high degree of probability, although they facilitate the identification of functional disorders of this part of the digestive system);
esophagoscopy and biopsy of the esophagus (is one of the most useful methods of examination in the development of esophagitis).

Depending on what causes of regurgitation are identified, treatment can also vary significantly.

Regurgitation in newborns after feeding

In most cases, regurgitation in newborns and infants after feeding can be cured by changing lifestyle and diet. As a rule, it is not possible to radically change the diet, since liquid food predominates in the diet of children, and at an early age they are not able to stand upright on their own.

At the same time, treat physiological regurgitation in newborns and infants after feeding in the absence of unpleasant symptoms using medication is not recommended. As a rule, this is associated with impaired absorption of calcium and iron, as well as an increased risk of intestinal and respiratory infections.

Thus, it can be said that in the absence of an obvious pathology, as well as developmental disorders, the treatment of regurgitation in newborns after feeding is expectant.

As a rule, regurgitation after feeding infants is quite common and occurs slightly more often than in newborns. When complaints of regurgitation appear, attention is drawn to their frequency and severity of concomitant symptoms.

First of all, before appointing medications, regurgitation after feeding infants try to treat dietary modification. If this does not help, they proceed to taking medications. With the ineffectiveness of conservative treatment, depending on the specific clinical situation, a decision is made to conduct an operative intervention.

As a rule, if frequent regurgitation in infants causes the development of respiratory disorders (which is confirmed by instrumental examination data), a fundoplication is possible. With this surgical intervention, the bottom of the stomach wraps the esophagus on both sides, which creates a kind of functional cuff that prevents the gastric contents from being thrown into the esophagus.

Currently surgical interventions are performed using laparoscopic access, which has significantly reduced the number of postoperative complications and the amount of time spent in the hospital.

Frequent spitting up in an older child

Frequent regurgitation in a child and adults in the absence of the effect of changing the diet is treated with the following groups of drugs:

alginate compounds (they have a symptomatic effect due to the formation of a viscous gel when interacting with hydrochloric acid, but their long-term use is not recommended, since components that have an adverse systemic effect are formed);
histamine H2 receptor blockers (widely used to manage reflux symptoms and are the most effective and, at the same time, safe drugs);
proton pump inhibitors (reduce the total amount of regurgitated stomach contents and facilitate general symptoms by reducing the severity of esophagitis);
prokinetic drugs (increase the tone of the lower esophageal sphincter, improve esophageal clearance and facilitate gastric emptying);
buffer agents that reduce inflammatory process in the mucous membrane with local binding.

Frequent regurgitation in a child of preschool, school age and older persons age group cause surgery when:

inefficiency of optimal drug therapy;
dependence on long-term drug therapy;
the appearance of unpleasant symptoms (asthma, cough, chest pain and recurrent pulmonary aspiration of refluxate);
the development of a number of complications from the digestive system (Barrett's esophagus or peptic stricture).

Regurgitation in older people, as in children, is carried out in the following sequence:

lifestyle modification (eating changes and weight loss);
conservative treatment;
operation.

Often in adults and the elderly, fundoplication is performed in combination with pyloroplasty in violation of the evacuation of gastric contents as a result of obstruction of the antrum of the stomach. In rare situations, it is necessary to resort to the creation of a gastrostomy (as a rule, with severe lesions of the nervous system). Nasointestinal sounding is used much more often.

What to do if the child hiccups after spitting up

Quite often the child after regurgitation begins to hiccup. This phenomenon is based on a direct or indirect effect on the diaphragmatic muscle. This is accompanied by non-specific respiratory dysfunction due to convulsive contractions of the diaphragm.

As a rule, if a child begins to hiccup after spitting up, this is most likely due to the rapid filling of the stomach with food. Swallowing air also increases the likelihood of hiccups. In this case, the stretched stomach in the horizontal position of the child begins to put pressure on the diaphragm. The cause of hiccups can also be a hernia of the diaphragmatic opening, in which irritation of the phrenic nerve can occur.

In this regard, in order for the child to hiccup less after spitting up, it is recommended to give him a vertical position and, if he eats, immediately stop feeding. If the hiccups continue for long period time, is debilitating in nature and is not associated with eating, it is recommended to show the child to a specialist. The development of hiccups may be associated with damage to the central nervous system.

Prevention of regurgitation before and after feeding infants in most cases allows you to get rid of this unpleasant phenomenon.

So, the prevention of regurgitation before and during feeding includes:

feeding the child more often, but with smaller amounts of food;
preventing the development of allergic reactions by eliminating eggs, dairy products and beef from the diet;
changing the nipple (size mismatch can lead to swallowing excess air).

An important step in the prevention of regurgitation after breastfeeding is to give the child vertical position within 20-30 minutes after eating. As a rule, this makes it possible to facilitate the evacuation of the liquid contents of the stomach under the influence of gravity.

Regurgitation is a normal physiological process for newborns, which is associated with the characteristics of the baby's body. It represents the involuntary discharge of breast milk or formula along with air from the stomach into the mouth. This phenomenon is typical for every child in infancy. Regurgitation begins spontaneously and occurs within 15-30 minutes after feeding.

Regurgitation in newborns occurs about three times a day, while the volume should not exceed 5 ml of food taken. In most newborns, they pass 4-7 months after birth, in some they do not end up to a year.

Sometimes babies have profuse regurgitation and regurgitation with a fountain. The reasons for this process are different. It can be ordinary overeating, and digestive disorders, and even a malformation of the gastrointestinal tract. In any case, when spitting up a fountain, you should consult a doctor.

Causes

The main cause of regurgitation is the failure of the digestive tract in infants. In the first months of life, the body of newborns only adapts to new conditions and new food, which leads to various reactions. However, in this case regurgitation should not exceed the above volume norms.

Another common cause is aerophagia, or swallowing air when eating. This is due to improper feeding organization, when the baby does not grasp the nipple or bottle correctly. It is important for a nursing mother to establish feeding, as it is wrong organized process leads to problems. And it's not just spitting up. With such feeding, the child does not receive the necessary amount of breast milk and does not eat up.

Spitting up is characteristic of premature babies with undeveloped sucking reflex, swallowing and breathing. The problem disappears as the body develops and gets used to new conditions.

Violation in the work of digestion, pathology in development internal organs and nervous central system- causes of regurgitation with a fountain, which are combined into one group called dysphagia. Dysphagia manifests itself in various ways:

bloating, increased gas formation and colic in newborns. Increased formation of gases and colic - common occurrence for babies, especially in the first months of life. The reasons still lie in the underdevelopment of digestion. However, if flatulence is observed often, and colic in a baby causes severe pain, you should consult a doctor;
Anomalies in the development of the central nervous system. Typically, this is an increase intracranial pressure. In this case, the problems are not in the work of the digestive organs, and it is necessary to undergo a thorough examination by a neurologist;
Pathology of the development of the digestive organs, including the esophagus and stomach, including intestinal obstruction, stenosis and other diseases;
Digestive disorders - diarrhea or constipation in infants. Indigestion in newborns often appears due to malnutrition of a nursing mother. Many products, especially in the first two or three months of a baby's life, negatively affect well-being.

Regurgitation is caused by overfeeding, eating too much, and feeding too often. Pediatricians advise to feed the child on demand and not force him to eat.

Profuse regurgitation or vomiting?

It is important to distinguish pathology from the norm. Many nursing mothers exaggerate the problem, while others, on the contrary, do not notice developmental disorders. In newborns, it is difficult to distinguish strong regurgitation and vomiting, but these phenomena speak of different problems. let's consider distinctive features these phenomena:

The volume of regurgitation should not exceed 5 ml at a time, vomiting can occur in an unlimited amount;
Regurgitation occurs only once after feeding, vomiting may be repeated;
When spitting up, food comes out original form, with vomiting, the milk is partially digested. Curdled milk or food with a sour smell are signs of vomiting;
When spitting up, the baby's well-being does not worsen. If a child vomits, he often refuses food, sleeps restlessly and feels unwell;
Regurgitation occurs only within half an hour after feeding, vomiting can be at any time;
Only vomiting can go like a fountain!

Thus, regurgitation with a fountain is vomiting. The causes of such an ailment often lie in the malnutrition of a nursing mother, too fatty, spicy or salty foods, poor-quality foods. In addition, newborns often have an allergic reaction, which can manifest itself in the form of vomiting. In this case, a hypoallergenic diet during breastfeeding will help.

If a nursing mother has adjusted the diet and excluded foods that irritate the baby from the menu, and vomiting with a fountain continues, you should urgently consult a doctor. Frequent and profuse vomiting may indicate an abnormal development of the internal organs of the baby.

When to sound the alarm

We offer a table of regurgitation intensity, the readings of which will help a young mother determine the degree of danger of the process.

With an intensity of three points inclusive, it is necessary to consult a doctor and start treatment!

There are other signs that indicate developmental disabilities. First of all, it is a loss or shortage in weight. How to correctly calculate the weight of newborns up to a year, see. Frequent and profuse regurgitation, vomiting with a fountain are accompanied by screaming and crying, violation of the stool, smell from the mouth. Special attention should be reversed if regurgitation continues after a year.

How to help a baby

With signs of pathology, be sure to consult a specialist. Only he will identify the problem and appoint proper treatment. Do not self-medicate, it can only worsen the situation!;
Do not leave the baby lying down when vomiting or spitting up! Take the child upright and hold for about 15 minutes. Do this after every feeding. This will make it easier for the air to escape;
Organize your baby's food. Make sure that the baby captures both the nipple and the areola. Incorrect latch on the nipple causes problems for the mother as well. As a result, there are cracks and abrasions on the nipples, which cause pain and sometimes cause infectious diseases!;
If your baby is formula- or formula-fed, hold the bottle correctly at a 45-degree angle. Do not hold the bottle horizontally! Make sure that the nipple is full, and as little air as possible passes through the hole in the bottle;
Proper nutrition of a nursing mother is the key to good health, normal growth and development. Read more about nutrition while breastfeeding at the link /;
Constant monitoring of the newborn by doctors. Get regular check-ups and check-ups;
Place your baby on your tummy before feeding. Periodically, you can massage the tummy with light stroking movements;
Try to breastfeed only. Breast-feeding will provide the child's body with vitamins and elements necessary for full development and growth. Breast milk strengthen immunity, protect against diseases;

Sometimes, to fix the problem, you need to take medications and special therapeutic mixtures. Medicines and suitable mixture prescribed by a doctor! IN extreme cases if other methods have not had the desired effect, surgical intervention is required.