Spitting Up – Reflux

Is this your child’s symptom?

• Spitting up small amounts of breastmilk or formula. Also called reflux.
• Spitting up 1 or 2 mouthfuls of milk at a time
• No effort or crying
• Normal symptom in half of young babies

Symptoms of Normal Spitting Up

• Smaller amounts often occur with burping (“wet burps”)
• Larger amounts can occur after overfeeding
• Most often seen during or shortly after feedings
• Occurs mainly in children under 1 year of age
• Begins in the first weeks of life
• Caution: normal reflux does not cause any crying

Complications of Spitting Up (GERD)

• Most infants are “happy spitters.” Normal spitting up (normal reflux) occurs in half of babies. It does not cause crying or colic.
• Normal crying occurs in all babies. Frequent crying (called colic) occurs in 15% of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
• If they develop complications, it’s called GERD (gastro-esophageal reflux disease). This occurs in less than 1% of babies.

Symptoms of GERD

GERD problems occur in less than 1% of infants:

• Choking on spit up milk
• Heartburn from acid on lower esophagus. Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort.
• Poor Weight Gain

Cause

• Poor closure of the valve at the upper end of the stomach (weak valve)
• Main trigger: overfeeding of formula or breastmilk
• More than half of all infants have occasional spitting up (“happy spitters”)

Reflux Versus Vomiting: How to Tell

• During the first month of life, newborns with true vomiting need to be seen quickly. The causes of vomiting in this age group can be serious. Therefore, it’s important to tell the difference between reflux and true vomiting.

Reflux

The following suggests reflux (normal spitting up):

• You’ve been told by a doctor your baby has reflux
• Onset early in life (85% by 7 days of life)
• Present for several days or weeks
• No pain or crying during reflux
• No effort with spitting up
• No diarrhea
• Your baby acts hungry, looks well and acts happy.

Vomiting

The following suggests vomiting:

• Uncomfortable during vomiting
• New symptom starting today or yesterday
• Forceful vomiting
• Contains bile (green color)
• Diarrhea is also present or
• Your baby looks or acts sick.

Pyloric Stenosis (Serious Cause)

• This is the most common cause of true vomiting in young babies.
• Onset of vomiting age 2 weeks to 2 months
• Vomiting is forceful. It shoots out of the baby’s mouth. This is called projectile vomiting.
• 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.

When to Call for Spitting Up – Reflux

Call Doctor or Seek Care Now

• Blood in the spit up
• Choked on milk and turned blue or went limp
• Age less than 12 weeks and spitting up changes to vomiting (forceful or projectile)
• Age less than 1 month old and looks or acts abnormal in any way
• 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

• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Chokes a lot on milk
• Poor weight gain
• Frequent crying
• Spitting up is getting worse
• Age more than 12 months old
• Spitting up does not get better with this advice
• You have other questions or concerns

Self Care at Home

• Normal reflux (spitting up) with no problems

Seattle Children’s Urgent Care Locations

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

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Care Advice for Spitting Up (Reflux)

1. What You Should Know About Spitting Up:
   • Spitting up occurs in most infants (50%).
   • Almost always doesn’t cause any pain or crying.
   • Spitting up does not interfere with normal weight gain.
   • Infants with normal reflux do not need any tests or medicines.
   • Reflux improves with age.
   • Here is some care advice that should help.
2. Feed Smaller Amounts:
   • Skip this advice if age less than 1 month or not gaining weight well.
   • Bottlefed Babies. Give smaller amounts per feeding (1 ounce or 30 mL less than you have been). Keep the total feeding time to less than 20 minutes. Reason: Overfeeding or completely filling the stomach always makes spitting up worse.
   • Breastfed Babies. If you have a good milk supply, try nursing on 1 side per feeding. Pump the other side. Switch sides you start on at each feeding.
3. Longer Time Between Feedings:
   • Formula. Wait at least 2½ hours between feedings.
   • Breastmilk. Wait at least 2 hours between feedings.
   • Reason: It takes that long for the stomach to empty itself. Don’t add more milk to a full stomach.
4. Loose Diapers:
   • Do not put the diaper on too tight. It puts added pressure on the stomach.
   • Don’t put pressure on the stomach right after meals.
   • Also, do not play too hard with your baby during this time.
5. Upright Position:
   • After meals, try to hold your baby in the upright (vertical) position.
   • Use a front-pack, backpack, or swing for 30 to 60 minutes after feedings.
   • Decrease the time in a sitting position (such as infant seats).
   • After 6 months of age, a jumpy seat is helpful. The newer ones are stable.
   • During breast or bottle feeds, hold your baby at a slant. Try to keep your baby’s head higher than the stomach.
6. Less Pacifier Time:
   • Frequent sucking on a pacifier can pump the stomach up with swallowed air.
   • So can sucking on a bottle with too small a nipple hole.
   • The formula should drip 1 drop per second when held upside down. If it doesn’t, the nipple hole may be clogged. Clean the nipple better. You can also make the nipple hole slightly bigger.
7. Burping:
   • Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
   • Do it when he pauses and looks around. Don’t interrupt his feeding rhythm in order to burp him.
   • Burp each time for less than a minute. Stop even if no burp occurs. Some babies don’t need to burp.
8. Add Rice Cereal to Formula:
   • If your baby still spits up large amounts, try thickening the formula. Mix it with rice cereal.
   • Start with 1 level teaspoon of rice cereal to each ounce of formula.
9. Acid Blocking Medicines:
   • Prescription medicines that block acid production are not helpful for normal reflux.
   • These medicines also can have side effects.
   • They do not reduce excessive crying from colic.
   • They are only useful for symptoms of heartburn.
10. What to Expect:
    • Reflux gets better with age.
    • After learning to sit well, many babies are better by 7 months of age.
11. Call Your Doctor If:
    • Spitting up changes to vomiting (forceful or projectile)
    • Poor weight gain
    • Your baby does not get better with this advice
    • 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: 06/08/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Is My Baby’s Spit-Up Normal?

Find out why your baby spits up, and why there’s very little cause for concern when it happens.

By Health Promotion Board in collaboration with Dr. Yvonne Ng, Senior Consultant, Department of Neonatology, National University Hospital.

Spit-up is perfectly normal: most babies under 6 months old experience some amount of spit-up. Nevertheless, it is normal for mummies and daddies to get a little anxious each time it happens.

Normal baby spit-ups usually happens right after feeding or burping. It looks like the milk that was just fed or it may appear slightly curdled. Spit-ups occur when your baby feeds too quickly and swallows too much air with his milk. It also happens when he overfeeds.

Your baby spits up because he is still young, and the junction between the food pipe and stomach needs a bit of time to get “tighter”. The spit-ups will become less frequent as your baby grows older.

Related:
Feeding Your Baby: Breastfeeding

When to Be Concerned about Spit-Up

Bring your baby to the doctor immediately in these cases:

1. Baby’s spit-up is green in colour. This may mean that there is a blockage in your baby’s intestines, which is a serious condition.
2. He vomits continuously in large amounts.
3. He appears dehydrated (e.g. less urine, dark urine crying without tears, dry mouth).
4. He looks unwell and is in distress.
5. His tummy is bloated or swollen.
6. He has fever, or diarrhoea.

Related:
Your Growing Baby

Tips to Reduce Spit-Up

While spitting up is perfectly normal for infants, here’s what you can do to minimise it from happening.

1. Burp your baby after feeding

This helps him expel the air he may have swallowed during his feeds. Hold your baby on your lap, support his head and body with one hand and gently rub or pat his back with your other hand. Do so for a few minutes after feeding. There’s no need to force it: if your baby doesn’t burp, he probably just doesn’t need to.

2. Don’t overfeed your baby

Stop feeding your baby when he shows signs that he is content, such as turning away from the breast or bottle, or feeling sleepy.

Remember, spitting up is common and is no cause for concern as long as your baby is eating and growing well. Keep up the good work, mummy and daddy!

Visit Parent Hub, for more useful tips and guides to give your baby a healthy start.

Download the HealthHub app on
Google Play or
Apple Store to access more health and wellness advice at your fingertips.

This article was last reviewed on

Wednesday, December 21, 2022

Catalog-Item Reuse

Find out why your baby spits up, and why there’s very little cause for concern when it happens.

<div><div><p>
         By Health Promotion Board in collaboration with Dr. Yvonne Ng, Senior Consultant, Department of Neonatology, National University Hospital. </p><p>Spit-up is perfectly normal&#58; most babies under 6 months old experience some amount of spit-up. Nevertheless, it is normal for mummies and daddies to get a little anxious each time it happens.</p><p>Normal baby spit-ups usually happens right after feeding or burping. It looks like the milk that was just fed or it may appear slightly curdled. Spit-ups occur when your baby feeds too quickly and swallows too much air with his milk. It also happens when he overfeeds.</p><p>Your baby spits up because he is still young, and the junction between the food pipe and stomach needs a bit of time to get “tighter”. The spit-ups will become less frequent as your baby grows older.</p><p>
         <strong>Related&#58;
            <a href=”https&#58;//www.healthhub.sg/live-healthy/1141/pregnancy-feeding-your-baby-breastfeeding” title=”Feeding Your Baby&#58; Breastfeeding”>Feeding Your Baby&#58; Breastfeeding</a></strong></p></div><div><h3>When to Be Concerned about Spit-Up</h3><p>Bring your baby to the doctor immediately in these cases&#58;
</p><ol><li>Baby’s spit-up is green in colour. This may mean that there is a blockage in your baby’s intestines, which is a serious condition.</li><li>He vomits continuously in large amounts.</li><li>He appears dehydrated (e.g. less urine, dark urine crying without tears, dry mouth).</li><li>He looks unwell and is in distress.</li><li>His tummy is bloated or swollen.</li><li>He has fever, or diarrhoea.</li></ol><p></p><p>
         <strong>Related&#58;
            <a href=”https&#58;//www.healthhub.sg/live-healthy/9/guide_your_growing_baby” title=”Your Growing Baby”>Your Growing Baby</a></strong></p></div><div><h3>Tips to Reduce Spit-Up</h3><p>While spitting up is perfectly normal for infants, here’s what you can do to minimise it from happening.
</p><h4>1. Burp your baby after feeding
</h4><p>This helps him expel the air he may have swallowed during his feeds. Hold your baby on your lap, support his head and body with one hand and gently rub or pat his back with your other hand. Do so for a few minutes after feeding. There’s no need to force it&#58; if your baby doesn’t burp, he probably just doesn’t need to.
</p><p>
         <img src=”/sites/assets/Assets/Categories/Kids/Opmz_Opmz_iStock-854320974_640.jpg” alt=”” />
         </p><p>
      </p><h4>2. Don’t overfeed your baby</h4><p>Stop feeding your baby when he shows signs that he is content, such as turning away from the breast or bottle, or feeling sleepy.</p></div><div><p>Remember, spitting up is common and is no cause for concern as long as your baby is eating and growing well. Keep up the good work, mummy and daddy!
</p></div><p><a href=”https&#58;//www.healthhub.sg/programmes/183/parent-hub/baby-toddler/common-status”>Visit Parent Hub, for more useful tips and guides to give your baby a healthy start. </a></p><p><em>Download the HealthHub app on
   <a href=”https&#58;//play.google.com/store/apps/details?id=sg.gov.hpb.healthhub&amp;hl=en_SG” target=”_blank” rel=”nofollow”>Google Play</a> or
   <a href=”https&#58;//itunes.apple.com/sg/app/healthhub-sg/id1034200875?mt=8″ target=”_blank” rel=”nofollow”>Apple Store</a> to access more health and wellness advice at your fingertips.</em>
</p>
   
   
   
   
   
   
   
   
   
   
   
   
   <div><hr /><p>
         <strong>Read these next&#58;</strong></p><ul><li>
            <a href=”https&#58;//www.healthhub.sg/live-healthy/1186/baby-has-come-home-dealing-with-changes” title=”Baby Has Come Home&#58; Dealing with Changes”>Baby Has Come Home&#58; Dealing with Changes</a></li><li>
            <a href=”https&#58;//www. healthhub.sg/live-healthy/1216/baby-up-and-about-safely” title=”Baby up and about Safely”>Baby Up and About Safely</a></li><li>
            <a href=”https&#58;//www.healthhub.sg/live-healthy/1478/healthy-start-for-your-baby” title=”Healthy Start for Your Baby”>Healthy Start for Your Baby</a></li></ul></div>
   
 
</div>

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Wednesday, December 21, 2022

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Q&A: Is My Baby’s Spit-Up Normal?

Articles

causes of regurgitation in infants and infants – Children – tsn.ua But this is still a reason to listen to the opinion of a pediatrician. Evgenia Bukharina, a pediatrician of the highest category, a neonatologist of the Dobrobut Medical Network, told us why a child spit up and in what cases it can be a cause for alarm.

What is regurgitation in newborns?

Regurgitation or reflux is the return of the contents of the esophagus or stomach into the mouth. Usually it is food mixed with saliva and gastric juice. Approximately 85% of newborns spit up in the first weeks of life.

Causes of regurgitation in infants

Most often in infants it is anatomical features of the structure of the gastrointestinal tract . The sphincter between the esophagus and stomach in an infant is not as pronounced as in an adult, and is closed by a different mechanism. It is a fold of the stomach lining, like petals that form a valve. This area does not shrink, as in adults, not letting food back out of the stomach. In young children, this hole is constantly in a half-open state. Thus, when the child lies in the crib and the exit from the stomach is higher than the entrance, food is thrown out of it, as from an open bottle.

How do you tell regurgitation from vomiting?

Normally, the child burps, as a rule, not abundantly and not often. At the same time, his general well-being is not disturbed. He is still cheerful, mobile, playful, his skin color does not change. Unlike normal regurgitation, vomiting is a rather complex reflex act in which the contents of the stomach are ejected out in the same way, but the abdominal muscles and diaphragm are involved. In young children, vomiting is also accompanied by impaired breathing and heartbeat. Thus, regurgitation is a physiological condition for some children, vomiting is a dangerous symptom. However, in order to distinguish one from the other, it is still better to consult a pediatrician.

When should I see a doctor?

Also read

There are a number of diseases in which regurgitation is a pathological, dangerous symptom. First of all, these are such diseases as pyloric stenosis and pylorospasm. In the place separating the stomach and duodenum, there is a sphincter, as well as at the entrance to the esophagus. When the food is already sufficiently prepared in the stomach, it opens, pushing it into the duodenum. With pylorospasm, this sphincter spasms, and food is not completely removed from the stomach. With pyloric stenosis, food is not excreted almost completely. In both cases, when feeding a child, the stomach overflows, because he has not yet got rid of the remnants of the previous feeding, and the child begins to spit up. In these cases, regurgitation is plentiful, often has a curdled consistency, and a sour smell.

Usually, these diseases appear around the 2-4th week of a child’s life. If pylorospasm can be defeated by taking antispasmodic drugs, then in the case of pyloric stenosis, surgical treatment is necessary. In any case, a surgeon’s consultation is needed to confirm the diagnosis and treatment.

Sometimes regurgitation can be associated with problems of the nervous system . In this case, a consultation with a neurologist is necessary.

Some causes of regurgitation in healthy children

Baby’s health

Even healthy babies can spit up quite often. They are associated with incorrect breastfeeding . Some babies suckle greedily, taking in a lot of air when feeding. Then, together with the air accumulated in the stomach, a large content of the milk eaten is excreted.

Sometimes spitting up can be associated with the composition of breast milk . If a mother consumes a large amount of carbohydrate foods, this can cause bloating in the child, which provokes the release of stomach contents.

The baby may spit up if he is overfed . This is often the case for restless children. Despite the fact that it is now customary to feed on demand, it is still difficult for the mother of a newborn to discern his needs. Then she can apply it to her breast at every call. In this case, there really is a chance to overfeed the child. The same is true for “greedy” babies who do not get enough, so they eat more volume than they should.

Rules for children who frequently spit up:

After feeding, hold the baby in a “column” for at least 10-15 minutes.

The head end of the crib needs to be raised slightly. To do this, you can put a terry towel under the head of the mattress.

Also read

For children who often spit up, there are certain mixtures – the so-called anti-reflux. They are thicker in consistency and due to their density they pour out of the stomach worse. But these mixtures should be prescribed only by a doctor, and they are therapeutic, and not the main food. You can use such mixtures only for a certain period of time before recovery. This mixture can be eaten not only for children on artificial feeding, but also for babies.

Summing up, regurgitation is not dangerous if it is not frequent, not plentiful, while the child gains weight well, looks and feels satisfactory. If something bothers you, it is better to consult a pediatrician, surgeon and neurologist.

Tatyana Koryakina

Thank you for your help in preparing the material, pediatrician of the highest category, neonatologist of the Dobrobut Medical Network Evgenia Bukharina , med.dobrobut.com.

“Why does the baby spit up after breastfeeding?” — Yandex Q

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Anonymous

359Z”> February 22, 2018

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Q was asked 1 similar questionAnswerSpecify Elena Kiseleva

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, pediatrician of the highest category
Moscow · April 27, 2022

Moderate regurgitation in newborns after feeding – variant of the age norm. And often it’s not about nutrition, but about imperfection of the sphincter that connects the esophagus to the stomach – it does not close properly, which helps the return of food to the mouth. There is no danger in this, the feature goes away as the sphincter muscles get stronger and the child will stay upright longer. The older the baby, the less often he spits up.

Other explanations for spitting up: improper formula (in case of artificial feeding), chaotic breastfeeding and overfeeding, hasty sucking and swallowing excess air, food allergy to cow’s milk protein in the mother if she is breastfeeding and consumes dairy products and, to unfortunately, congenital metabolic disorders, surgical pathologies.

Distinguishing spit-up from vomiting

• Baby spitting up small amounts of breast milk, formula, or curds.

• Regurgitation does not have a yellow and green tint, an unpleasant odor.

• Regurgitation does not cause discomfort, the child eats with appetite, feeding does not cause irritability and discontent.

• Weight gain does not drop.

• From 4–6 months of age, regurgitation gradually subsides and practically disappears by 1 year.

Intense and profuse regurgitation in the baby, which caused weight loss, nighttime awakenings, poor health and impotence – an occasion to immediately tell the pediatrician about this in order to distinguish the norm from the pathology.

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Rainbow of Motherhood

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Marina Gorohova

Regurgitation during breastfeeding is most often a variant of the norm provided that the child is gaining weight well.
This is due, first of all, to the immaturity of the sphincters in a newborn child.
It is also common for babies to spit up a lot from mothers with excess milk production.
The popular recommendation to hold the baby in a “column” post-feeding alone is often… Read more

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Alyn Hill

January 9, 2021

I disagree a little about NOT keeping a column. Because during the “column” the child’s organs rise in physiological … Read more kabrita. com.ua

Answer

Tatyana Kocheva

Regurgitation is a normal phenomenon in the life of a newborn. There may be several reasons – the child simply overate, swallowed a lot of air along with food. In infants, as a rule, the esophageal sphincter (muscle) that closes the stomach and prevents food from passing into the esophagus is still poorly developed. Therefore, along with the air, part of the milk eaten also comes out. Usually to… Read more

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Kabrita

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Kabrita® – gentle nutrition based on wholesome goat milk from the Netherlands 6 Apr 2021 kabrita. com.ua

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Tatyana Kocheva

Regurgitation is a normal age-related physiological phenomenon. The child swallows air along with food, this air comes out along with excess food. The reasons for regurgitation can also be – overfeeding, tight swaddling after eating, active movements or massage after eating, a tight elastic band on clothes. Regurgitation can also be due to the immaturity of the child’s gastrointestinal tract and, in more rare cases … Read more 9Mothercare 005 Answer

Representative

Post-feed regurgitation is normal for both babies and bottle fed babies. This is often a sign that the newborn is swallowing air while feeding. The solution to the problem lies in the correct application.
Young mothers do not always immediately manage to establish the correct attachment of the baby to the breast the first time. If the problem… Read more

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Nadezhda Valentinova

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Looking for beauty in life. It turns out there are so many! · 6 Dec 2018

We burped for a long time and a lot, up to a year, even longer, I was constantly wet. .. But my son’s weight was 10 kg in half a year, 12 kg a year. The pediatrician said that “a full child is a sign of health,” but it fights because he eats a lot and the esophagus has not yet fully formed. Something like this…

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Mamako®

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MAMAKO® is gentle baby food based on goat’s milk.
· 19 Mar 2020 · mamako.ru

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Daria

Normally, a newborn and a child up to a year old can spit up several times a day due to the anatomical and physiological characteristics of the gastrointestinal tract. This is true for breast, mixed and artificial feeding, since it is not a matter of nutrition, but of the structure of the gastrointestinal tract.
Spitting up can cause:
– strong anxiety of the child;
– active game – according to… Read more

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DocDeti

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DocDeti are evidence-based medicine clinics.
3 branches in Moscow:
– Lonosovsky pr. 7k5
-… 1 Apr 2021 docdeti. ru

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Ekaterina Dyukoreva

Hello!

Because babies have weaker sphincters and spend most of the day in a horizontal position. The milk just flows out. As the child grows, the sphincters close more tightly, and there is more and more vertical position. The spitting stops.

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Tatiana S.

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Pirogova in 2003, residency at MONIKI in 2005, doctor… 5 Feb 2019

Normally, children can spit up for up to a year, due to insufficiency of valves between the esophagus and stomach, the muscles of the valves are still weak. And in the stomach, in addition to food, there may be air, it then comes out, provoking regurgitation. In order for only air to come out, immediately after feeding the baby, you need to hold it in a column for 20-30 minutes so that there is no air in the stomach, before feeding the baby … Read more

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Fatima Abayeva

September 7, 2020

20-30 minutes in a column? Seriously? It is impossible to keep my child calmly even for 3 minutes, a tantrum begins with . .. Read more

Comment the answer … Comment …

Treatment of Children June 6, 2020

Regurgitation is the passive ejection of stomach contents into the esophagus and oral cavity (gastroesophageal reflux). Regurgitation is a common occurrence, especially in infants in the first months of life.
Regurgitation occurs due to the anatomical and functional immaturity of the digestive system:
– short abdominal esophagus;
– underdeveloped circular muscles in the cardia of the stomach… Read more

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Answers to similar questions

Why does the baby spit up a lot after breastfeeding? — 1 answer, asked by November 29, 2018 Anna Babkina

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correctly captures the nipple during feeding, which is why a large amount of air enters with the milk, which comes out (again, along with the milk). Perhaps there is a lot of milk or the baby is in a hurry to eat, but unable to cope with the flow, it again captures excess air.