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Baby spit up white curds: The request could not be satisfied


Should Breastfed Babies Be Spitting Up White Chunky Milk?

Breastfeeding provides your baby with natural nutrition in the most convenient way. Your milk is easy to digest and has antibodies to help keep your baby’s digestive system healthy.

Breastfeeding also minimizes air swallowing and too-rapid feedings that can make spitting up worse in bottle-fed babies.

However, even breastfed babies often spit up after a feeding. The appearance of the spit-up varies, but, most of the time, white chunks in the milk are normal.

Appearance and Smell

The appearance of your baby’s spit-up varies depending on when he spits up.

If he spits up immediately after breastfeeding, the spit-up looks like fresh milk.

If the milk has had time to mix with stomach acids, it typically has white chunks and a curdled appearance, similar to the sour milk you get by adding vinegar to milk.

Curdled and lumpy spit-up also may have a sour smell, similar to vomit. This chunky appearance and bad smell are normal, according to Pediatrician Jennifer Shu on HealthyChildren.org.

Causes of Spitting Up

My Newborn Will Not Settle After Feeding

Some babies are greedy feeders and take in more than their stomachs can handle. Even a breastfed baby spits up when she’s had more to eat than she can hold in her stomach.

Burping or drooling can also trigger spitting up, as can jostling the baby or putting her down quickly. The immaturity of an infant’s digestive tract makes spitting up more common in the early months, but some illnesses can cause spitting up or vomiting.

Baby Reflux

Approximately half of all babies experience spitting up due to infant reflux, a type of gastroesophageal reflux disease, or GERD, according to the Mayo Clinic website. Reflux occurs during the early months until the valve between the stomach and the esophagus develops fully, but it usually resolves as the baby matures. Although the amount of spit-up is often small, overfeeding can increase it. Infant reflux usually doesn’t cause the baby to feel distress or cry.

Vomiting and Illnesss

Baby Cries When Burping

Vomiting is different from reflux or simple spitting up because it typically produces a large volume and can be a sign of illness.

For example, a baby may lose most or all of the feeding by vomiting. If your baby vomits several times in a day or every day, or if he vomits bright green matter, the American Academy of Pediatrics recommends consulting a pediatrician. Vomiting during the first month of life, looking or acting sick, forceful vomiting, diarrhea with vomiting, failure to gain weight and refusing feedings are other signs you should consult a physician immediately.

Minimizing Spit-Up

If your breastfed baby spits up a lot and your doctor has ruled out medical issues, you can reduce the problem by taking a relaxed and unhurried approach. If your physician recommends it, try feeding the baby smaller amounts more often. Burp him after he takes each breast rather than at the end of the entire feeding.

Keep him upright or sitting for 30 minutes after the feeding, Mayo Clinic recommends. When you lay him down, put him gently on his back to avoid bringing up milk.

Reflux or Acid Reflux? – Balanced Breastfeeding

All babies have reflux. Some babies have acid reflux. 

Reflux: backwards flow of milk (when it goes up instead of down). Think “Happy Spitter.”

Acid Reflux: when stomach acid flows back along with the milk up the esophagus, causing heartburn-like pain. This is an “Unhappy Spitter.”

Silent Reflux: acid or non acid spit up that you don’t see come out baby’s mouth. They may seem to throw up in their mouth, then swallow it back down. This may or may not be painful for them.

A baby with normal reflux: 

  • Has a small to moderate amount of spit.
  • Is rarely bothered by spitting up.
  • Sometimes chokes on their puke little and it might come out their nose. It bothers them and he may get upset for a minute, but that was probably just because they were scared that they couldn’t breathe for a second.  This kid is upset because they were startled, not in pain.
  • Has spit up that looks like chunky “curdled” looking milk or it may look exactly like freshly pumped milk. Neither really mean anything, one was just in their tummy a little longer than the other.
  • May or may not be hungry after spitting up. More often than not, they would be interested in sucking, but not eating after spitting up (i.e. on a pacifier).  This may surprise you since it looked like they just threw up the entirety of their feeding!
  • Doesn’t mind laying flat on their back.

The baby with normal reflux we will refer to as a “Happy Spitter.” The spitting up bothers you more than it bothers your baby. The worst problem you have is a laundry problem. 

A baby with excessive reflux: 

  • Has a moderate to very large amount of spit.
  • Is rarely bothered by spitting up.

Now, there are two categories here: the well gaining spitter and the poorly gaining spitter. Pay attention. The advice I am about to give it for the well gaining spitter. If you have a poorly gaining spitter, do not follow the following advice. Instead, see “unhappy spitter” below, because a poor gainer is not a happy baby. 

If you have a well gaining spitter, you likely tend toward an oversupply of milk.  You may also  have a fast let down, leading the baby to eat a lot of milk quickly, sometimes finishing a feeding in less than 10 minutes, drinking rapidly throughout most of the feeling.

If your baby shows you signs that he has taken in a lot very quickly and needs a break, give him a break. Let him digest a little! If he is looking to suck, offer him a pacifier and hold him upright so he can let his brain catch up with his belly. 

A baby with acid reflux: 

  • Seems to be in pain after spitting up.

Sometimes, a baby will spit and then scream. The main difference here is that a parents almost always say, “My baby seems like they are in pain.” This is the most important identifying factor of acid reflux. A parent’s instinct really kicks in and says that something is not right. If this is the case, it is time to get your baby’s health care provider involved in the conversation. 

What to do about reflux:

Babies have immature digestive tracts. The muscles and flaps that are supposed to keep his food down tend to not work so well all the time and the food just sloshes back up into his throat. Holding a baby upright helps keep the food in his tummy and out of his throat. 

During feedings, try to angle the pillow while feeding so baby’s head is higher than his hips. If you think you have too much milk or a fast let down, check out those techniques here. 

A realistic word to the wise:  There is no exact number of minutes that a baby should be held upright in order to decrease the risk of spitting up. Pediatricians will recommend  holding baby upright for as long as thirty minutes after feeding! However much this might be helpful, it is rarely reasonable. Try this: if 30 minutes works, try 25 minutes. Then, try 20. You get the point.

  • Lessen the acidity of the spit up: 

Meds. Acid reflux hurts! It is heartburn, after all, so if your baby is having painful spit ups, strongly consider talking to your doctor about medication.

FYI: Sometimes you need to try a few different types and strengths of reflux medication for it to work. Also, this medication is weight dependent, so as baby gets bigger, the medication may need to be increased in order for it to work better. 

Also, your pediatrician will most likely only be able to handle the basics of managing reflux, so if the first few tries of medication aren’t working, you or he should suggest visiting a pediatric GI specialist.

Remember: reflux and food intolerance are different. I DO NOT recommend taking a whole bunch of foods out of your diet and also treating the reflux with medication. Why? Because then you will have no idea which worked. You will be left without ice cream at night when you might not have needed to inflict that unnecessary torture on yourself.

Still not sure what is up with your unhappy baby?

Try this:

The Unhappy Eater: A baby who is crying while eating, popping on and off, or popping off and crying. 

Pyloric Stenosis (for Parents) – Nemours Kidshealth

What Is Pyloric Stenosis?

Pyloric stenosis is a condition that can affect the gastrointestinal tract in babies. It can make a baby vomit forcefully and often, and can lead to other problems, such as dehydration. Pyloric stenosis needs immediate medical treatment.

What Happens in Pyloric Stenosis?

Food and other stomach contents pass through the pylorus, the lower part of the stomach, to enter the small intestine. Pyloric stenosis is a narrowing of the pylorus. When a baby has pyloric stenosis, this narrowing of the pyloric channel prevents food from emptying out of the stomach.

Pyloric stenosis (also called infantile hypertrophic pyloric stenosis) is a type of gastric outlet obstruction, which means a blockage from the stomach to the intestines.

Pyloric stenosis affects about 3 out of 1,000 babies in the United States. It’s more likely to affect firstborn male infants and also runs in families — if a parent had pyloric stenosis, then a baby has up to a 20% risk of developing it. Most infants who have it develop symptoms 3 to 5 weeks after birth.

What Causes Pyloric Stenosis?

It’s thought that babies who develop pyloric stenosis are not born with it, but have progressive thickening of the pylorus after birth. A baby will start to show symptoms when the pylorus is so thick that the stomach can’t empty properly.

The cause of this thickening isn’t clear. It might be a combination of several things; for example, use of erythromycin (an antibiotic) in babies in the first 2 weeks of life or antibiotics given to moms at the end of pregnancy or during breastfeeding can be associated with pyloric stenosis.

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What Are the Signs of Pyloric Stenosis?

Symptoms of pyloric stenosis typically begin when a baby is around 3 weeks old. They include:

  • Vomiting. The first symptom is usually vomiting. At first it may seem that the baby is just spitting up often, but then it tends to become projectile vomiting, in which the breast milk or formula is ejected forcefully from the mouth, in an arc, sometimes over a distance of several feet. Projectile vomiting usually takes place soon after the end of a feeding, although in some cases it can happen hours later.

    The vomited milk might smell curdled because it has mixed with stomach acid. The vomit will not contain bile, a greenish fluid from the liver that mixes with digested food after it leaves the stomach.

    Despite vomiting, a baby with pyloric stenosis is usually hungry again soon after vomiting and will want to eat. It’s important to know that even with the vomiting, the baby might not seem to be in great pain or at first look very ill.

  • Changes in stools. Babies with pyloric stenosis usually have fewer, smaller stools (poops) because little or no food is reaching the intestines. Constipation or poop with mucus also can happen.
  • Failure to gain weight or weight loss. Most babies with pyloric stenosis will fail to gain weight or will lose weight. As the condition gets worse, they might become dehydrated.

    Dehydrated infants are less active than usual, and they may develop a sunken “soft spot” on their heads and sunken eyes, and their skin may look wrinkled. Because less pee is made, they can go more than 4 to 6 hours between wet diapers.

  • Waves of peristalsis. After feeds, increased stomach contractions may make noticeable ripples, which move from left to right over the baby’s belly as the stomach tries to empty itself against the thickened pylorus.

It’s important to call your doctor if your baby has any of these symptoms.

Other conditions can cause similar problems. For instance:

  • gastroesophageal reflux (GER) usually begins before 8 weeks of age. GER involves lots of spitting up (reflux) after feedings, which can look like vomiting. But most babies with GER don’t have projectile vomiting, and while they might have trouble gaining weight, they usually have normal poops.
  • a milk protein allergy also can make a baby spit up or vomit, and have diarrhea. But these babies don’t have projectile vomiting.
  • gastroenteritis (inflammation in the digestive tract that can be caused by viral or bacterial infection) also can cause vomiting and dehydration. But babies with gastroenteritis usually also have diarrhea with loose, watery, or sometimes bloody stools. Diarrhea usually isn’t seen with pyloric stenosis.
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How Is Pyloric Stenosis Diagnosed?

The doctor will ask detailed questions about the baby’s feeding and vomiting patterns, including what the vomit looks like. The baby will be examined, and any weight loss or failure to maintain growth since birth will be noted.

The doctor will check for a lump in the abdomen, which usually is firm and movable and feels like an olive. If the doctor feels this lump, it’s a strong indication that a baby has pyloric stenosis.

When pyloric stenosis seems likely, an abdominal ultrasound usually is done. The enlarged, thickened pylorus can be seen on ultrasound images. The doctor may ask that the baby not be fed for several hours before an ultrasound.

Sometimes a barium swallow is done instead of an ultrasound. Babies swallow a small amount of a chalky liquid (barium), and then special X-rays are taken to view the pyloric area of the stomach to see if there is any narrowing or blockage.

The doctor also might order blood tests to check levels of electrolytes (minerals that help keep fluids balanced and vital organs working properly). An electrolyte imbalance often happens due to the ongoing vomiting of stomach acid and dehydration, and needs to be corrected.

How Is Pyloric Stenosis Treated?

When an infant is diagnosed with pyloric stenosis, either by ultrasound or barium swallow, the baby will be admitted to the hospital and prepared for surgery. Any dehydration or electrolyte problems in the blood will be corrected with intravenous (IV) fluids, usually within 24 hours.

A surgical procedure called pyloromyotomy, which involves cutting through the thickened muscles of the pylorus, will relieve the blockage. The pylorus is examined through a very small incision, and the muscles that are overgrown and thickened are spread and relaxed.

The surgery can also be done through laparoscopy. This is a technique that uses a tiny scope placed in an incision in the belly button, allowing the doctor to see the area of the pylorus. Using other small instruments placed in nearby incisions, the doctor can complete the surgery.

Most babies return to normal feedings fairly quickly, usually 3 to 4 hours after the surgery. Because of swelling at the surgery site, a baby may still vomit small amounts for a day or so. If there are no complications, most babies who have had pyloromyotomy can return to a normal feeding schedule and go home within 24 to 48 hours of the surgery.

If you’re breastfeeding, you might worry about continuing while your baby is hospitalized. The hospital staff should be able to provide a breast pump and help you use it so that you can continue to express milk until your baby can feed regularly.

After a successful pyloromyotomy, your baby won’t need to follow any special feeding schedules. Your doctor will probably want to examine your child at a follow-up appointment to make sure the surgical site is healing properly and that your baby is feeding well and maintaining or gaining weight.

Pyloric stenosis should not happen again after a pyloromyotomy. If your baby still has symptoms weeks after the surgery, there might be another medical problem, such as gastritis or GER, so let your doctor know right away.

When Should I Call the Doctor?

Pyloric stenosis is an urgent condition that needs immediate treatment. Call your doctor if your baby:

  • has lasting or projectile vomiting after feeding
  • is losing weight or not gaining weight as expected
  • is less active than usual or is very sleepy
  • has few or no stools (poops) over a period of 1 or 2 days
  • show signs of dehydration, such as more than 4 to 6 hours between wet diapers, a sunken “soft spot” on the head, or sunken eyes

Common Freaky Newborn Behaviors NOT to Worry About

Normal newborn behavior can seem concerning and sometimes alarming to the uninitiated. Is she eating enough? Is she eating too much? Why is she crying? Why won’t she sleep? How much spit up is normal?  With so much to worry about, it might be refreshing to learn about some newborn behaviors that often make parents wonder, but are usually nothing to worry about. Of course, if you like to worry, here are Freaky Things Parents of Babies and Toddlers CAN Worry About.

Don’t worry (much) about…

  1. Breastfed babies over 1 month old that don’t poop every day, or even every few days. As long as they’re eating well and wetting plenty of pee-diapers, poop will happen, eventually – Probably requiring a full bath and several changes of clothing. Some dramatic babies poop only once or twice a week (but continue to eat and urinate as usual).
  2. Happy babies that spit up a lot. Whether it’s a lot of milk or a little, if the baby is otherwise happy and thriving, consider spit-up a Laundry Problem, not a pathology. If milk’s been down less than an hour, it will look and smell like milk. If it’s been down there longer, it will probably look and smell like curdled cottage cheese. Normal.  Spitting up – even 20 times a day –  is a normal baby behavior, and some healthy babies spit up far more than others.
  3. Infants who love the pacifier (once breastfeeding is well established). Give it or don’t give it, as you see fit. Don’t stress and agonize too much. It’s a just little piece of plastic, not crack cocaine. If it works for your baby, go with it. Around six months, your baby will begin to learn to self-comfort herself by sucking her fingers or thumb, and you can remove the binky altogether if you desire. If you choose to keep the pacifier, begin to restrict use to the car and crib once your baby is mobile.
  4. Occasional random projectile vomit. Yes, Exorcist Baby just likes to keep you guessing. And mopping up. As long as baby seems comfortable and is able to later eat normally without further projectile vomiting, just shrug it off  and mop it up. Repeated projectile vomiting, when milk seems to “shoot out” with volume and force, means a call to the pediatrician but a one-time occurrence doesn’t have to mean anything.)
  5. Sneezes and snuffly noses. A baby’s nose is a (mostly) self-cleaning device. Babies produce lots of thin mucus and a have reflex which causes them to sneeze a few times in a row when you step out into bright sunlight, essentially causing them to “blow” their cute little noses. Thin clear mucus, sneezing and snuffly sounds are normal for infants and are not the sign of a cold.
  6. Babies who spit up through their nose. Rarely discussed in baby books, and very normal (albeit kind of freaky). It must not be too comfortable for your baby, but there’s not much you can do about it. Remember when your friends made you laugh while drinking Pepsi and it would come out your nose? Yeah, like that. It’s all connected back there.
  7. Newborns who fall asleep but forget to shut their eyes, leaving only the whites showing. You can gently close their eyelids, it won’t bother them. They’ll grow out of this one fairly quickly. Thankfully, right? Looking for things to worry about? Here’s some Freaky Things Parents of Babies CAN Worry About.

Is Curdled Milk on a Baby’s Tongue a sign of Thrush?

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About 2-5% of newborns or infants have thrush in the first year of life. If you wonder whether the curdled milk on a baby’s tongue is a sign of thrush, you may be right. Read on to learn about newborn thrush vs. milk tongue, plus how to get rid of thrush on a baby’s tongue.

As a first-time parent, you get worried about every little change you see in your newborn. If you notice curdled milk on a baby’s tongue, it definitely needs treatment as it is a symptom of thrush in babies.

Thrush on a baby’s tongue resembles curdled milk or cottage cheese on a baby’s tongue. If you have seen curdled milk on a baby’s tongue, don’t jump to a conclusion just yet before you read this article. It could be as simple as milk staining on a baby’s tongue.

So, let’s go ahead and learn the difference between curdled milk on a baby’s tongue (thrush) vs. milk tongue and what you can do to get rid of thrush or milk residue on a baby’s tongue.

Disclosure: This post may contains affiliate links. As an affiliate and amazon associate, I earn commission on qualified purchase at no extra cost to you.

What is Thrush in Newborn?

Thrush is a fungal infection caused by an over-abundance of yeast called Candida Albicans. This fungus usually lives on our skin and mucous membranes. Most people have Candida as normal flora, but an overgrowth of it can result in an infection. Usually, the immune system and good bacteria in the body control it and stop it from occurring.

However, infants are at more risk of developing thrush as their immune system is still growing. This is why thrush infection is very common in healthy newborns or infants in the first year of their life.

Thrush in an infant can appear as curdled milk on the baby’s tongue, cheeks, the roof of the mouth. Also, thrush in the baby’s mouth can cause yeast diaper rash. Thrush can be uncomfortable and painful for an infant and a breastfeeding mom as they pass infection among each other.

What is Milk Tongue?

Milk tongue in a newborn is often mistaken for thrush by parents. Milk tongue is the white coating of milk or formula on a baby’s tongue.

Almost all newborns have a white coating on their tongue because their primary nutrient source in the first six months of life is breast milk. If your baby is formula-fed, you might notice a thicker white coating on the baby’s tongue.

Milk tongue is often gets cleared as your baby nurses. The tongue’s rubbing against the hard palate on the baby’s mouth removes the milk residue on the baby’s tongue while nursing. However, you may see milk tongue persistently in babies having difficulty nursing because of anatomical reasons such as tongue-tie.

How do you tell if Baby has Thrush or just Milk Tongue?

The difference between thrush vs. milk tongue is noticeable, and with a little bit of investigation, you can differentiate both easily.

Milk tongue is a thin, even white layer too thick white coating on the baby’s tongue. It is usually temporary and limited to the tongue only. Milk tongue can be easily cleaned by gently rubbing your clean fingertip in a circular motion or gently rubbing clean dumped muslin cloth on the baby’s tongue.

Also, some stubborn milk tongue is stiff to get rid of and sometimes, you will also find your baby’s tongue covered in curdled milk if baby spits up frequently due to reflux. These temporary milk residue on baby’s tongue does not mean that baby has thrush.

On the other hand, thrush appears as white patches on the baby’s tongue. In the early stages, it looks like patches of cottage cheese. It resembles a curdled milk coating on the baby’s tongue as it progresses. Unlike the milk tongue, it is not only confined to the tongue, but it can affect the inside of cheeks, lips, and gums (1). Also, babies with mouth thrush can develop yeast diaper rash, another common ailment among newborns.

The curdled milk on the baby’s tongue can be wiped away as well, but often it will leave sore spots that may result in bleeding. It can make it hard for the baby to feed later. So, if you suspect thrush in your baby, steer clear from rubbing the baby’s skin to clear the white patches on the baby’s tongue.

Sometimes, thrush can be hard to get rid of and takes several weeks to eliminate oral thrush.

Another difference between thrush and milk tongue is associated pain and discomfort for babies while feeding. Unlike milk tongue, thrush from baby’s tongue can pass onto mother’s nipple or vice versa.

How do Babies get Thrush?

As mentioned earlier, thrush is caused by a yeast called Candida Albicana, which is a normal part of our body’s flora. Our body’s mature immune system fights off invading harmful bacteria, viruses, or fungus to keep the balance of ‘good’ and ‘bad’ flora in our body in normal circumstances. However, when you are sick or taking antibiotics, this balance is shifted, causing ‘bad’ Candida to overgrow and cause infection.

Infants are prone to catching thrush because of their developing immune systems. Infants might contract this infection in your birth canal during vaginal delivery or develop later if they were treated with antibiotics for other conditions. Infants can also pick-up infection if breastfeeding mothers yeast infection on nipple due to sore nipple, cracked nipple, or wet nipple.

How do you get rid of Thrush or Curdled Milk on a Baby’s Tongue?

If you suspect that curdled milk on a baby’s tongue is thrush, you need to contact your pediatrician to discuss the treatment plan. They will often prescribe oral anti-fungal (Nystatin or fluconazole) for a mom and a baby.

Both are effective in treating fungal infection. However, Nystatin did not work for my newborn. It only works if given every 90 minutes. Also, it isn’t easy to apply in a baby’s mouth. Another reason to avoid Nystatin is that it contains sugar as an ingredient, encouraging fungal growth.

If you want to avoid using medication in your newborn, here are several natural remedies that can work to get rid of fungal infection in your baby.

Disclaimer: Inform your pediatrician before using natural remedies to treat thrush in babies.

Calendula Officinalis

Calendula Officinalis is a marigold plant used for ages to treat skin conditions (wound healing) and fungus infection (2). This plant’s colorful petals are rich in flavonoids and have been shown to exhibit anti-inflammatory, antidiabetic, anti-thrombogenic, anticancer activities in animal studies (3).

Research suggests that calendula may effectively treat diaper rash, vaginal yeast infections, and other skin conditions (4). Juice of Calendula is typically used to treat thrush on mother’s affected nipples. Naturopathic doctors often use it as an alternative to the potentially carcinogenic Gentian Violet. It is applied topically on the baby’s tongue, cheeks, gum, and mother’s nipple.

Grapefruit Seed Extract

Grapefruit Seed Extract is made from the seeds and pulp of grapefruit. It is known for its antibacterial, anti-fungal, anti-viral properties. It is a popular alternative for the treatment of Candida infection. However, there is no direct scientific evidence for its effectiveness in treating thrush.

To use it for thrush, dilute 10 drops of GSE (buy here) in one ounce of water. Apply it to the mother’s nipple and baby’s mouth before every feeding and every hour. It usually takes 2-3 days to clear off the fungus.

Coconut Oil

Coconut oil is another beneficial and popular natural remedy for thrush treatment. Its anti-fungal and antibacterial properties are attributed to medium-chain fatty acid and lauric acid in coconut oil (5).

Apply cold-pressed coconut oil (buy here) topically to the mother’s nipple and inside the baby’s mouth to clear off the Candida infection.

Include Probiotic in Diet

Probiotics (Lactobacillus) are live bacteria that our body needs to keep fungus under control. Specifically, when babies are given antibiotics to treat other conditions, probiotics are necessary to prevent the overgrowth of fungus.

Yogurt is rich in Lactobacillus. However, babies can’t eat yogurt, so you need to include probiotics drops for babies. Probiotics are beneficial in babies with colic and reflux.

You can also use acidophilus powder to treat thrush in babies. Apply acidophilus powder on your clean finger and let baby suck on it before feeding.

How to Prevent Thrush in Babies?

Newborn thrush is rarely serious. The mild form of thrush can be treated easily and usually takes 2-3 weeks to clear. However, Candida infection is highly contagious, so care should be taken if you or your baby has any thrush symptoms.

To prevent thrush from recurring, you need to be careful about your hygiene practice diet.

It is common practice to eat a healthy diet and drink enough water when fighting any infection. If you or your baby has a thrush infection, you need to cut down on your sugar intake to worsen the symptoms (6). You are also reducing the intake of yeasty food such as bread, nutritional yeast, mushroom as they may aggravate thrush.

Eating a balanced diet and drinking enough water is essential when fighting any infection. Reducing sugar intake and processed food is necessary, as a sugary diet can worsen the thrush symptoms. Some moms have also suggested reducing the intake of yeasty foods such as bread, mushrooms, and nutritional yeast as they may exacerbate thrush. If you decide to make a diet change, you may want to consult a doctor first.

Include fermented foods like plain yogurt, sauerkraut in your daily diet. Also include foods with antibacterial properties like turmeric, garlic, ginger in your regular food preparation. In case you are taking antibiotics to treat other conditions, take probiotics supplements (like this one) to restore the intestine’s normal flora.

Because thrush spreads quickly from wherever it comes in contact with other surfaces, maintaining hygiene is essential in preventing thrush spread.

  • Keep your nipple dry after each feed, use a disposable breast pad, and change often.
  • Wash baby’s clothes or anything that frequently come in contact with Candida at high temperature.
  • Sterilize baby’s bottles, nipples and toys frequently. You can also sterilize them by boiling them for 20 min in water.
  • Wash your hands thoroughly after each diaper change. Do not use antibacterial soap as it kills good flora for the hands.
  • Candida can not thrive in an acidic environment, including white vinegar in washing baby’s cloth. You can also rinse your nipple with white vinegar—Mix 1 tsp of white vinegar in 150 ml of water for rinsing your nipple.

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Should I Wipe Milk off Baby’s Tongue?

There is no harm in wiping milk off your baby’s tongue if you think your baby has a milk stain on the tongue. Dental professionals recommend cleaning the baby’s mouth after each feed. You can use a clean washcloth dipped in warm water or sterile gauze and gently wiped off any milk residue on the baby’s tongue.

However, if you see curdled milk on a baby’s tongue or any sign of thrush, wiping off milk from the baby’s tongue may leave the area red, sore. It may also lead to bleeding and make feeding difficult for a baby.

Can Babies get Thrush from Expressed Milk?

If you are dealing with thrush infection in your baby and you, you should not freeze express milk for later use. Freezing expressed milk does not kill Candida (7). Although, no scientific studies are investigating the risk of feeding described milk to babies when you have a thrush outbreak. But there is still a risk of reinfecting babies with thrush later with the expressed milk that has been frozen during the thrush outbreak.

Can you scrape Thrush off Baby Tongue?

It is better not to scrape thrush off the baby’s tongue. Unlike the milk tongue, which is easy to wipe off with a damp washcloth, rubbing thrush or curdled milk on the baby’s tongue can leave the tongue red, sore, and may lead to bleeding. It can make subsequent feeding difficult and may cause baby to latch and unlatch while feeding.

It is not advisable to scrape thrush off the baby’s tongue. In treating thrush, you need to contact your doctor and discuss the treatment plan.

What happens if Baby Thrush is left Untreated?

If thrush is left untreated in babies, it can cause further complications. It could enter the bloodstream and infect another part of the body, causing systemic Candida infection. Once you have a systemic Candida infection, it can cause serious life-threatening conditions like meningitis. It can also infect the esophagus, eyes, joints, and urinary tract (8)


I hope this post has helped you differentiate thrush (curdled milk on a baby’s tongue) vs. milk tongue. As long as you know the difference and treat thrush with persistence and take hygiene very seriously, you can get rid of thrush in babies in 2-3 weeks. Once you find out your baby has thrush, do contact your pediatrician and discuss the treatment plan. Before you go ahead and use the natural remedies listed above for treating thrush in your babies, speak to your doctor.

Good luck, Mamas!

How about you?

How did you treat thrush in your babies? Do you have natural thrush remedies that worked for you? Please let us know in the comment below.

If you find this article helpful, share it to your friends.


  1. Mohrbacher, N., Stock, J., & La Leche League International. (2003). The breastfeeding answer book. Schaumburg, Ill: La Leche League International
  2. Jahdi, F. et. al. The impact of calendula ointment on caesarean wound healing: A randomized control clinical trial. J Family Med Prim Care. 2018 Sep-Oct; 7(5): 893–897. DOI: 4103/jfmpc.jfmpc_121_17
  3. Buzzi, M. et. al. Therapeutic effectiveness of Calendula officinalis. J Wound Care.2016 Dec 2;25(12):732-739.
  4. Mahmoudi, M, et. al. Comparing the effects of Bentonite & Calendula on the improvement of infantile diaper dermatitis. A randomized controlled trial. Indian J Med Res. 2015 Dec; 142(6): 742–746. DOI: 10.4103/0971-5916.174567
  5. Shino B, Peedikayil FC, Jaiprakash SR, Ahmed Bijapur G, Kottayi S, Jose D. Comparison of Antimicrobial Activity of Chlorhexidine, Coconut Oil, Probiotics, and Ketoconazole on Candida albicans Isolated in Children with Early Childhood Caries: An In Vitro Study. Scientifica (Cairo). 2016;2016:7061587. doi: 10.1155/2016/7061587. Epub 2016 Mar 14. PMID: 27051559; PMCID: PMC4808662.
  6. Shino B, Peedikayil FC, Jaiprakash SR, Ahmed Bijapur G, Kottayi S, Jose D. Comparison of Antimicrobial Activity of Chlorhexidine, Coconut Oil, Probiotics, and Ketoconazole on Candida albicans Isolated in Children with Early Childhood Caries: An In Vitro Study. Scientifica (Cairo). 2016;2016:7061587. doi: 10.1155/2016/7061587. Epub 2016 Mar 14. PMID: 27051559; PMCID: PMC4808662.
  7. Rosa C, et al. Yeasts from human milk collected in Rio de Janeiro, Brazil. Rev Microbiol 1990;21(4):361-63.
  8. Bongomin F, Gago S, Oladele RO, Denning DW. Global and Multi-National Prevalence of Fungal Diseases-Estimate Precision. J Fungi (Basel). 2017;3(4):57. Published 2017 Oct 18. doi:10.3390/jof3040057

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Baby vomiting mucus, milk, or blood: Causes and tips for coping

Newborn babies can vomit for all number of reasons. While it’s distressing for parents and baby alike, there is usually a very simple explanation.

In the early days after the birth, many babies will vomit up mucous from their stomach. This is mostly the remnants of the amniotic fluid that was swallowed in the womb, mixed with mucous produced by the lining of the baby’s stomach, in preparation for absorbing milk feeds. 

Baby vomiting mucus

Occasionally, a baby’s mucous can be quite thick, and the baby may temporarily gag on it in the back of their throat. This can cause them to look like they are choking, and possibly go red, or blue, in the face. Understandably, parents find this quite distressing to watch, however babies will usually deal with it on their own. Sitting your baby upright, or placing her over your shoulder, will generally help her to swallow the mucous or spit it out.

Baby vomiting after feeding

Once your baby is taking larger volumes of milk, it is very normal for her to vomit, or ‘regurgitate’, part of the milk around feed time. (However, some babies do not vomit much until they are about 2 to 3 months old.) Your baby may vomit a lot, or only on occasions. If you are lucky, she won’t vomit at all, unless she is physically unwell. Most babies will tend to vomit ‘off and on’ at various stages during the first 12 months of their life. A few babies will have problems associated with vomiting, due to reflux.

Your baby may have little ‘delicate’ vomits that just overflow gently from their mouth, or they may vomit with dramatic style, in a great gush coming from the mouth and nose! (A very attractive party trick!) Observing this type of vomit can leave parents feeling very concerned (and possibly astonished, at the sheer force of it), or upset about all the milk that has ‘gone to waste’. Unlike adults and older children, babies vomit quite effortlessly, and don’t often seem disturbed, or distressed by it.

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Newborns can bring so much stress on parents.Image: iStock

RELATED: How to tell if it’s a gastro bug or food poisoning

Common causes of baby vomiting

The most common cause of a baby vomiting in the early weeks is by some of the milk being brought up with a pocket of air, when your baby burps.

The other term for this type of vomiting is ‘positing’. If milk comes up soon after a feed, it looks (and smells) fairly similar to how it went down – a milky liquid. If the milk comes up a while after the feed, it will usually be partially digested, and often have lumps of curdled milk. Partially digested breast milk doesn’t tend to have a strong odour, but formula milk usually will.

The other reason why babies vomit frequently is because the muscle valve at the top of their stomach (between the oesophagus and the stomach) is weak and immature. In adults, this valve closes tightly after swallowing food, to keep food down. It takes a great deal of force to push this valve open to allow an adult to vomit. For babies, the valve does close, but not as tightly. It can be easily forced open with gentle pressure behind it.

In the normal process of digesting milk (and food), and then guiding the stomach contents into the bowel, the stomach performs a ‘contracting’ action. The pressure from these contractions can force milk back up the baby’s oesophagus, to vomit. This may also happen if the baby’s stomach is ‘overfull’, or is gently pressed on. For example, by resting the baby too far over your shoulder, or your baby is slouched over while sitting, or if she is having ‘tummy time’.

Most babies who vomit frequently are happy, healthy and put on weight. They will eventually ‘grow out’ of it by the time they are one year old (or even earlier for some). It may improve somewhat, after six months or so, when your baby is eventually sitting up, and spending more time in upright positions, as gravity will often help to keep things down.

For many parents, it can be hard to keep a smile on your face, if you feel that you are constantly covered in vomit, or it is seeping down the back of your new lounge! Carrying around a spare cloth nappy or hand towel, often becomes part of your wardrobe.(Some parents buy coloured ones, to ‘coordinate’ with their outfits!)


If you are concerned that your baby is vomiting excessively, or seems unwell or distressed, you should seek medical advice. Vomiting in conjunction with any of the following symptoms could be a concern and require a visit to medical professional:

  • having less than six wet nappies in 24 hours
  • losing interest in feeding
  • being lethargic
  • having diarrhoea
  • having a fever
  • the vomit having a very offensive smell or if it consists of clear, bright yellow, orange or greenish bile fluid

Baby vomit is very common. Image: iStock 

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Blood in baby vomit

In the first few days after the birth, it is not unusual for a baby to vomit up small amounts of old blood. This is because babies often swallow blood during the birth (whether a vaginal birth or Caesarean). The blood in the vomit usually looks dark red, or brown and ‘coffee ground’ in appearance. This will not harm your baby, and will slowly work its way through her system.

Blood can also be seen in a newborn’s vomit if you have cracked and/or bleeding nipples (usually damaged from incorrect positioning of the baby on the breast). Occasionally, the skin of the nipples may not even look obviously split or broken, however there is some soreness associated with the baby suckling. The blood in the baby’s vomit may give the milk a pink, or dark red stain, or look like streaks of dark brown. Again, the blood will not harm your baby but you may need to look at correcting your baby’s attachment for breastfeeding, to prevent further nipple damage. Do not stop your baby from breastfeeding, just because she is swallowing blood.

NOTE: If your baby is being formula fed and you notice blood in her vomit, or if the blood appears in the breast milk continuously and you don’t think you have nipple soreness (or any signs of damaged nipples), you should seek advice from your local doctor.

How to cope with your vomiting baby

  • Keep spare nappies, hand towels or washers handy during and after feeds. Carry one around with you when you go out and make use of bibs over gorgeous new outfits, until your baby is ‘on show’ for special occasions.
  • Handle your baby gently after feeding. Avoid jiggling them around and lifting them up and down too quickly. (This can have the same effect as the ‘Big Dipper’ ride).
  • Many parents worry about replacing what has been brought up. If your baby seems hungry, offer them the breast again, or give them another 40 – 60ml of formula (or whatever amount they are happy to take).
  • DO NOT change your baby’s feeding pattern in an attempt to fix the vomiting. Giving her more feeds, or spacing feeds further apart will not alter a baby’s vomiting.
  • DO NOT change your formula, if bottle feeding. This will not prevent your baby from vomiting.
  • DO NOT thicken formula (or add other substances such as rice cereal) in the belief that it will be ‘heavier’ and therefore stay down. Altering directions for formula preparation can lead to constipation, unhealthy weight gains and possibly cause vomiting, making your baby unwell.
  • Remember, the majority of babies who vomit thrive, and are not worried by it. Although their parents may be!

This article was first published in October 2015 and updated in June 2021. 

What Those Nasty White Chunks That Sometimes Come From Your Throat Are

Today I Found Out what those foul smelling, small, white-ish, chunks that you can sometimes feel at the back of your throat when you swallow are. They’re called Tonsilloliths or Tonsil Stones.

Although most people experience these little white balls  at the back of the throat that often get coughed up into the mouth, this widespread affliction is rarely talked about and the awareness about it very low.  Many suffer in silence believing that they’re alone or the occurrence is nothing more than dregs of last night’s dinner.  Another reason people don’t dispense with their problem of tonsil stones is because they are embarrassingly nasty and foul smelling!

Tonsilloliths, also known as tonsil stones are stinky little globs of mucus, dead cells, debris and bacteria that form in the tonsil crypts which are simply small pockets or divots that appear in everyone’s tonsils. When the trapped dead cells, mucus, and debris harden or calcify, they form white/yellow ball in the tonsil pockets. They usually appear as tiny little chunks in the shape of cauliflower and smell like they could wake up your dead grandma.

The strong unpleasant odor is caused by a build-up of sulfur-producing bacteria that feeds on the tonsil stones collected in the crypts of the tonsils and is a combination of hydrogen sulfide, methyl mercaptan, and other stinky substances that form in it. Tonsil stones can range from a size of a small peppercorn to a rather large size causing discomfort in the throat and in some cases uncomfortable side effects, including sore throat and ear pain and tonsillitis. It is also believed to be one of the reasons for Halitosis (bad breath).

Tonsil stones are fairly common in adults and children. However, they tend to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of tonsillitis. Studies have shown that people who have had their tonsils removed, under most circumstances, almost never experience tonsil stones.

There are some effective treatments for reducing the occurrence of tonsil stones. Removing one’s tonsils is an option, but not the best solution as tonsils play a role in the immune system and are meant to function like nets, trapping incoming bacteria and virus particles that are passing through your throat. Easy home treatments like gargling salt water, or non-alcohol mouthwash is often advised for getting rid of tonsiloliths. A water pick that emits powerful pulses of water is also a useful tool for clearing the tonsil crypts. The simplest solution is to use a cotton swab or toothbrush so you can push the nasty little things out and rinse your mouth free of them.

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Bonus Facts:

  • There are about 9,000 taste buds on the surface of the tongue, in the throat, and on the roof of the mouth. Taste buds contain chemoreceptors that respond to chemicals from food and other substances that are dissolved by the saliva in the mouth.
  • Your mouth produces 1 liter (1.8 pints) of saliva a day. We each produce about 10,000 gallons of saliva in a lifetime. Saliva is required for taste—until food is dissolved by saliva, we cannot taste it.
  • The average American eats 50 tonnes of food and drinks 50,000 liters (11,000 gallons) of liquid during his life. It also takes food seven seconds to go from the mouth to the stomach via the esophagus.

Expand for References:

90,000 The child spits up after kefir and cottage cheese

A newborn baby spits up a curdled mass: reasons for spitting up after feeding

Babies in the first year of life gain weight very quickly and need a lot of food. Their digestive system does not always deal with it easily. Therefore, in the first months of life, babies often spit up. Usually this is a small amount of milk, but sometimes the baby spits up a curdled mass, which indicates that the milk has already been exposed to gastric juice.Very rarely, regurgitation is a symptom of the disease.

The baby spit up curd

Features of the baby’s digestive system

Spitting up of babies is called regurgitation. It is considered normal due to the nature of the infant’s digestive system, which is in the process of development.

Food passes from the mouth to the stomach through the esophagus. At the lower end of the esophagus is a muscle ring called the lower esophageal sphincter. It ensures that food stays in the stomach.However, in young children, the sphincter does not yet function properly and the stomach is relatively small. Therefore, food can be pushed back into the esophagus and then into the mouth.

Esophagus and stomach of the baby

Causes of curdled belching

Most often, the baby spits up curd for the following reasons:

  1. If the baby has received an excess amount of food, he can then regurgitate some of it. It is especially difficult to control how much a baby eats when breastfeeding;
  2. Swallowing air together with milk, which is likely with very active sucking, improper positioning of the bottle with the formula, or when the baby is loosely taking the breast nipple into the mouth.An air bubble formed in the stomach displaces its contents.

Correct attachment to the breast

Important! To prevent the baby from sucking too actively, it is necessary to observe the intervals between feedings, not allowing the baby to become very hungry.

  1. Excessive activity after eating. Within half an hour after eating, you need to provide the baby with peace. Overly active games, gymnastics with a baby, bathing can lead to regurgitation of cottage cheese in infants;
  2. External pressure in the tummy area.For example, a child is swaddled tightly, or his diaper is tightly buttoned. Pressure can also build up inside the abdomen due to flatulence;
  3. Incorrect selection of milk formula can cause digestive problems, including regurgitation in newborns after feeding with curd.

What is the norm

The norm is to belch twice a day in half an hour after the end of feeding. Saliva may be present in milk or curd secretions, and its smell may be sour. At the same time:

  • weight gain has a positive trend;
  • the baby, when spitting up a curdled mass, remains calm and cheerful, he has a good appetite;
  • urine excretion occurs up to 10 times daily;
  • The volume of gastric secretions does not exceed 2 tablespoons.

If a child can spit up a lot and does it often, he has poor sleep, rare urine flow, and the weight does not increase, this is out of the normal range.

Important! When a baby spits up milk or cottage cheese during hours not related to feeding, and there is bile or traces of blood in the secreted contents, you should immediately get a specialist’s advice.

What is the danger of regurgitation with curd

The risk of any regurgitation is that the baby is able to choke on the secreted masses, so you cannot put the baby on its back after feeding, it can only be laid on its side.

The child lies on its side

Important! With frequent and profuse regurgitation, backward mass from the stomach may damage the esophagus or cause respiratory problems if it enters the lungs.

Sometimes the baby spits up cottage cheese due to pathological reasons:

  1. Infections of the gastrointestinal tract. In addition to fever, diarrhea and feeling unwell, they can be accompanied by curdled belching with the presence of mucus in it;
  2. CNS pathology. With these diseases, the child spits out a fountain of curd, does not sleep well, throws his head back;
  3. Pyloric stenosis (narrowing of the passageway between the stomach and the duodenum), which also includes cheesy belching and weight loss.

How to reduce curdled belching

Parents can reduce the amount of emitted belching and reduce its frequency if they do the following:

  1. Try to prevent your baby from getting too much food. Better he should eat in small portions, but more often;
  2. In order for the air to escape, the baby must be held upright at the end of feeding for 5 to 30 minutes;

Raising the baby vertically

  1. The position of the baby when he takes food should not be horizontal, it is necessary to raise the baby’s upper body at an angle of approximately 45º;
  2. Make sure that the baby tightly covers not only the breast nipple itself, but also the surrounding area;
  3. When bottle feeding, make the hole in the nipple small enough so that the formula does not flow out too freely and quickly;
  4. If the child often spits up curd, active games are not allowed for half an hour and even more after the end of feeding, you do not need to bathe the baby, perform massage and gymnastics.On the contrary, massage treatments and gymnastics are very beneficial if done shortly before the next feed. They promote the release of gases and strengthen the abdominal muscles;
  5. Do not press diapers tightly or swaddle tightly after eating;
  6. When frequent belching is associated with a reaction to formula milk, you can try to replace it or use special antireflux drugs;
  7. The baby must breathe well through the nose to avoid air entrapment in the mouth, therefore, you need to take care of the cleanliness of the nasal passages.

When to see a doctor

When a child eats well and is not worried about his general condition, health problems are unlikely, even if he regurgitates from time to time. Parents should be alert and consult a doctor in the following cases:

  • regurgitation occurs with high frequency, the baby’s skin is noticeably pale, he does not recover and grows poorly;
  • There is abdominal pain, the baby is anxious, crying and arching his back;
  • the child is coughing and has trouble breathing, in which case the esophagus may be irritated by acid from the stomach;
  • belching is not associated with food, can occur arbitrarily;
  • instead of regurgitation, vomiting occurs, sometimes with a fountain;
  • Frequent regurgitation is accompanied by diarrhea, while children lose a lot of fluid, dehydration may occur.

Important! In all cases, you need to figure out why, after feeding, the baby spits up with curd, whether this is due to the physiological characteristics of his body and fits into the norm, or the development of pathology is possible.

Most often, parents should not worry about regurgitation of a curdled mass. As the baby grows and his digestive tract develops, they will decrease. By 10-12 months, only 5 out of 100 children have such problems. However, it is still better to keep these manifestations under control and contact a pediatrician if warning signs appear.


Why cottage cheese is very healthy and nutritious

Cottage cheese is a low-calorie cheese with a mild taste.

Its popularity has grown over the past few decades and is often recommended as part of a healthy diet.

Curd is rich not only in protein, but also in important nutrients.

For these reasons, it is widely used by athletes and in weight loss programs.

This article explains why cottage cheese is so healthy and how to include it in your diet.

Soft, white, creamy cottage cheese. It is considered a fresh cheese, so it does not undergo an aging or ripening process to develop flavor.

As a result, it tastes very mild compared to aged cheeses.

Cottage cheese is made from pasteurized cow’s milk cottage cheese of various levels, including non-fat, reduced fat or regular milk.

Cottage cheese is also available in different sizes, usually small, medium or large.

It is also available in cream, whipped cream, lactose-free, sodium-free and sodium-free versions.

You can enjoy this versatile cheese alone or as an ingredient in recipes.

Short Description Curd is a soft white cheese with a mild flavor. This is a fresh cheese with a different content of milk and cottage cheese.

The nutritional value of curd will vary depending on the level of milk fat used and the amount of sodium added.

One cup (226 grams) low fat (1% milk fat) cottage cheese provides the following (1):

  • Calories: 163
  • Proteins: 28 grams
  • Carbohydrates: 6.2 grams
  • Fats : 2.3 grams
  • Phosphorus: 24% of the Recommended Daily Allowance (RDI)
  • Sodium: 30% of RDI
  • Selenium: 37% of RDI
  • Vitamin B12: 59% from RDI
  • Riboflavin: 29% of RDI
  • Calcium: 11% of RDI
  • Folic acid: 7% of RDI

It also has decent amounts of vitamin B6, choline, zinc and copper.

The carbohydrate content of the curd is about 3%. It is made up of lactose, a milk sugar that some people cannot tolerate.

If you eat large amounts of cottage cheese, consider buying low-sodium or sodium-free varieties. High sodium intake raises blood pressure in some people, potentially increasing the risk of heart disease (2).

It is noteworthy that protein accounts for more than 70% of the calories in cottage cheese.

Summary Curd is an excellent source of protein and is relatively low in calories. It is also rich in many nutrients such as B vitamins, calcium, phosphorus and selenium.

Making curd is a simple process. You can even make this at home.

The process begins with the clotting of milk. For this, acidic substances, such as lime juice or vinegar, are added to warm milk.

When the acidity of the milk increases, the cottage cheese containing casein protein is separated from the whey, the liquid part of the milk.

When the curd has hardened, it is cut into pieces and cooked until more moisture is released, then it is washed to remove acid and drained to remove moisture.

The result is a sweeter curd that can be easily crumbled. Finally, ingredients can be added to add flavor to the finished product, including cream, salt, herbs, and spices.

Summary Curd is made by adding acid to milk, which causes the milk to curdle.Then the curd is drained and crumbled to form the final product.

Weight loss diets often include cottage cheese.

This is partly due to its high protein and low calorie content.

One study involved people on a high-protein diet such as cottage cheese for 1 year.

The diet has been shown to help reduce body weight by an average of 2.8 kg in women and 1.4 kg in men (3).

Additionally, a high intake of protein, such as casein in curd cheese, has been shown to help increase feelings of fullness (4, 5, 6).

In fact, cottage cheese seems to induce satiety as much as eggs do.

This feeling of fullness can lead to reduced calorie intake and weight loss (5, 7).

In addition, curd contains a large amount of calcium.

Research has linked calcium and other dairy components to weight loss and easier weight maintenance, especially when combined with exercise (8, 9, 10, 11).

In addition, dietary calcium is associated with metabolic processes that reduce fat storage and accelerate fat loss (10).

Summary Curd is rich in protein and calcium, both of which are associated with weight loss.

Curd cheese is popular among athletes and people involved in sports.

Thanks to its high protein content, it is an excellent product to include in your diet if you are looking to build muscle.

When combined with resistance training, a diet high in protein can help you increase muscle mass (8).

In addition, the proteins in curd are especially effective for building muscle mass.

Casein, 80% protein and slowly absorbed, is as effective as whey protein for building muscle – and even better at preventing muscle breakdown due to its slower absorption (12, 13).

Casein also contributes to the prolonged absorption of amino acids, which is associated with an increase in the ability to build muscle (14, 15, 16).

Many bodybuilders like to eat cottage cheese before bed. This results in a sustained release of amino acids into the blood and muscle overnight, which can reduce muscle breakdown.

Brief Description Casein Protein Cottage Cheese Casein is slowly absorbed, promotes muscle gain and helps prevent muscle breakdown.

Curd has also been associated with other health benefits.

May help prevent insulin resistance

Insulin resistance can lead to type 2 diabetes and heart disease.

However, calcium in dairy products is believed to reduce insulin resistance (9, 17).

In fact, one study found that consuming dairy products can reduce the risk of insulin resistance by 21% (18).

May help strengthen bones

Curd, in addition to calcium, is a good source of phosphorus and protein. These nutrients have been consistently linked to improved bone health (19, 20, 21).

High Selenium

A cup of curd per cup (226 grams) offers 37% of the RDI for selenium.This mineral has been shown to increase the antioxidant defenses of the blood (1, 22, 23).

Summary Curd may help reduce the risk of insulin resistance and heart disease. It may also help improve bone health and provide antioxidant protection.

The mild taste and soft texture of curd make it easy to add to dishes and recipes.

Here are some creative ways to eat curd:

  • Pancakes or waffles. Mix it with batter instead of milk.
  • Salads. Add it to your favorite salads for more protein.
  • Fruit. Combine with fruits such as berries, chopped bananas, peach wedges, tangerine wedges and melon slices.
  • Granola. Sprinkle muesli on top and sprinkle with honey.
  • Sour cream substitute. Suitable for replacing sour cream.
  • Dipping sauces. Mix it with dipping sauces instead of milk.
  • Smoothie. Combine it with milk and fruit for a fruity smoothie.
  • Toast. It produces a creamy spread rich in protein.
  • Bakery products. Bake muffins, cakes, bread or rolls from it.
  • Substitute for Mayo. Spread it on sandwiches or use in recipes.
  • Scrambled eggs. This will give the eggs an extra creamy texture.
  • Lasagna. Use it instead of ricotta cheese.

Summary Curd is a versatile ingredient that can be added to many dishes and recipes.

Curd is a dairy product that can cause problems for some people.

Lactose intolerance

The lactose content of cheese decreases with age.

Because curd is a fresh, unripe cheese, it contains more lactose than aged cheeses such as Parmesan, Cheddar or Swiss.

In addition, the curd can contain even more lactose if milk is added to the curd.

For these reasons, curd is not the best choice if you are lactose intolerant.

When people with lactose intolerance eat cottage cheese, they can experience digestive problems such as bloating, gas, diarrhea, and stomach pain.

Allergy to dairy products

In addition to lactose, curd contains casein and whey, two types of protein in cow’s milk that some people are allergic to.

If you have an allergic reaction to any dairy product, you may be intolerant of cottage cheese.

Summary Curd can cause digestive problems if you are lactose intolerant. It can also cause allergic reactions in people who are allergic to dairy products or milk proteins.

Curd – curd cheese with mild flavor and smooth texture.

It is rich in many nutrients including protein, B vitamins and minerals such as calcium, selenium and phosphorus.

If you are looking to lose weight or build muscle, cottage cheese is one of the healthiest foods you can eat.


Kefir curd | Delicious cuisine: community of happy recipes!

, Lindsay @ FunnyLoveBlog

The best hummus with just two ingredients! Prepare the lemon tahini dressing first, then add the chickpeas and hummus!

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This fall spiced chutney is made with late summer ingredients.Use as a milder substitute for cranberry sauce – it’s very versatile! Add a spoon on top of your favorite white meat, spoon into a turkey roll, or serve with sweet potatoes or apple chips, or both!

Beth Pierce

This gummy family cake contains seven ingredients and needs to be baked in less than ten minutes and is so popular at dinners and family gatherings that it is usually the first dessert. Bake one for your family today and let them be the judge.

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This peanut butter cup smoothie is the perfect start to the day! It’s completely vegan, gluten and keto free and ready in just 5 minutes! It tastes like dessert but is made entirely from superfoods, so it’s incredibly nutritious for your body! Plus, with all those healthy fats, proteins, and fiber, you’ll be full until lunchtime!

, Lindsay @ FunnyLoveBlog

Crab bisque and mac and cheese in this epic pair! These pasta and cheese are sticky, seasoned with Old Bay, and easy to make!

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This instant chicken bone broth is quick and easy to make in an instant pot: rich, filling and incredibly tasty.


Since it’s BBQ season, I thought I’d make a BBQ recipe, so it’s fried chicken time (Kai Young)! It can also be cooked in the oven when you have barbecued. I believe that delicious grilled meats need a good marinade – and this recipe will definitely not disappoint. It is full of flavor and you should try it this summer.


13 amazing benefits of cottage cheese that show how good it is for you

Cottage cheese, often referred to as the perfect cheese for a low-fat diet, has been used since the 70s.It has a creamy texture and a salty taste. And cheese has several other benefits that most of us don’t know about. But no more. Read on to find out more about the benefits of cottage cheese.


Why is cottage cheese useful?

Cottage cheese is an excellent source of calcium, B vitamins and vitamin A – all this makes it useful.

Calcium in cheese strengthens bones and prevents osteoporosis. B vitamins provide energy and vitamin A is good for the eyes.Well, we need to know a little more about curd.

Back to the table of contents

What are the advantages of cottage cheese?

1. Helps fight cancer

Cottage cheese is used in the popular Budwig diet, which is one of the best diets for cancer. The diet mainly includes cottage cheese and flaxseed oil and is known to help in the treatment of cancer.

Curd is rich in sulfur protein, some healthy saturated fats and other important nutrients such as B vitamins, phosphorus, calcium and selenium.Fermented foods like cottage cheese also contain beneficial probiotic bacteria that are known to prevent digestive system cancer.

The Budwig diet has also been found to fight breast cancer (1). Other studies also show how the diet increased the mortality rate of women already battling breast cancer.

Did you know?

Richard Nixon, the 37th President of the United States, used to eat cottage cheese and a pineapple ring for lunch; in fact, the cheese came from Knudsen’s dairy farm in Los Angeles.

2. Cottage cheese may help treat diabetes

According to the American Diabetes Association, cottage cheese is the best choice of cheese. And low-fat cottage cheese is preferable. Cottage cheese is a good source of protein, a nutrient that is especially important for diabetics.

It is also an excellent source of calcium and vitamin D, which is a powerful combination for treating diabetes. Studies have shown that women who consume adequate levels of calcium and vitamin D (1200 mg and 800 IU, respectively) per day are 33% less likely to have diabetes …

3. Strengthens bones

An abundance of calcium keeps curd on the list of essential bones for healthy bones. This is another reason why it can also help in the treatment of osteoporosis. Besides calcium, cheese also increases phosphorus intake. Both minerals form hydroxyapatite, a mineral that increases bone density, and several studies show how calcium and phosphorus deficiencies can be harmful to bones (2Trusted).

4. May Improve Digestive Health

Ironically, the calcium in curd can reduce heartburn and prevent indigestion.And cottage cheese is a good source of probiotics, which are known to improve digestion and prevent other related problems like constipation and irritable bowel syndrome.

But the beneficial properties of cottage cheese for digestion may not apply to people with lactose intolerance. If you are lactose intolerant, we recommend not to eat cottage cheese and consult your doctor.

5. May reduce the risk of heart disease

Curd contains vitamin B12, which is known to reduce excess homocysteine ​​levels.Excess homocysteine ​​can cause heart problems and other neurological problems that curd can prevent.

Curd is also low in fat, which is another reason it may be beneficial for heart health (3Trusted).

However, more research is needed in this regard. Consult your doctor before using curd for this purpose.

6. Cottage Cheese May Help Bodybuilding

Cottage Cheese is a constant source of muscle-building protein (one cup contains 27 grams of this nutrient).More importantly, cheese contains casein protein, which is slow to digest and offers your body a constant supply of important amino acids.

And riboflavin in cheese helps with protein absorption and improves bone health, which is especially important for bodybuilders. Eating cottage cheese before bed is one good way to get the protein your muscles need.

Cheese also helps prevent muscle cramps thanks to its natural sodium content. Sodium helps maintain a healthy fluid balance in the body and even interacts with other electrolytes to improve muscle contractions.

7. May help you lose weight

Protein in curd can keep you feeling full, which means you eat less, which means you have a chance to lose a few pounds in a healthy way. Some studies also show that calcium (which rich in cottage cheese) from dairy products can stimulate fat burning and suppress fat accumulation, which ultimately contributes to weight loss.

Curd is also known for its low calorie content.This is another plus if you are looking to lose weight.

8. May enhance immunity

Although there is very little research on this, some sources link the immunostimulating properties of cottage cheese to its magnesium content. Magnesium activates various enzymes in the body and supports immunity.

9. May help detoxify

The phosphorus in the curd plays a role here. According to research, phosphorus is the second most abundant mineral in the body, and it does an excellent job of removing waste.And the probiotics in the cheese flood the intestines with beneficial bacteria, thereby promoting detoxification.

Did you know?

It takes 100 pounds of milk to make 15 pounds of cottage cheese.

10. Helps slow down aging

In a sense, curd can slow down the signs of aging and improve skin and hair health. Cheese is a good source of selenium, which fights flaking and dandruff (4). In addition, vitamin E and other antioxidants found in cheese fight free radicals and make the skin healthier.

Your skin also needs proline to make collagen. Curd is a good source of proline and therefore promotes collagen production.

11. May improve vision

Some research suggests that increasing your intake of vitamin A and zinc can reduce your risk of vision loss. Curd contains both of these nutrients and therefore may play an important role in protecting your vision.

However, more research is needed to confirm this.

12. Cottage cheese is good for pregnant women

Cottage cheese is rich in protein, vitamin B12, dietary calcium and phosphorus – all of which are necessary for pregnant women. But make sure the cheese is made from pasteurized milk, as the unpasteurized version contains harmful bacteria that can cause miscarriage in pregnant women (5Trusted).

13. Is an integral part of the keto diet

If you are on a keto diet, fatty dairy is a big YES. As the name suggests, the keto diet is designed to achieve ketosis – a phenomenon in which your body uses fat for energy rather than glycogen or carbohydrates.This process is great for losing weight and also lowers the risk of certain diseases (6Trusted).

We are convinced of the benefits of cottage cheese. This might be quite unexpected, given the negative picture our societies have painted with cheese and other dairy products, but curd has its advantages, and it’s time for us to start realizing them.

This brings us to the next section – the nutrients in curd that make it what it is.

Back to the table of contents

What is the food profile of cottage cheese?

9011 9012 g

total carbohydrates



90 carbohydrates From9 (95.9 kJ)

3 9011 9011 9011


ol 0.01


90 selected113

9011 9011 9011 9011

Nutritional Facts

Serving Size 226 g

Calories 163 Calories% of Fat 20
saturated fat 1 g 7%
Trans fat
Cholesterol 9 mg 3%
Fiber 0 g 0%
Sugar 6 g
9012 9012 9012 9012

9012 9012 9079 9012

9012 9012 9080 0%
Calcium 14%
Iron 2%
Calorie Information
Amount per serving % DV
From fat 20.3 (85.0 kJ)
From protein 120 (502 kJ)
From alcohol 0, 09 (0.0128 0.09)
Proteins and amino acids
Amount per serving % DV
Protein 28.0 g 56%

9011 9011 9011 9011 9011
% DV
Vitamin A 92.7IU 2%
Vitamin C 0.0 mg 0%
Vitamin D
Vitamin E (alpha
Vitamin K 0.2 μg 0%
Thiamine 0.0 mg 3%
Riboflavin 0.4 mg 22% 1%
Vitamin B6 0.2 mg 8%
Folate 27.1 μg 7%
127 79

acid 0 , 5 mg

Choline 39.5 mg
Calcium 138 mg 14%
Iron 0.3 mg 2%
Magnesium 11.3 mg 3%
Phosphorus 303 mg 30%
128 9012 9012 9012 901

9080 9080 Calcium

Zinc 0.9 mg 6%
Copper 0.1 mg 3%
3 μg 29%
Fluoride 71.4 μg

Now we come to an important discussion – is Greek yogurt better than cottage cheese? Could this be a good replacement?

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Curd Vs. Greek yogurt

Cottage cheese is higher in calories, but also contains more protein. Although low-fat Greek yogurt is lower in fat, it contains comparatively less protein.

And if we talk about carbohydrates, then both are the same. While curd is high in sodium (around 800 milligrams per cup), Greek yogurt contains around 65. When it comes to sugar, Greek yogurt has more of it, so curd may be a better option for those trying to avoid sugar.

But when it comes to probiotics, Greek yogurt has the advantage. This makes Greek yogurt much easier to digest than curd.

And if you are wondering if it is always worth buying cottage cheese from the market, we have good news for you.

Back to the table of contents

How to make cottage cheese at home

A simple process. And all you need is raw milk. You can take half a gallon of raw milk and some salt (for flavor).

Here’s what you need to do:

  1. Skim the milk and place in a glass jar in the refrigerator for later use.
  2. Pour skim milk into a glass bowl and cover with cheesecloth. Leave it on for a couple of days until it becomes a jelly-like consistency. There should be no watery whey on top.
  3. Skim off excess cream and pour the condensed milk into a large saucepan. Place on low heat for about 10 minutes, until milk separates into curd and whey.
  4. Pour the curd and whey into a strainer, a muslin butter cloth (and another bowl) and drain for about 2-3 hours.
  5. Remove the curd from the muslin butter cloth and transfer to another bowl. Crumble them into small pieces. Salt. Now you can pour out the rest of the cream you saved earlier and mix well. Your homemade cottage cheese is ready!

Back to the table of contents


Curd has been around since the 1970s, and for good reason. Not only does it taste great, it also has incredible health benefits.Within certain limits, this can be a great addition to your diet.

Tell us how this post helped you. Just leave a comment in the box below. We value your feedback.

Expert Answers to Reader Questions

What are the healthiest ways to eat cottage cheese?

There are several ways to include cottage cheese in your diet in a healthy way:

  • Add it to your fruit salad.
  • Add to smoothies.
  • Add to pancake batter to make curd pancakes.
  • Add paste.

How much cottage cheese can you eat per day?

Recommended daily dosage ranges from 25 grams to a bowl. We suggest that you discuss the appropriate dosage with your doctor.

What are the side effects of excess cottage cheese?

Because cheese is an excellent source of protein, eating it along with other protein-rich sources can lead to excess protein intake, which will ultimately lead to kidney strain and organ problems.

In addition, if you are lactose intolerant, eating cottage cheese can cause allergic reactions and gastrointestinal problems.

And given the large amount of sodium, excess consumption of cottage cheese can lead to hypertension, which is also bad for the heart.

How long does the curd last?

Refrigerated storage lasts 5 to 7 days. In the freezer, cottage cheese can be stored for up to 3 months.

Can cottage cheese be fed to dogs?

Yes.The calcium and protein found in cheese can be beneficial for your dog. But avoid this if you have digestive problems.

What is the best substitute for cottage cheese?

Plain Greek yogurt is a good substitute. Even ricotta cheese or sour cream can help.


  1. “Flaxseed sprouts cause …”. US National Library of Medicine.
  2. “Bones need calcium and …”. WebMD.
  3. Heart Matters.British Heart Foundation.
  4. Top Ten Products for Glowing Skin. Forbes.
  5. “Prevention of infections during pregnancy”. Centers for Disease Control and Prevention.
  6. “Very low carbohydrate content …”. US National Library of Medicine.

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Ravi Teja Tadimalla is an editor and published author.He graduated from SRM University in Chennai and has been working in digital media for over six years. He holds a professional certificate in food, nutrition and research from Wageningen University. He considers himself a sculptor, born to discard content and reveal its dormant splendor. He began his career as a research writer with a focus on health and wellness, and has over 250 articles to his credit. Ravi believes in great potential for a healthy person through natural products and organic supplements.His other interests are reading and theater.


Foods that should not be given to infants and young children


Babies should not eat too much salt as it is harmful to their kidneys.

Do not add salt to baby food or cooking water, and do not use bouillon cubes or gravy, as these are often high in salt.

Keep this in mind when cooking for the family if you plan on giving the same meal to your child.

Avoid salty foods such as:

  • bacon
  • sausages
  • chips with added salt
  • crackers
  • chips
  • ready meals
  • takeaway


Your child does not need sugar.

Avoiding sugary snacks and drinks (including fruit juices and other fruit drinks) will help prevent tooth decay.

Saturated Fat

Avoid giving your child too many foods high in saturated fat such as chips, cookies and cakes.

Checking food on labels can help you choose foods that are low in saturated fat.

See food labels for more information.


Sometimes honey contains bacteria that can produce toxins in the intestines of the baby, resulting in infant botulism, which is a very serious condition.

Do not give honey to your child until he is 1 year old. Honey is sugar, so avoiding it will also help prevent tooth decay.

Whole nuts and peanuts

Whole nuts and peanuts should not be given to children under 5 years of age, as they may choke on them.

You can give your toddler nuts and peanuts from about 6 months old if they are crushed, crushed, or are smooth nuts or peanut butter.

If your family has a history of food or other allergies, talk to your GP or healthcare team before introducing nuts and peanuts.

Learn more about food allergies in infants and young children.

Certain cheeses

Cheese can be part of a healthy and balanced diet for infants and young children and contains calcium, protein and vitamins.

Pasteurized fat cheese can be eaten by infants from 6 months of age. This includes hard cheeses such as soft cheddar cheese, cottage cheese and cream cheese.

Infants and young children should not eat soft cheeses that have ripened in mold, such as brie or Camembert, as well as ripe goat’s milk and soft cheeses with blue veins, such as Roquefort, as there is a higher risk that these cheeses may carry bacteria called listeria.

Many cheeses are made from unpasteurized milk. They are best avoided due to the risk of listeria.

You can check the labels on the cheeses to make sure they are made from pasteurized milk.

But these cheeses can be used as part of a cooking recipe, as the Listeria die during the cooking process. For example, baked brie is a safer option.

Raw and lightly cooked eggs

Eggs can appear in babies from about 6 months of age.

If the eggs are chicken and have a red lion imprinted on them, or you see a red lion with “British Lion Quality” on the box, your child may be eating raw eggs (eg in homemade mayonnaise) or lightly cooked eggs.

Chicken eggs that do not have the red lion mark should be boiled until both the white and the yolk are hard. So should duck, goose or quail eggs.

Avoid raw eggs, including raw cake mixes, homemade ice cream, homemade mayonnaise, or desserts containing raw eggs that you cannot verify are marked with the red lion seal.

Rice drinks

Children under 5 years old should not use rice drinks instead of breast milk or infant formula (or cow’s milk after 1 year old), as they may contain too much arsenic.

Arsenic is found naturally in the environment and can enter our food and water.

Rice tends to absorb more arsenic than other grains, but that doesn’t mean you or your child can’t eat rice.

The EU allows maximum allowable levels for inorganic arsenic in rice and rice products, and even stricter levels are set for products intended for young children.

Don’t worry if your child has already eaten rice drinks. There is no immediate risk for them, but it is better to switch to another type of milk.

Learn more about arsenic in rice

Raw Jelly Cubes

Raw Jelly Cubes can be a choking hazard for babies and young children.

If you are making jelly from raw jelly cubes, be sure to follow the manufacturer’s instructions.

Raw shellfish

Raw or lightly cooked shellfish such as mussels, shellfish and oysters can increase the risk of food poisoning, so it is best not to give them to babies.

Shark, swordfish and marlin

Do not feed your baby shark, swordfish or marlin. The amount of mercury in these fish can affect the development of the baby’s nervous system.

Additional Information

Last Page Checked: November 15, 2018
Next Review Date: November 15, 2021

. 90,000 Premature babies born between 28 and 37 weeks of gestation

Yatsyshina E.E., Ph.D.

Premature babies are those born at a gestational age of 28 to 37
full weeks. The reasons for premature birth are varied: too
young age of the mother, previous abortions, pathological atypical course
pregnancy, illness, physical and mental trauma, nicotine and alcohol.

Premature babies have distinctive external features. They have skin
thin, dry, wrinkled, abundantly covered with fluff.Lack of maturity
blood vessels is clearly manifested if you put the child on its side – the skin
acquires a contrasting pink color. The bones of the skull are malleable, not only open
a large, but also a small fontanel. The auricles are soft – the cartilage in them is not yet
formed, pressed to the head, and not separated from it, as in full-term. Nails not
reach the edge of the phalanges of the fingers, the umbilical cord is located below the middle of the body, and not in
center. The underdevelopment of the genitals is indicative: girls have small genitals
the lips are not covered with large ones; in boys, the testicles are not descended into the scrotum.

Premature baby is bad, sucks sluggishly, swallows with difficulty, cry is weak,
breathing is irregular. Skin redness is more intense and lasts longer.
Physiological jaundice of the skin can be delayed up to 3-4 weeks
life, instead of 1 week. The umbilical cord falls away much later and the umbilical
the wound heals more slowly. In premature babies, often at 1-2 weeks of life
edema appears, located mainly on the legs and abdomen.

Has its own characteristics and physiological weight loss after birth.A premature baby “loses weight” by 5-15% of the birth weight, in contrast to
full-term, which loses weight only up to 5-8%. Mass is restored from
prematurely later than 1 week of life, only by 2-3 weeks the weight reaches
values ​​at birth. Moreover, the timing of mass recovery is in a straight line
depending on the maturity of the child, that is, not only on the date of his birth, but also
the degree of adaptation of the child to environmental conditions, depending on the course
pregnancy and the presence or absence of malformations.Deeply premature
children with diseases in 3-4 weeks of life can only recover
physiological weight loss, but not add to it.

In premature infants, the nerve centers that regulate the rhythm are not fully formed
respiration, the formation of lung tissue is not completed, therefore, their respiration rate
fickle: with anxiety it reaches 60-80 per minute, at rest and in sleep –
truncated. The heart rate also depends on the condition of the child and
environmental conditions.When the ambient temperature rises and when
anxiety of the child, the heart rate rises to 200 beats in 1

In premature babies, asphyxia, intracranial hemorrhages, they
more often suffer from pneumonia, infectious diseases. These children are more likely to
anemia develops, especially during the period when intensive growth begins and
weight gain (2-4 months).

The further development of the child is determined not only by the degree of prematurity,
but also in many respects the state of his health at the given time period.By the end of the year
weight increases 5-10 times compared to birth weight, average height
is 70-77 cm in children with a minimum degree of prematurity. Fully compared by
development with full-term at 2-3 years of age. Children with severe prematurity and
suffering from any medical conditions align with full-term babies by 7-8
years. Moreover, during puberty, children may also lag behind,
born prematurely, from peers in physical development.

Feeding premature babies

One of the problems in nursing premature babies, especially babies with
extremely low body weight is a feeding problem. Premature
children are very sensitive to nutritional deficiencies. This is due to limited
reserves of protein, fat, energy. Ability to absorb, digest and exchange
nutrients in these children is significantly reduced. Surface ratio and
body weight in a premature baby is high, which determines a higher
the need for nutrients and energy.

Adequate feeding explains much of the success in
nursing premature babies. Relative functional weakness
the gastrointestinal tract of a premature baby requires special care when
the appointment of feeding. Prematurely born children differ more
intensive growth rates compared to full-term and therefore need
more intensive intake of energy and plastic material with food. At the same
time, functional ability of the digestive system to assimilate nutrients
their substances are relatively limited, and food tolerance is lower than that of
full-term babies.Therefore, the physiological rationale for optimal modes
feeding is possible only taking into account the characteristics of the premature organism and
organs of his digestive system. When prescribing nutrition to premature
newborns take into account not only their need for nutrients, but also
anatomical and physiological features of this contingent of children. Differences in
clinical condition and ability to adapt with the same
mass and height indicators, but with different gestational ages,
dictate the need for an individual approach to the appointment of food.

Peculiarities of the digestive system of prematurity

Development of all functions of the digestive system, their maturation,
occurs both in the prenatal period and after the birth of the child. This
the process is uneven. Formation of gastrointestinal motility
tract begins at the earliest stages of intrauterine development.

The ability to suck in premature babies appears mainly after 32
weeks of gestation. With premature birth, insufficient development of sucking and
swallowing reflexes in a child are often aggravated by perinatal lesions
central nervous system.

Consequently, in the period of intrauterine development, the formation of various
stages of the digestion process in a human fetus occurs unevenly and
formed only by the end of the mentioned period. This determines the relative
functional immaturity of the digestive system in a premature baby, so
more significant, the less his gestational age.

Transient decrease in the tone of the lower esophagus and the predominance of tone
sphincter of the pyloric stomach over cardiac for premature babies
typical.Peristalsis of the esophagus is highly active, and possible
simultaneous contractions of the esophagus along the entire length. All this contributes
regurgitation of stomach contents and regurgitation in immature children.

Characteristic features include decreased sucking and weakness.
swallowing reflex. Salivation in premature babies begins with the first
feeding, but at the same time the volume of salivation is reduced compared to full-term
newborns. Salivation is necessary to create negative pressure in
oral cavity when sucking, and the amylolytic activity of saliva promotes
the normal course of digestion.

The volume of the stomach in premature babies is small, the mucous membranes are tender, good
vascularized and have poorly expressed folding, and various departments
the stomach is not sufficiently differentiated. Stomach motility depends mainly on
way, on the type of enteral nutrition. Human milk is retained in the stomach for
shorter period (it is shorter by 30-60 minutes) than milk mixtures. Deceleration
gastric emptying can be associated with the immaturity of the child and with various
perinatal pathology: respiratory disorders, central
nervous system, adrenal insufficiency, intoxication in severe
infectious processes.The formation of the evacuation function of the stomach occurs
in parallel with the formation of intestinal motor function

In premature babies, the tendency to regurgitation (regurgitation) is explained
the predominance of the tone of the pyloric sphincter over the underdeveloped sphincter
cardiac part. The secretion of gastric juice is reduced. Moreover, in
newborns in gastric secretions, in addition to the usual pepsin, was found
fetal pepsin, the activity of which is 1.5 times higher. His concentration
decreases from 2 months of age.

Pancreatic function is preserved even in very premature infants. Intestinal
enzymes involved in protein and carbohydrate metabolism are formed
earlier than lipolytic enzymes, therefore, in premature babies it is often
there is an increased excretion of fat in the stool.

The main intestinal enzymes in these children are less active than in
their full-term peers, but gradually this activity increases.

Formation and normal functioning of the organs of the gastrointestinal tract
in newborns is largely associated with the presence in breast milk
growth factors (epidermal, insulin-like, transforming).

Determinant in the development of the digestive tract after the birth of a child
is enteral nutrition. Nutrient intake in
the gastrointestinal tract is a powerful stimulus for activating its motor and
secretory activity. Moreover, even minimal amounts of food (about 4 ml per
1 kg per day) have the same stimulating effect
on the intestines, as well as large volumes.

Intestinal motility depends on the feeding method. Portioned
nutrition in immature children leads to a decrease in duodenal motility and can
provoke regurgitation, while prolonged infusion of milk in
the stomach through a nasogastric tube allows you to keep it stable.At
reducing the concentration of the nutrient mixture, its stimulating effect on the intestines
decreases. Cool and warm meals do not affect intestinal motility.

The composition of the intestinal microflora affects the state of metabolic
processes and resistance of the body of children born prematurely to
various pathogenic agents. Dysbacteriosis is often accompanied by severe
infectious and inflammatory diseases of the neonatal period. Character
feeding is in many ways directly related to intestinal colonization.

Diseases acquired after birth impair activity
the digestive system of premature babies, narrowing its adaptive capabilities.
With severe perinatal lesions of the central nervous system and infectious
processes in premature newborns enzymatic activity of the digestive
the path is reduced by an average of 1.5 times. By the age of one month, only
its partial restoration.

Principles of feeding premature babies 1 month of life

Clinical condition and ability to adapt at the same weight and height
indicators of a child at different gestational ages may differ, which
suggests the need for an individual approach to prescribing a diet
premature babies.

  1. Current nutritional guidelines currently suggest:
  • A full-term healthy baby should be breastfed with
  • The first latch to the breast is performed immediately after the initial
    activities and lasts at least 30 minutes.
  • A similar approach is recommended for healthy premature babies with
    gestation period 35 weeks or more, body weight 2000 g or more, active sucking.
  • Contraindications to breastfeeding can be:
  • Absolute contraindications:

    • metabolic disorders in a child requiring special nutrition,
    • maternal drug addiction,
    • open form of tuberculosis in the mother,
    • HIV infection in the mother.

    Relative contraindications:

    • extremely low birth weight,
    • maternal mental illness,
    • maternal viral hepatitis B,
    • hyperbilirubinemia (yellowness of the skin) in a newborn,
    • the mother took certain medications (radioactive isotopes,
      chemotherapy, antimetabolites).
  • In case of contraindications to breastfeeding, it is recommended
    carry out artificial feeding with adapted formulas.
  • Enteral nutrition (through the oral cavity) in healthy premature infants and
    full-term, with pathology of the perinatal period, possibly with the following
    • absence
      surgical diseases requiring intervention,
    • the presence of peristalsis
      intestines and passage of meconium,
    • if stock
      the ability of a full-term and premature baby to retain and assimilate
      human milk or specialized mixtures.
  • Enteral nutritional contraindications:
    • extremely serious condition of a premature and full-term baby,
    • malformations of the gastrointestinal tract,
    • severe hemorrhagic syndrome.
  • In the presence of contraindications to enteral nutrition and before
    elimination, complete parenteral nutrition is performed (intravenous
  • With complete parenteral and trophic nutrition, the calculation of the volume of fluid and
    electrolytes are carried out according to the recommendations of the RASPM by the doctor supervising
    for the premature.
  • It should be considered necessary to carry out a minimum (trophic) nutrition of 3-5 ml in both full-term and premature babies, even with
    the impossibility of providing the child’s energy needs in terms of the severity of the condition due to enteral nutrition, but in the absence of contraindications to enteral nutrition.
  • The initial volume of trophic nutrition is determined by the child’s body weight and increases gradually (from 3-5 ml) under the control of tolerance to volume.
  • Very premature infants (body weight less than 1500 g) are fed through a tube in the stomach and a gradual transfer from the tube is advisable.
    feeding on breast (from a bottle) after reaching the full age volume of enteral nutrition.
  • It is recommended to use breast milk or an adapted formula (for full-term or premature infants) for enteral feeding.
  • When breastfeeding deeply premature babies, it is advisable to use breast milk fortifiers (enhancers).

  • Transfer to feeding with specialized mixtures (lactose-free hydrolysates) can be carried out in the presence of impaired tolerance
    (portability) to the composition.
  • With the appearance of pronounced signs of fatigue when sucking in a premature
    or a full-term baby with neonatal disease and
    being in a state of moderate severity, control
    weighing and feeding (from a bottle or through a tube).
  • Definition of feeding tactics

    1. The choice of feeding method is determined by the severity of the child’s condition, weight
      body at birth, gestational age.
    2. Early start of feeding: regardless of the method chosen, it is advisable to start the first feeding within 2-3 hours after the birth of the child and no later than 6-8 hours.
    3. Maximum use of enteral (oral)
    4. Fortification of diets of deeply preterm infants receiving
      female milk.
    5. The use of artificial feeding only specialized milk formulas intended for feeding premature babies.

    Methods of feeding premature babies

    When breastfeeding, four questions must be answered: when to start
    food, in what volume, what is preferable and what method to carry out
    feeding. Currently, the degree of prematurity is allocated depending on
    gestational age.With this approach, the feeding method is as follows

    90,050 90,024 babies less than 32 weeks of gestational age should be fed through
    nasogastric tube with expressed milk, it is necessary to start expressing in the first
    6 hours postpartum,

    90,024 newborn infants aged 32-34 weeks of gestation are fed both
    probe or bottle,

    90,024 babies over 34 weeks of age can breastfeed and can be tube-fed
    or from a bottle.

    Depending on the well-being of the newborn and birth weight, method
    feeding assumes the following:

    Newborns weighing more than 2000 g, with good health, can be applied to the mother’s breast on the first day
    life. Usually a 7-8 feeding regimen is established.

    For premature babies, a free feeding regimen is unacceptable.
    due to the inability of such children to regulate the volume of milk sucked and
    frequent diseases of this age, however, night feeding is possible.

    When breastfeeding, watch for signs
    fatigue – cyanosis around the eyes and lips, shortness of breath. The presence of this symptomatology
    is an indication for a more rare attachment to the breast or for the transition to
    complete bottle feeding with expressed breast milk with significant
    severity of symptoms.

    The efforts of doctors and mothers should be aimed at preserving breast
    feeding as much as possible, taking into account the value of mother’s native milk for an immature baby.

    Children weighing 1500-2000 g are given a trial bottle feeding. At
    unsatisfactory sucking activity is performed by probe (gastric
    probe) feeding in full or in part.

    Very premature babies weighing less than 1500 g are fed through
    probe. For this purpose, silicone probes are used, which are installed in
    stomach for nasogastric feeding. You need to make sure
    correct installation of the probe by lowering its free end into water (no
    air bubbles).When carrying out probe feeding, it is necessary to periodically
    before feeding, control the amount of milk or milk remaining in the stomach
    mixture, which should not exceed 10% of the entered amount in
    previous feeding .. Repeated suction of a large amount of food from
    stomach, as well as the presence of frequent and profuse regurgitation are
    indications for revising the feeding scheme or changing the way of feeding.

    Probe feeding can be in portions or by using the method
    long-term infusion.With portioned meals, the frequency of feeding is
    7-10 times a day. Given the very small volume of the stomach, deeply premature
    children with this method of feeding are malnourished, especially
    in the early neonatal period, which dictates the need for additional
    parenteral (intravenous) administration of nutrients.

    Long-term tube feeding is carried out using syringe infusion
    pumps. The syringe and adapter are filled with human milk or formula and
    connected to the baby’s probe.Only the volume of milk in the syringe is taken into account.
    A specific infusion rate is set. It is necessary to control the process
    feeding, which is carried out by medical personnel caring for the child. At
    this may be attended by the mother of the child to learn the skills of caring for

    There are various long-term infusion regimens. Breast milk or
    specialized milk formulas can enter the body of a premature baby
    child around the clock, which is quite physiological, since with intrauterine
    the development of the fetus, the supply of nutrients is continuous, or during certain
    periods at short intervals.The most convenient are feeding schemes,
    when the 2-hour infusions are followed by the same breaks or when after
    For 3-hour injections, an hour break is set. Possibly a small night
    a break during which glucose solutions are administered, if necessary, or
    Ringer. The initial infusion rate of milk can be 1.5-3 ml per
    1 kg per hour. The speed gradually increases, reaching to
    6-7 days 7- 9 ml per 1 kg
    in hour. This provides deeply premature or severely
    condition for more mature newborns, a larger amount of food than with

    Carrying out long-term probe feeding allows you to reduce the volume or
    completely exclude parenteral nutrition. Compared to portioned administration
    breast milk or milk formulas, stagnation decreases,
    the intensity and severity of jaundice, a constant level is maintained
    blood glucose, the frequency of regurgitation and respiratory disorders associated
    with feeding.

    If the severity of the child’s condition does not allow enteral
    feeding (through a tube or from a bottle), parenteral is prescribed
    food (intravenous fluids).Deep prematurity is not
    an indication for complete parenteral nutrition, since even extremely
    immature children (body weight less than 1000g) can metabolize human milk or
    specialized products in a certain volume and only need to be carried out
    partial parenteral nutrition in the first days of life. Required volume
    solutions for partial parenteral nutrition is selected individually and
    gradually decreases as the resistance of the premature grows
    the newborn to enteral nutrition.Increasing the volume of feeding should
    carried out very slowly to allow time for increased activity
    digestive enzymes and the establishment of absorption mechanisms. Start scheme
    enteral nutrition is as follows: a sample with distilled water, then
    volume of water or several injections of 5% glucose solution, then breast milk
    mother. The appearance of breast milk in the gastrointestinal tract of the baby leads to
    a cascade of changes in its development and stimulates it.

    Use of trophic (or initial) food for preparation
    gastrointestinal tract to enteral feeding is well tolerated. Introduced
    approximately 10-14 ml / kg / day. Mother’s whole breast milk preferred
    or a woman who gave birth prematurely (thermally untreated), but may also
    use a specialized mixture for premature babies in half

    Feeding in this mode lasts from 7 to 14 days, then slowly
    concentration and volume increases.Using the initial method
    feeding leads to a decrease in the yellowness of the skin, less often
    metabolic bone disease occurs, as well as increased production
    hormones of the gastrointestinal tract. Decide to switch to enteral
    Feeding in extremely low birth weight infants is often difficult.
    Tactics are decided by the attending physician. At the same time, the degree of prematurity is taken into account,
    disease data, current clinical status, functioning
    gastrointestinal tract and other factors.Optimal timing should
    be strictly individual for each low birth weight child and vary in
    according to the different course of the disease. Minimal enteral nutrition
    is prescribed not for the purpose of feeding the newborn, but for the formation and maintenance
    normal functioning of the intestinal wall (otherwise the morphological
    the structure of the intestinal mucosa and its permeability increases, the level of
    intestinal hormones), preventing mucosal atrophy, activating
    intestinal motility and to prevent congestion in
    gastrointestinal tract.Introduction of human milk or adapted milk
    mixtures through a nasogastric tube should begin within 12-48 hours after
    birth of a child. The initial feed volume is no more than 10 ml per
    1 kg
    per day and increases extremely slowly, no more than 1/3 of the volume that
    the child received the previous day. It is preferable to carry out
    long-term infusion of human milk using infusion pumps, since
    slow and prolonged introduction of the product contributes to the development of motor skills
    intestines, while with fractional feeding, the motility is reduced.

    Depending on the degree of prematurity and birth weight
    the feeding pattern is as follows:

    Body weight less than 1000g.

    1. complete parenteral nutrition + “trophic nutrition”
    2. partial parenteral nutrition + continuous tube infusion

    Body weight 1000 – 1500 g.

    1.partial parenteral nutrition + continuous tube infusion

    1. Continuous tube infusion

    Body weight 1 500 – 2 000 g.

    1. Continuous tube infusion
    2. tube feeding or portions from a bottle
    3. breastfeeding

    Body weight 2000 – 2500 g.

    1. tube feeding or portions from a bottle
    2. breastfeeding.

    Breast attachment time

    The doctor determines the time of the appointment of the first feeding of the premature baby
    newborn, which is determined by his condition after birth.Delayed
    the first feeding increases the initial weight loss,
    and also, can lead to violations of the water-electrolyte balance,
    acidosis and a number of other undesirable pathological conditions.
    A premature baby born in a relatively satisfactory condition
    may receive the first feed within minutes after birth, or
    after 4-6 hours. The maximum duration of the “hungry” period, after
    birth should not exceed 24 hours.Sometimes such a long delay in
    prescribing food is necessary if the child has suffered severe
    antenatal asphyxia (hypoxia), as well as if there is a suspicion of
    intracranial hemorrhage, with frequent regurgitation. If a premature baby
    does not receive nutrition for 12 or more hours, intragastric administration of 5% is necessary
    glucose solution (5 ml every 3 hours) or parenteral administration
    10% glucose solution (3-5 ml), which is determined by the attending doctor.

    In the presence of an active sucking reflex and general
    the satisfactory condition of children weighing more than 2,000 g is applied to the chest,
    prescribing first 1-2 breastfeeds, and the rest from the bottle. When the appearance
    signs of fatigue (cyanosis of the nasolabial triangle, lethargy sucking)
    breastfeeding is discontinued and pumped with expressed milk from the nipple. At
    breastfeeding control over the amount of milk sucked
    carried out systematically by weighing the child before and after feeding.It should be remembered about the small capacity of the stomach in premature babies. Therefore, in
    the first days of life, the volume of one feeding can be from 5 ml (in the first
    day) up to 15-20 ml (on the third day of life).

    Frequency rate of feeding premature infants

    The frequency of feeding is determined by the weight of the child, his general condition and
    degree of morphofunctional maturity. Premature newborns accepted
    prescribe 7-8 times feeding (with an interval of 3 hours).With deep
    prematurity and in some pathological conditions the frequency of feeding
    increase up to 10 times a day. Feeding very premature babies and
    newborns in a severe and moderate condition with diseases,
    should be performed using a nasogastric tube. At the same time, food
    dosed and injected using a sterile syringe or special dosing
    device (infusion pump). As the sucking reflex revives and if
    an adequate swallowing reflex is transferred to feeding through the nipple.

    Requirements for energy and essential nutrients

    To monitor the adequacy of feeding a premature baby
    the doctor should regularly calculate the nutrition (daily). When calculating
    nutrition for premature babies should use only the “high-calorie” method:
    the child should receive with food:

    • in 1 day 25-30 kcalkg,
    • in 2 days – up to 40 kcal,
    • for 3 days – up to 50 kcal,
    • on the 4th day of life – up to 60 kcal kg,
    • on the 5th day of life – up to 70 kcalkg,
    • on the 6th day of life – up to 80 kcal,
    • on the 7th day of life – up to 90 kcalkg,
    • by 10-14 days of life – up to 100-120 kcal.

    The amount of the diet is determined by the content of calories in the mixture that the
    child. The calorie content of the mixture is indicated on the package and the calorie content of the diet.
    prematurely born baby should increase gradually and daily.

    Basal metabolic rate in premature babies in the first weeks of life
    lower. To maintain it in a thermoneutral environment for a premature baby
    during the first 2-3 weeks is required for full parenteral
    nutrition about 40 kcal, and with enteral feeding – about 50
    kcalcgsut.To increase body weight by 1
    you need an additional 3-4.5 kcal. Thus, a premature baby
    should receive daily 50 kcal to maintain basal metabolism and
    45-67 kcal kg to achieve an increase in body weight equal to intrauterine (15
    hkg). Taking into account energy consumption, the energy needs of premature babies
    make up during the first two weeks of life up to 120 kcal.

    By the 17th day of life, energy needs increase to 130 kcalkgsut.At
    artificial feeding, the calorie content of the diet should not exceed 130
    kcalcgsut. The use of human milk in the nutrition of premature babies, as well
    as well as carrying out mixed feeding, it involves an increase in calorie intake to
    monthly age up to 140 kcal. Calculation of nutrition for artificial
    feeding is carried out taking into account the calorie content of the mixtures used.

    Starting from the second month of life of a premature baby born with a mass
    body more than 1500 g,
    the calorie content of the diet is reduced monthly by 5 kcal kg to the norms adopted
    for mature children and constituting 115kcalkg.Reducing calorie intake
    deeply premature babies (body weight less than
    1500 g
    ) is carried out at a later date – after 3 months of age for 5-10
    kcal kg of body weight, taking into account the child’s condition, food tolerance, character
    weight curve.

    Calculation of calorie content and amount of food does not give a complete picture of
    the qualitative composition of the diet received by a premature baby. Necessary
    take into account the nutritional needs of premature babies in basic nutrients.

    The protein requirement in premature babies is higher than in babies born in
    term. Previously, when feeding premature babies with breast milk, it was recommended
    protein consumption at the rate of 2.2-2.5 gkg day in the first 6 months of life and 3.0 –
    3.5 kg of weight in the second half of the year, and with artificial and mixed feeding
    it was decided to provide a higher intake of protein – up to 3.0-3.5 gkgsut
    in the first half of the year and 3.5-4.0 gkg day – in the second (due to this, with
    artificial feeding, the energy value of the diet increased by
    10-15 kcalkgsut compared to breastfeeding).Now the majority
    researchers recommend the introduction of 2.25-4.0 gkgsut of protein for premature babies,
    since intrauterine growth rate can be achieved with
    intake of at least 2.8-3.1 gkg day of protein into the body, while
    consumption of more than 4.0 gkg day leads to severe metabolic disorders,
    to plasma hyperosmolarity and acidosis. The lower the gestational age of the child,
    the higher its need for protein (full-term newborns – up to 2.2 g / kg / day).

    The need for fat in premature babies is based on the characteristics of its
    metabolism in immature children and on the fat content of human milk.The need for premature infants in fat is 5-7 gkg, but the most
    the optimal consumption can be considered to be 6.0-6.5 gkg in the first half of the year and 5.5 –
    6.0 gkg – in the second. Features of lipid metabolism in premature newborns
    newborns consists in the later development of lipolytic function by
    compared with proteolytic, which can lead to hyperlipidemia and steatorrhea.
    Therefore, the amount of fat in the diet should not exceed the recommended amount.

    The need for carbohydrates in premature babies during the first year of life
    regardless of the type of feeding is 10-14 gkg day.The basis for
    calculations are the energy requirements of premature babies and the carbohydrate content
    in human milk.

    The need for fluid in premature babies in the first day of life
    is 30-50 mlkgsut. By the end of the first week of life, the amount of fluid
    administered per day is 70-80 mlkg for children weighing less than 1500g and
    80-100 mlkg with a weight of more than 1500g. The calculation takes into account the liquid contained
    in breast milk (87.5%). By the 10th day of life, the water regime is 125-130
    mlkg day, by day 15 – 160, by day 20 – 180, by day 30 – 200 mlkg day.

    As a drink in the first days of life, use boiled water, solution
    Ringer with 5% glucose solution (in a 1: 1 ratio), as well as 5% solution
    glucose. At the age of 2-3 days for very premature babies in the unloading mode
    5% glucose solution is injected 5-8 times a day through a gastric tube or
    intravenously at the rate of 30-50 mlkg day.

    From 1 month of age, boiled water is used as a drink.
    The need for vitamins in premature babies is not well understood.It is believed that they are higher than that of term babies, due to the significant
    growth rate and high metabolic rate. This is of particular importance for
    deeply premature babies. Vitamin requirements after 34 weeks of gestation
    approaches the values ​​adopted for mature children.

    The needs of term infants have been established based on the level of B vitamins
    human milk. With artificial feeding, the content of vitamins in the daily
    rations increases by about 20%, taking into account their digestibility.

    Usually premature babies fed by a native mother
    milk, do not need additional introduction of vitamins. Nevertheless,
    the vitamin composition of breast milk is determined by the characteristics of the diet of nursing
    mothers. Therefore, it is necessary to pay attention to their rational nutrition. But,
    taking into account the immaturity of the processes of metabolism of nutrients and
    excretory systems of the body, for prematurely born children, excess
    intake of vitamins can have even more negative consequences than
    insufficient introduction.

    Doses can be considered sufficient for the intake of a premature baby
    15-30 mg kg day for vitamin C and 0.15-0.20 mg kg day for vitamin B2, 0.125-0.150
    mgkg day for vitamin A and 1.0 mgkg day for vitamin E.

    Additional prescription of vitamin D to premature infants receiving
    breast milk does not prevent the development of rickets and osteopenia. Feeding
    prematurely born children with specialized milk formulas,
    contain a sufficient amount of minerals such as calcium,
    phosphorus, magnesium, copper or enriched with “enhancers” breast milk allows
    avoid the development of this pathology.

    The need for minerals and trace elements is determined by the increased
    the growth rate of prematurely born children, as well as almost complete
    lack of a reserve of minerals (during the last trimester
    pregnancy, the fetus accumulates about 80% of calcium, phosphorus and magnesium). More
    high needs of premature babies for these substances are:

    in calcium – 4.7 mmolkg or 188 mgkg day,

    in phosphorus – 4.0 mmolkg or 124 mgkgsut,

    in magnesium – from 2 to 6 mg kg day.

    Feeding premature babies with human milk and standard
    infant formula may not provide the required level of intake
    minerals, which can lead to the development of osteopenia, rickets and bone
    deformations in the future. Therefore, premature babies should receive female
    milk enriched with specialized additives containing the necessary
    minerals or specialized products for premature babies, in
    composition of which the amount of calcium, phosphorus and magnesium is increased.Important for
    meeting the needs of prematurely born children is not only
    the level of intake, but also the ratio of calcium and phosphorus in specialized
    products. It can range from 1.4 to 2.0. The optimal ratio is
    1.7: 1.8, at which the maximum absorption of minerals occurs.
    Violation of this ratio leads to increased excretion in the urine.
    The ratio of calcium and magnesium should not exceed 11: 1, taking into account the negative
    the effect of increased calcium content in foods on the absorption of magnesium.

    Iron reserves in the body of premature babies are limited and can
    disappear by the end of the first month of life. Therefore, the need for iron
    are covered by the introduction of source products of this element (fruit,
    berry and vegetable juices, as well as mashed potatoes). Iron content in breast milk
    relatively low, but highly digestible. However, it is not
    covers the need for this element in premature babies, often not
    prevents them from developing anemia.Therefore, from 3-4 months of age
    feeding is advisable to carry out mixtures, additionally enriched
    iron. The need for iron is 2-4 mg / day. Human milk is not
    provides such a high level of intake of this microelement.

    With artificial feeding, the need for additional
    the appointment of iron preparations is determined by the doctor individually, taking into account
    survey results.

    Basic products for feeding premature babies

    Nutrition of premature babies should assume compliance with the chemical
    the composition of food, the physiological capabilities of the digestive system, as well as
    ensuring optimal requirements for energy and plastic material.More than all other food products meet these requirements maternal
    milk. The amino acid spectrum of mother’s colostrum and milk is maximized
    corresponds to the nature of protein metabolism in a premature baby. Breast fats
    milk are characterized by easy digestibility. Lactose is the main carbohydrate
    breast milk, it is broken down and absorbed without significant energy expenditure.
    In addition, human milk carbohydrates have a positive effect on
    the formation of the microbial landscape and the functional state of the intestine.Pectoral
    milk contains a number of protective factors, including immunoglobulins,
    immunologically active leukocytes, lysozyme, complement components,
    antistaphylococcal factor, lactoferrin, prostaglandins and others. All this together
    with a balanced vitamin and mineral composition explains the unique
    properties of breast milk, making the benefits of natural

    Human milk after premature birth has a special composition, in
    better suited to the nutritional needs of premature babies
    substances and consistent with their capabilities for digestion and assimilation: in it
    contains more protein (1.2-1.6 g per 100 ml), especially in the first month
    lactation, which provides an increased need for this food ingredient,
    slightly less fat, which corresponds to insufficiently mature lipolytic
    function of premature babies, and less lactose, with the same total carbohydrate level.In addition, the milk of women after preterm birth is characterized by more
    high content of a number of protective factors, in particular, lysozyme. Female milk
    easily absorbed and well tolerated by premature babies, which allows
    achieve the full volume of enteral nutrition earlier than

    Despite the differences in composition, the milk of women who have given birth prematurely can
    meet the nutritional needs of premature babies with relatively
    large body weight – more than 1800-2000.Premature babies with less body weight
    after the end of the early neonatal period, they gradually begin to experience
    deficiency in protein, calcium, phosphorus, magnesium, copper, zinc and vitamins of group B, C,
    D, E, K, folic acid.

    The use of human milk in the diet of premature babies does not create
    load on an immature organism, but also unable to provide growth rates,
    close to intrauterine (15 gkgsut). When feeding with donor milk
    pasteurization disrupts the absorption of fat and protein, reduces the content of vitamins and
    biologically active substances.

    Breastfeeding of a premature baby is limited to the following
    factors: – during the lactation period, the content of protein and sodium in the breast
    milk falls, while the baby’s needs remain high, in the process
    storage of breast milk decreases the concentration and availability of nutrients
    substances (fats, vitamins), – the content of phosphorus and calcium in milk is less
    the needs of a premature baby, often a premature baby is shown
    fluid restriction.

    To eliminate the above “disadvantages” of breast milk are designed as follows
    called breast milk enhancers. Breast milk enhancers are
    special drugs that are added to breast milk (special
    liquids or powders) and increase its calorie content, protein content,
    electrolytes and vitamins, without increasing its osmolarity. Application at
    preterm newborns “fortified” breast milk is included in the standard
    care for newborns in many countries.

    Maintain the main benefits of breastfeeding and at the same time
    ensure the high nutritional requirements of a premature baby
    becomes possible with the enrichment of human milk with “amplifiers”. They
    are specialized protein and mineral (“Pre-Semp”, Semper,
    Sweden) or protein-vitamin-mineral (“S-26-SMA”, Wyeth Lederly, USA)
    additives, the introduction of which into freshly filtered or pasteurized female
    milk allows you to eliminate nutritional deficiencies in diets prematurely
    children born.”Amplifiers” are packaged in sachets and are added according to the instructions
    to 50 or 100 ml of human milk.

    Another method that allows you to maintain a sufficiently large amount of female
    milk in the diet of premature babies is an introduction to the diet
    specialized mixtures based on whey protein hydrolyzate. With this
    the purpose can be used products “Alfare” (Nestlé, Switzerland) and “Nutrilon
    Pepti TCS ”(Nutricia, Holland).

    These mixtures are distinguished by a high content of whey proteins subjected to deep hydrolysis, the presence in the fat component
    medium chain triglycerides and lack of lactose.They organically replenish
    insufficient nutrient content in breast milk, easily absorbed and
    well tolerated by premature babies, especially those with low birth weight.
    It is sufficient to introduce into the diet of children receiving human milk,
    products based on whey protein hydrolyzate in a volume of 15-30%.
    enrichment of human milk with “enhancers” and the addition of mixtures based on
    whey protein hydrolyzate, replenishing nutritional deficiencies, allow
    improve their metabolism in immature children and thus increase the increase in
    body weight.In the absence of the possibility of using the specified
    specialized supplements and products in the nutrition of premature babies
    mixed feeding is necessary. For this purpose, should be appointed
    specialized milk formulas intended for nutrition
    premature babies.

    In some cases, breastfeeding of a premature baby
    turns out to be impossible: hypogalactia or agalactia of the mother, the presence in
    milk antibody titer for hemolytic disease of the newborn, disorder
    acts of sucking and or swallowing, due to deep prematurity or severe
    morphofunctional immaturity, severe clinical condition, intolerance
    newborns of breast milk proteins, lactase deficiency, etc.e. Described
    conditions suggest the need to use donor milk or, so
    called, “substitutes” for breast milk.

    Thus, when choosing a medium for enteral nutrition, each time we stand
    before a dilemma: breastfeeding and close your eyes to insufficient
    nutrient delivery and fluid overload, or
    beneficial factors that breast milk provides to the baby and feed
    the child with a balanced hypercaloric product for the sake of faster growth.A complex problem is solved by the attending physician.

    Type of feeding

    The most balanced food product for children of the first year
    life is the mother’s breast milk. Breastfeeding has a unique
    biological and emotional impact on the health of both the child and the mother.
    A complex of biologically active substances supplied with mother’s milk is not only
    provides protective reactions of the body, but also controls the development and
    differentiation of organs and tissues of the child.However, the percentage of children in
    artificial feeding, is quite significant and reaches 4 months of age
    40-50%, and by 6 months it increases in some regions to 60-80%.

    Mixed feeding is when a baby is breastfed.
    feeding (before the introduction of complementary foods), at least 15 daily amount of food
    receives in the form of milk mixtures.

    Artificial feeding can be considered such that the amount
    breast milk in the baby’s diet is less than 13.

    Feeding a child only with donor milk should be classified as mixed,
    since during its pasteurization, milk loses some of the albumin, immunoglobulins,
    vitamins, and with improper expression, it may have an insufficient amount
    fat. Donated milk is best used for supplementation (lack of milk in
    mother), when the child switches to artificial mixtures (sudden
    cessation of mother’s breast milk feeding). In this case, the first
    week 23 should be donated milk and 13 – milk formula.Then the proportion of the mixture is gradually increased, bringing to the required from the daily

    Indication for transferring to mixed feeding (supplementary feeding)
    is true hypogalactia (lack of milk in the mother). Signs
    lack of milk in the mother is the following: lack of milk in the breast
    gland after feeding with careful expression, anxiety of the baby
    after feeding, insufficient weight gain, decreased urination.V
    in these cases, control feeding is carried out 2-3 times for several days
    (weighing the baby before and after feeding, find out the amount of sucked

    Supplementation should be given after feeding from a spoon or bottle to the breast.
    with a nipple that has an extension at the end. The hole in the nipple should be like this
    so that when the bottle is tipped over, the mixture flows out of it in drops, and not in a trickle.
    In all cases, it is necessary to strive to improve lactation and refuse the introduction
    mixtures.If, due to various circumstances, the mother cannot breastfeed the baby in
    during the day, it is important to keep at least 3 breastfeeds, otherwise lactation
    will fade away completely.

    Transfer to artificial feeding

    When transferring premature babies to mixed or artificial feeding
    in the first 2-3 days, the amount of the mixture is 5-10 ml in 1 feeding 1-3 times in
    day. Further, the amount of the mixture in the diet is increased until a complete replacement 1-2
    feeding (3-5 days), and after 7 days the volume of the introduced product can
    make up to 50% of the diet.

    If necessary, a full
    transfer of a premature baby to artificial feeding (with
    satisfactory tolerance of the product, the physiological nature of the stool,
    adequate sucking and no regurgitation). Prescription of eubiotic drugs
    has a beneficial effect on the transition to artificial feeding.

    Artificial feeding of premature babies

    In the nutrition of children born prematurely, only
    specialized formulas for feeding premature babies.For mixed and artificial feeding, it is better to use adapted
    dry mixes. Adaptation of the protein component consists in the introduction into the mixture
    whey proteins, which are closer in amino acid composition
    to human milk and forms a more delicate clot in the stomach than casein.
    Adaptation of the fatty component consists in replacing milk fat (partially or
    completely) for natural oils (coconut, corn, soy, sunflower,
    palm, etc.). With the help of vegetable oils, the mixture contains
    medium chain fatty acids (coconut oil), linoleic acid (soy
    butter). As a rule, mixtures contain small amounts of natural
    emulsifiers (lecithin, mono- and diglycerides), contributing to the best
    digestion of fats in the intestinal lumen, and carnitine, which improves oxidation
    fat in body tissues. To adapt carbohydrates, lactose is introduced into the mixture,
    often in combination with dextrinmaltose.Dextrinmaltose is cleaved and
    absorbed more slowly than lactose, which provides a longer
    the intake of carbohydrates into the child’s body.

    Adapted mixtures contain all the necessary vitamins, micro- and
    macronutrients. Most of the adapted formulas contain taurine,
    a sulfur-containing amino acid present in human milk in free form.

    There are also mixtures (“casein formulas”) based on
    cow’s milk, the main protein of which is casein.The advantages of such
    mixtures is that they reduce the number of regurgitation in children,
    cause a feeling of fuller satiety, can be exposed in case
    the need for heat treatment. The “casein formulas” include a blend
    Nestogen (Nestlé, Switzerland) and some others. These dairy products
    differ in composition from standard milk mixtures. They contain more
    protein – 1.9-2.4 g kg of protein in 100 ml. A prerequisite for the prevalence
    whey proteins over caseins.Slightly higher energy value
    product. The fat component of most foods includes
    medium chain triglycerides. The carbohydrate component is presented, in addition to lactose,
    dextrinmaltose. Content of vitamins, minerals and trace elements

    In recent years, there has been a trend towards a decrease in protein in specialized
    products for premature babies by improving the quality of protein
    component, namely, an increase in the proportion of whey proteins and their hydrolyzate (

    Some products contain long-chain fatty acids, the synthesis of which
    from linoleic and linolenic acids in immature children is difficult. Mandatory
    components of infant formula for premature babies are irreplaceable
    the amino acid taurine and L-carnitine, which is involved in the metabolism of fatty acids.

    When artificial feeding of premature newborns should be
    use specialized adapted formulas for small children,
    up to the moment they reach a body weight of 2500g.Cancellation of any
    specialized products are being implemented gradually. The main reference point
    is an increase in body weight. Reaching the weight limit of 25000g cannot
    serve as an absolute contraindication to further use
    specialized dairy products intended for feeding
    premature babies. In a small volume, such mixtures can, if necessary,
    apply for several months. In this case, it is mandatory
    calculation of food rations not only by calorie content, but also by the content in it
    basic nutrients (especially protein).It should be noted that for
    using specialized breast milk substitutes for
    premature babies are not recommended to exceed the calorie intake of 130 kcal
    body weight.

    Only in the absence of an opportunity to provide a premature baby with these
    food (which are intended solely for clinical
    use), you can resort to feeding the newborn with standard
    breast milk substitutes. Standard mixtures intended for
    feeding full-term newborns cannot be considered completely
    adapted in the nutrition of children born prematurely.To the first products
    include: dry mixes “Enfalak”, “Nenatal”, “Frisopre”, “Pre-Bona”, “Pre-nan”
    (“Alprem”) and some others. Liquid (ready-to-use) products for
    feeding premature babies is represented by mixtures: “Similak special care” and
    “Pre-Tuttelli”. All of them contain complete, easily digestible proteins, as well as,
    vegetable and or milk fats, milk sugar (sometimes with the addition of polymers
    glucose), vitamins and minerals, iron salts and a number of essential vitamins.WITH
    mid-1980s added to these mixtures: taurine, inositol, a number of trace
    elements (selenium, manganese, iodine, etc.), carnitine and other components. V
    Some mixtures contain medium chain triglycerides. Last years
    attempts are being made to include in the number of ingredients and long-chain fatty
    acid. The desirability of using the latter until today is actively

    The composition of “partially adapted” mixtures contains casein and does not contain
    whey proteins, they do not have a fully balanced fatty acid
    composition, and not only lactose is used as a carbohydrate component, but also
    also sucrose and starch.Such mixtures should not be given to children in the first 2
    months of life due to the lack of enzymes that break down
    polysaccharides. These mixtures include Malysh (Russia), Detolakt (Ukraine),
    Milumil, Milozan (Germany) and others.

    In recent years, for the nutrition of children 5-6 months of age
    apply the so-called “subsequent formulas”. In their name or is there an indication
    for the age of children (NAS 6-12), or the number 2 is used (2-semester of life):
    for example, HIPP-2.

    In case of allergy to cow protein, dairy-free mixtures based on soy and
    high-hydrolysis mixtures with maximally degraded protein, for example, Alfare.

    For lactose intolerance (milk sugar), use adapted
    milk formulas without lactose, where the word “lactose-free” is added to the name of the mixture,
    as well as use mixtures on soy protein or hydrolyzed lactose-free

    Modern preventive direction in the nutrition of young children
    allowed the development of food products for healthy children at risk of
    the development of allergic diseases: mixtures with a reduced content of allergens.On the packaging of the mixture, an indication is added to the name that the mixture is hypoallergenic.

    Methods for preparing dry milk mixtures for feeding a child, usually
    indicated on the box (package). Cooking rules should be strictly adhered to.
    mixtures and their storage.

    Of dry standard breast milk substitutes in Russia,
    the following mixtures: “Enfamil-1”, “Nutrilon”, “Bona”, Piltti “,” Tuttelli “,” Nan “,
    “Frisolak” and others. The liquid mixture “Tuttelli” has proven itself well, not
    requiring preparation.

    Most domestic mixtures are only partially adapted, and
    it is extremely undesirable to use them when feeding premature babies, for
    with the exception of acidophilic “Baby”.

    Assimilation of fermented milk mixtures that can be used in nutrition
    premature babies, promoted by pre-cleavage

    proteins, coagulation in the form of small flakes, and the presence of lactic acid.
    The composition of kefir based on whole cow’s milk does not allow
    recommend its use due to the high content of nitrogenous
    substances and high osmotic activity.In the future, kefir can
    be used in the appropriate time frame as complementary foods.

    Introduction of complementary foods

    When feeding premature babies, it is necessary to ensure the timely introduction of complementary foods and additional food products. Complementary foods for premature babies are introduced at approximately the same
    terms as full-term, or two weeks earlier. Since for lightweight
    children who received massive therapy are characterized by dysbiotic changes and
    various disorders of gastrointestinal tract motility, sequence of administration
    products has its own characteristics.

    The first complementary food for full-term babies is introduced at 6 months, in some cases from 4
    months, in the form of vegetable puree. The second full-term complementary food is introduced at 7 months in
    the form of porridge.

    Porridge is introduced to premature babies earlier than vegetable purees (especially when
    the presence of malnutrition and iron deficiency anemia in the child), but not earlier than with
    4 months of age.

    The use of commercially produced porridge is preferred.
    The cereals in such products are environmentally friendly, easier to digest, since
    specially processed and enriched with vitamins and minerals
    substances.Introduction starts with gluten-free (buckwheat, corn, rice)
    and dairy-free cereals in the amount of 1 teaspoon. They get divorced by those
    adapted milk formulas that are currently receiving
    child. The porridge should not contain any additives (fruit, sugar and
    etc.). It is necessary to follow the stages in increasing the concentration of introduced into the diet
    cereals, starting with 5%, then – 7-8%, and subsequently – 10%. In porridge in
    then add vegetable (sunflower or olive) oil, and then
    creamy in the amount of 3-4 g
    for one serving.

    The second complementary food is introduced in the form of vegetable puree (with the addition of vegetable
    oil) in 5-6 months.

    With a tendency to develop iron deficiency anemia in premature infants, meat can
    introduced from 5-6 months of age, taking into account the maximum assimilation from it
    gland. Meat puree (beef, pork) are introduced with
    10 g
    at a time and no more than 2-3 times a week. From 7 months old child
    daily receives meat puree, the amount of which increases from 10g to 40g (by 8
    months), and by the age of 12 months – up to
    50 g per day.

    Hard-boiled egg yolk, pre-mashed in a small amount
    breast milk or formula, introduced into full-term nutrition after 6 months, and
    premature – from 3-4 months. Start with a small amount and work up to 12
    pieces per day. If there are signs of intolerance to the product, the yolk of chicken
    eggs are replaced with quail.

    At the same time, cottage cheese is introduced from 5
    a gram that is diluted with breast milk or formula
    and is given as a separate feeding.Its amount is about 10g per
    during the first month after administration, after a month – increases to 20g, and
    then increases by 5 g
    monthly until 50g. Curd can be prescribed after 6 months if
    protein deficiency in the first half of the year is replenished through the use of
    high-protein mixtures intended for feeding premature babies, which
    is preferred.

    Juices and fruit purees are introduced to full-term babies at the age of 6 to 7 months,
    starting with apple juice, 5-10 ml and increasing to 80-100 ml by the year.

    Juices and fruit purees are administered to premature babies after 6 months. The first
    introduced, as a rule, industrial sugar-free fruit puree,
    since its irritant effect is minimal, especially when compared
    with freshly prepared juices. Start with a minimum amount and work up to
    80-100 ml per year. Then, with good tolerance, juices are prescribed from 3-5
    drops and bringing to a year up to 100 ml.

    From the eighth month of life, the diet of a premature baby is supplemented with bread or
    unsweetened cookies.At the same age, vegetable soup from 5
    ml to 40-50 ml per day. Meat broth and pureed meat broth soup are introduced
    in meals at the age of 1 year and older.

    The introduction of the third complementary foods (kefir and / or whole milk) is possible at an age
    8-9 months, which replaces one feeding per day.

    Thus, when the child reaches a certain age (5-6 months)
    breast milk is no longer able to meet all of its basic needs
    food ingredients of food (“critical period for breastfeeding”).During this period of life, it becomes necessary to introduce products into the diet,
    containing large amounts of fats, carbohydrates, minerals, vitamins.

    The introduction of thick complementary foods is due to the dissatisfaction of the child
    the received volume of milk and the state of its physiological maturity. In connection with
    it is proposed to focus on the following signs of the child’s readiness to
    introduction of complementary foods:

    1. more than 5-6 months old,
    2. Extinction of the “pushing out” reflex (tongue) with a well-coordinated reflex of swallowing food,
    3. the child’s readiness for chewing movements when a nipple enters the mouth or
      other items,
    4. completed or ongoing teething,
    5. confident sitting, head grip and hold, as well as the ability
      express an emotional attitude towards food and satiety,
    6. maturity of the gastrointestinal tract function, sufficient to
      assimilate a small amount of thick complementary foods without frustration
      digestion and allergic reactions to this product.

    Not all of the listed signs may occur when the child reaches
    calendar age 5-6 months. In this case, the child is trained
    by trial introduction of small amounts of thick food – testing complementary foods. V
    a grated apple or
    fruit puree without sugar. After the child has sucked some
    milk, a small amount of the specified
    product.With good swallowing and no adverse reactions
    (for example, an allergic reaction) the amount of thick food gradually increases
    and give it before breastfeeding (second breastfeeding).

    Testing complementary foods begin from 4.5-5 months and within 3 weeks
    give 5-20 g.
    After that, the amount of complementary foods is quickly increased to 100-150 g in the form of any fruit or vegetable prepared without salt and sugar.
    Instead of vegetables, you can use cereals (rice, corn, buckwheat, etc.)).

    Gradual replacement of breastfeeding (or feeding with adapted formula)
    for complementary foods should be carried out within 4.5-5 months.

    Procedure for introducing complementary foods

    1. The second breastfeeding (milk formulas) is replaced by vegetable puree (from
      potatoes, carrots, cabbage, etc.) or porridge (rice, buckwheat, oatmeal).
      It is better to give wheat cereal porridge after 8 months.
    2. A month after the introduction of the first complementary foods, replace the fourth breast
      feeding (evening) for the second complementary foods (depending on the first complementary foods –
      porridge or vegetable (fruit) puree).Children of the first year of life tolerate better
      starch from rice and wheat. Porridge and vegetable puree are given in an amount of no more than
      150 g, adding to this (up to
      200 g) a little fruit or vegetable juice.
    3. From 7-8 months, minced meat, fish or minced meat is added to the main complementary foods
      from poultry meat (from 5 to 20 g),
      and by the year – up to 50 – 70 g
      meat or fish a day. In the same period of life (from 8 months) in the child’s diet
      you can enter the yolk, hard boiled. Whole cow’s milk is not
      recommend giving earlier than 9 months.
    4. At 8-10 months, the third feed is replaced (two
      breastfeeding – morning and last evening) for porridge or
      unadapted dairy products (milk, kefir, yogurt, cheese), you can
      give citrus fruits and their juices. To stimulate biting and chewing, injected into
      diet steam cutlets, non-finished vegetables, crackers, cookies. Complete
      weaning can occur at 1-1.5 years of age and later.

    Timely introduction of complementary foods is the key to successful nursing of a premature baby, especially with extremely low body weight,
    provides him with harmonious psychophysical development.

    The outlined principles of feeding are only a scheme, and in each specific
    case, it is necessary to take into account the individual characteristics of the child, the condition
    his health and the advice of a doctor who looks after the child.

    Prevention of food allergy

    At present, great importance is attached to the prevention of allergic
    diseases and this problem is designated as one of the most urgent modern
    tasks on the way of reducing the incidence of them. The preventive program includes
    primary, secondary (measures aimed at preventing the development of
    exacerbations of the disease) and tertiary (measures aimed at preventing
    adverse outcomes of allergic diseases in patients with severe course)
    prevention – a set of measures to prevent the occurrence of allergic
    diseases in children with a high risk of developing allergies. It is made up of
    antenatal (before birth) and postnatal (in the first year of a child’s life)

    Domestic and foreign researchers point to the possibility of
    intrauterine sensitization of the fetus to food and other allergens already in
    antenatal period. Most often this is due to the use of a pregnant woman
    a woman in excess of cow’s milk and highly allergenic products.It is assumed that the antigen can cross the placenta into the body
    fetus in combination with maternal antibodies (immunoglobulins E). To the mother’s
    immunoglobulin E plays a leading role in the new concept of sensitization
    fetus in the antenatal period. On the other hand, due to the high permeability
    fetal skin antigen can enter its body also through the amniotic
    fluid, lungs, or intestines. However, the significance of these mechanisms is still being studied.

    Basic principles for the prevention of food allergies in children:

    1. Rational nutrition of a pregnant woman.
    2. Hypoallergenic nutrition for pregnant women and nursing mothers with
      burdened family allergic anamnesis.
    3. Improvement of the environmental and industrial conditions
      activities of the expectant mother.

    If the expectant mother has indications of allergy manifestations in loved ones
    relatives or herself, it is advisable to follow a hypoallergenic diet.
    The characteristic of a hypoallergenic diet is the exclusion of foods that
    with increased sensitizing activity, containing food additives
    (dyes, preservatives, emulsifiers), as well as dishes with properties
    nonspecific irritants of the gastrointestinal tract.

    Highly allergenic products are excluded – fish, seafood, caviar,
    broths, spicy, salty, fried foods, canned food, smoked meats, ham, sausages,
    spices, eggs, spicy and fermented cheeses, mustard, peppers, from vegetables –
    radish, bell pepper, sauerkraut, pickled cucumbers and others
    pickles, mushrooms, nuts, fruits and berries of bright red and orange color, and
    kiwi, pineapple and avocado, carbonated drinks, beer, kvass, coffee, cocoa, honey,
    chewing gum, products containing dyes and preservatives.

    Limited to: semolina, pasta, bakery and pasta
    premium flour products, confectionery, sweets, sugar, salt,
    whole milk and sour cream (given only in dishes), yoghurts with fruit additives,
    lamb, chickens, early vegetables (subject to mandatory preliminary
    soaking), carrots, beets, onions, garlic, from fruits and berries – cherries, plums,
    black currants, bananas, lingonberries, cranberries, rosehip broth.

    Recommended: fermented milk products, yoghurts without fruit additives,
    mild cheeses, lean meat (boiled, stewed, as well as
    steam cutlets), cereals – buckwheat, rice, oatmeal, vegetables – all types
    cabbage, zucchini, squash, light pumpkin, green beans, green peas,
    from fruits – green and white apples, pears, light varieties of cherries and plums, white
    and red currants, gooseberries.Unflavored tea. Ghee is allowed
    butter, refined vegetable oil. Wheat bread of the 2nd grade,
    rye. Drink – tea, compotes, fruit drinks.

    Prevention of food allergies in children at risk of


    1. Long-term breastfeeding.

    2. Compliance with a hypoallergenic diet by the mother.

    1. In case of lack of breast milk – supplementary feeding with formulas based on hydrolysates
      protein for therapeutic and prophylactic purposes.
    2. Individual selection of foods and foods for complementary foods and the timing of their introduction.
      Elimination of whole cow’s milk up to 1 year. Excluding products with
      high allergenic ability.

    Secondary: (when the child is already sick):

    1. Strict hypoallergenic diet for a nursing mother.
    2. In some cases – limitation, in exceptional cases – complete cancellation
      breast milk replacement with formulas based on medicinal protein hydrolysates

    Prevention of food allergy in formula-fed children.

    For unburdened allergic anamnesis:

    1. Use of adapted milk formulas.
    2. Compliance with a rational feeding scheme, incl. exclusion of the whole
      cow’s milk up to 1 year.

    With a burdened allergic anamnesis:

    1. Use of mixtures based on protein hydrolysates
      therapeutic and prophylactic purposes.
    2. Individual selection of foods and foods for complementary foods and the timing of their introduction.
      Elimination of whole cow’s milk up to 1 year. Excluding products with
      high allergenic ability.

    Highly allergenic foods include eggs, nuts, honey, fish, seafood,
    caviar, mushrooms, vegetables and fruits with bright colors, chocolate, coffee, cocoa, citrus fruits,
    broths, canned food, smoked meats, spices. An allergenic product can be cheese
    milk, meat.Excluded from the diet of a pregnant woman and a lactating mother
    foods containing preservatives, carbonated drinks, foods containing
    histaminoliberators – sauerkraut, fermented cheeses, ham, sausages,

    In the first year of life, children at risk of developing allergic
    diseases must be breastfed. Breast milk
    contains components of humoral and cellular immunity and provides protection
    child not only from food antigens, but also from respiratory and
    gastrointestinal tract.Keeping breastfeeding at least 4-6
    months of life significantly reduces the risk of subsequent food
    allergies in a child. Complementary feeding for such children is introduced no earlier than the 6th month of life.

    In high-risk children, clinical manifestations of food allergy can be
    prevent or reduce its intensity, avoiding the introduction of highly allergenic
    products in the diet of a child in the first years of life. Introduction of cow’s milk
    or milk mixtures are prohibited completely until 1 year.Up to 2 years of nutrition
    the child excludes eggs, up to 3 years old – fish and nuts.

    Criteria for nutritional adequacy of premature babies

    Regular monitoring of the rationality and correctness of the calculation is required
    food, which is carried out by medical personnel. Traditionally to the main
    the criteria for the nutritional value include indicators of physical development
    (body mass dynamics). The birth weight of a child should be assessed in
    complex with the existing body length and head circumference to exclude congenital
    hypotrophy or intrauterine growth retardation.For this in Russia
    use the tables of G.M. Dementyeva et al, characterizing the intrauterine
    development of fetuses of different gestational ages.

    The main attention in assessing the indicators of physical development is given to
    values ​​of weight gain per month, as well as average daily
    weight gain. In this case, it is necessary to take into account more intensive processes
    development of premature babies in comparison with full-term peers. Counts,
    that the majority of premature babies at about 2 years of age reach
    the level of physical development, comparable to the indicators of full-term.First
    two months of life, an increase in body weight should be recognized as adequate at the rate of 10
    – 15 kg of birth weight.

    In addition to the daily calculation of nutrition in the first month of life, you should regularly
    calculate the consumption of basic nutrients and energy per 1 kg of body weight (at least once a month), which is carried out
    medical personnel in a hospital or clinic.

    When assessing the adequacy of nutrition in premature infants,
    some hematological parameters (content of hemoglobin, erythrocytes,
    hematocrit), as well as the state of protein metabolism (total protein content in
    serum, the ratio of the fraction of albumin and globulins).

    Thus, the rational feeding of premature babies is based on
    knowledge of their anatomical and physiological characteristics and levels of metabolic processes and
    is being built taking into account modern technologies.

    White plaque on the tongue of a baby – norm and pathology | World of mothers: Pediatrician’s blog

    After feeding, mothers often notice a white coating on the tongue of newborns or babies and wonder why it appeared?

    This phenomenon is very common and knowledge about this problem is important for all parents without exception.The reasons for the appearance of white plaque on the tongue of the baby can be different – in which situations it is worth worrying and taking action, and in which to leave everything as it is, in this article we will consider in more detail.

    When white plaque on the tongue is the norm

    The tongue is a mirror of nutrition and an indicator of the health of the entire digestive tract. Its mucous membrane is special – it has a rough surface, so food particles are retained and stain it in the appropriate color. Usually, the mucous membrane takes on the shade of the food eaten, and the next portion of food removes the previous plaque and stains it in its own color.After half an hour, there is usually no trace of such a plaque: saliva gradually rinses off milk or other food that remains on the tongue.

    In infants, the food is monotonous – breast milk or formula, so a white coating on the surface of the tongue in an infant is in most cases the norm. Traces from it are usually visible only on the tongue: in this case, the gums and cheeks are not covered with even a minimal plaque (which distinguishes it from thrush). In addition, the baby’s behavior does not change and he does not feel discomfort from this, there are no signs of anxiety.The layer of plaque is very thin: a pink tongue is clearly visible through it. It is clear that such a white coating on the tongue of an infant is not dangerous, but it can become an excellent habitat for the fungus that causes thrush. Therefore, if the plaque persists for a long time – give the crumbs a little water from a spoon – it will quickly wash off this plaque.

    Formula feeding can also cause a white coating on the tongue in a one-month-old baby. This phenomenon is completely safe: traces of food are gradually removed with the help of saliva.

    A safe plaque can be distinguished from thrush by these features:

    • the layer covers not only the tongue, but also the gums and palate;
    • it can be easily removed with water;
    • The whitish layer is translucent and is evenly distributed over the surface of the tongue.

    It is not worth getting rid of him in this case: gradually everything will return to normal by itself.

    When white plaque is caused by a disease – distinctive features

    Thrush or stomatitis caused by overgrowth of candida fungi is the most common cause of pathological plaque in the oral cavity of babies.The causative agents of this disease constantly inhabit the mucous membranes of all adults, and this is considered the norm. Healthy adult immunity does not allow them to develop uncontrollably.

    The ability to salivate in small children is low, the activity of salivary lysozyme is low, and other protective factors are in the stage of the formation of strong immunity, therefore, due to yeast-like fungi that feel like complete hosts on the mucous membranes of the baby’s mouth, and candidal stomatitis develops.

    In children, there are two ways of its occurrence:

    1. Intrauterine;
    2. Postnatal (after birth).

    The intrauterine (congenital) route of infection occurs when the fetus comes into contact with infected amniotic fluid. The child in the process of birth is in close contact with the birth canal of the mother, then infection occurs.

    Children born to mothers with urogenital candidiasis suffer from thrush 20 times more often than those born to mothers who are simply carriers of this pathogen.

    In the future (postnatal route), infection with the fungus can occur through the hands of the mother or medical staff.

    The second predisposing fact is that the oral mucosa of the newborn is still weak in terms of protection.

    Infant can become infected with a fungus in different ways:

    • nipples and toys;
    • maternal breast;
    • air;
    • kisses.

    You also need to take into account the influence of factors provoking the development of candidiasis:

    1. Frequent regurgitation.
    2. Fluid shortage.
    3. Hot and dry indoor air and dry mucous membranes.

    By increasing the humidity in the room and giving the child enough water, you can avoid excessive dryness of the mucous membranes. This will help them perform their functions normally and limit the growth of the fungus.

    Also, dryness of the oral mucosa occurs with nasal congestion, when the child is forced to breathe through the mouth. In this case, the mucous membrane should be moistened more often and nasal breathing should be restored – to clean the baby’s nose. You can read about its correct implementation in this article – “How to clean a baby’s nose”

    Less often, white plaque is accompanied by acute respiratory diseases:

    • angina;
    • scarlet fever; 90 025 90 024 viral infections;
    • for treatment with hormonal sprays.

    “Bad” white plaque has certain characteristics:

    1. It begins to “roll down” and forms lumps that are located not only on the surface of the tongue, but also on the inner side of the cheeks and gums.
    2. It looks like cottage cheese, and that’s why it got the name “milkmaid”. Sometimes clumps appear on the lips.
    3. When trying to remove plaque, the mucous membrane begins to bleed, redness (inflammation) is visible under them.With a harmless white plaque, there is no inflammation!
    4. In this case, the child becomes capricious, does not breastfeed well, and the temperature may rise.

    If these symptoms appear, you need to contact a specialist.

    Before visiting the pediatrician, observe all hygiene rules:

    • regularly boil the nipples;
    • Sterilize milk or formula bottles.

    Do not forget about this after your recovery: this will help to avoid reactivation of yeast-like fungi.

    It is advisable for a nursing mother to treat her breasts in the nipple area with a soda solution throughout the entire lactation period.

    Functional disorders of the gastrointestinal tract in children under 3 years old


    Yulia Kalenychina:

    Hello dear friends. The program “Point of application” is on the air, and we, its hosts, Oksana Mikhailova and Yulia Kalenichina are with you.Today we have a very burning topic that every young family faces – problems with a child’s stool. And with us today is the wonderful doctor Svetlana Popova – a pediatrician, a neonatologist. Svetlana, tell us, please, where do you work?

    Svetlana Popova:

    Hello. I work at the Center for Intrauterine and Postnatal Infections in Newborns at the Children’s 6th Clinical Infectious Diseases Hospital. I am very grateful that you invited me to this program, and first, let’s start with the norm.

    Yulia Kalenychina:

    What is normal stool, how often does it happen during the day during the neonatal period?

    Svetlana Popova:

    Normal stool in newborns and infants has a uniform yellow consistency with the smell of mother’s milk, not offensive, not harsh, sorry for the gastronomic comparison, with us, doctors, everything is always connected with food, for semolina porridge. How often does it happen? If the baby is breastfed, maybe after each feeding, if the baby is artificial, then even the absence of a chair for three days is not a pathology.At the same time, there are no other symptoms, if the child is not worried, then the mother should not be nervous that the child on artificial feeding did not go to the toilet for three days. And so, normally, 30-40 times a week, an infant has a chair. As I said, it is mushy, yellow in color, but there is an exception, which is also the norm – this is meconium, which appears immediately after birth. If the nature of the chair changes, there are a lot of reasons for this, and we need to highlight all of them now, because mothers are very anxious and very excited about the changes in the child’s chair.

    Yulia Kalenychina:

    What is the reason for the change in stool?

    Svetlana Popova:

    There are many reasons, the first is drugs.

    Yulia Kalenychina:

    After childbirth, mothers are often prescribed some kind of drugs.

    Svetlana Popova:

    Yes, and mothers after childbirth, and it happens that children after childbirth also need drugs.This is anemia when iron supplements are prescribed. The stool becomes darker with iron preparations, or is it antibacterial therapy, the stool becomes more liquefied, with a specific smell, but you should not panic, because after the drug is discontinued, the stool immediately normalizes.

    The second point is the quality of breast milk, that is, first of all, the mother must follow a diet, we will return to her a little later, the next is the formula. I often came across in my practice that the parents change the mixtures on their own, unreasonably, it happens that the mixtures are mixed, that is, the answer from the parents: “Well, he’s tired of it.”

    Yulia Kalenychina:

    I want variety.

    Oksana Mikhailova:

    Question about mixtures at once. If the mother thinks that the child is tired or does not fit, how many different mixtures can be given to the child at the same time?

    Svetlana Popova:

    The word “tired” should be eliminated altogether. The mixture is not suitable or is decided by the pediatrician or neonatologist. If the child eats it with pleasure, does not regurgitate, assimilates, gains weight, then the mixture is suitable, there is no need to look for anything else.We stay on this mixture for up to four months.

    Yulia Kalenychina:

    Because up to four months, the baby would also eat only mother’s milk. In fact, formula is a breast milk substitute, no combination is acceptable.

    Svetlana Popova:

    We do not take breast milk from one mother and combine it with another mother’s milk. Naturally, there should not be any variety, for changing the mixture – strict indications, we will also return to them later.Also, stool disturbance can begin due to early feeding. Very often our grandmothers suffer from this, who believe that it is time for the baby to be given a drying or pickled cucumber. Complementary feeding is strictly according to age, as prescribed by the pediatrician, precisely from those products that the pediatrician prescribes, and here the creative process is not appropriate.

    The next point is lactose intolerance, we will return to it too. Do not forget that stool disturbance in children is a moment of adaptation, that is, the child is frightened, overheated, or vice versa, overcooled, the chair may be more liquefied because of this, but it will be once, a maximum of two times in a row and at the same time not bring any discomfort to the child, that is, if the mother travels with the baby, changed their place of residence, went on a visit – this is also stressful for the child.

    Yulia Kalenychina:

    Changing the quality of mom’s nutrition.

    Svetlana Popova:

    A lot depends on the mother’s diet. A little later, I will definitely tell you which foods mothers should completely exclude from their diet.

    Oksana Mikhailova:

    Very often in our chats they ask the question that there really is a connection between mother’s stool and the child’s stool, that is, if the mother has constipation – the child has constipation, if the mother has loose stools – the child has loose stools, but plus the fact that the child breastfed.Is there such a connection or is it more of a myth?

    Svetlana Popova:

    If mom eats only drying and pasta, then there will be constipation. And if the mother is sick with an intestinal infection, then the child may also have liquefied stools.

    Yulia Kalenychina:

    Or only on cabbage, for example, on fiber.

    Svetlana Popova:

    Eats one fiber, respectively, the quality of breast milk affects the baby’s stool.Further: contact with unwashed objects, that is, if a nipple or toy falls, it is imperative to process, wash, disinfect before giving it to the child.

    The next moment is dysbiosis, a favorite topic for moms. Firstly, this is not a disease, it is a violation of the ratio of normal flora and pathogenic flora, and since the baby’s gastrointestinal tract is just being formed, it can prevail in one direction or the other. And here there are a lot of different opinions, whether it is worth prescribing probiotics, or the child himself adapts, but I can say that all modern adapted milk formulas contain probiotics.In other situations, you need to resolve the issue with the pediatrician. Tell me, is scatology a routine analysis in polyclinics?

    Yulia Kalenychina:

    In clinics, yes.

    Svetlana Popova:

    That is, if there is a violation of the stool, you can calmly look at the scatology, it is very informative, and I know that many pediatricians, great smart ones, even suspected cystic fibrosis in terms of scatology, and this is one of those diseases that requires correction, observation, treatment.The most urgent is the surgical pathology of stool disorders. A doctor’s consultation if there is blood, mucus, foam in the stool is required. If these components are in the child’s stool, the surgeon’s examination is unconditional.

    Oksana Mikhailova:

    We are sent photos in chats: a diaper, there is a chair, and there are green blotches. Is this something to be afraid of?

    Svetlana Popova:

    Green blotches most often occur with lactase deficiency and cereal intolerance.

    Oksana Mikhailova:

    And if mom ate cucumbers and herbs, maybe?

    Svetlana Popova:

    Do not exclude, it must be remembered that the color of the stool depends on the mother’s diet. Most often there are lumps, undigested food, this is a manifestation of dysbiosis, you should not be afraid either.

    Oksana Mikhailova:

    And it makes no sense to run to the clinic to demand a referral to dysbiosis from the district doctor.

    Svetlana Popova:

    What will he show? Coprology is the maximum that makes sense.

    Yulia Kalenychina:

    Let’s sum it up briefly: blood in the stool is a reason to call an ambulance.

    Oksana Mikhailova:

    That is, this is not a local doctor, but an ambulance.

    Svetlana Popova:

    A consultation with a surgeon is needed here.

    Yulia Kalenychina:

    And if mom ate a tomato or a beet, will it not affect the availability in any way?

    Svetlana Popova:

    Even if mom ate tomatoes and beets, call an ambulance, let the surgeon look.If it seemed to you that the stool is red, with blood, call an ambulance. Because one thing is blood in the stool, another thing is scarlet blood, when there are anal fissures, it is useless to debate here without a doctor’s examination.

    Liquefied stool in itself is not terrible, it can be the child’s adaptation to any change in the environment, symptoms that should be of concern to parents, for example, temperature, should also be added to them. That is, the child has a high fever, often liquefied stools, not even liquefied, but watery.What is liquefaction and what is wateriness? Watery stools that will be completely absorbed into the diaper is foul-smelling stools. The number of acts of defecation, that is, it can reach up to 20. The child is lethargic, sleepy, he has no desire to eat, he has a stomach ache, he constantly tightens his legs, he is puffy – this is also a reason to call an ambulance.

    Yulia Kalenychina:

    Or if the child has become lethargic, sleepy, and at the same time the chair is the same as we said now, this is also a reason to call an ambulance.

    Svetlana Popova:

    We must remember that the liquefied stool of a newborn is dangerous – it is dehydration, which can lead to the death of the child, so if a sluggish, drowsy, refuses to drink and eat, we call an ambulance, and there is no need to wait for a local doctor, he still will not help , here you need a dropper, here you need to take a blood test.

    Yulia Kalenychina:

    This is hospitalization.

    Svetlana Popova:

    Yes, a blood test, which will show the presence of inflammation, will show the viscosity of the blood, that it is thick and requires a dropper, infusion therapy, there is a hospital here.If it’s okay, and the child can be treated at home, no one will forcibly keep in the hospital.

    Yulia Kalenychina:

    Svetlana, what other advice can you give to parents if there is a liquefied stool, it is simply more frequent than the mother would like, and a little thinner?

    Svetlana Popova:

    We always identify the cause, we should not treat the symptom – our most important law, the postulate of all doctors, and we actively call for this, we are looking for the cause.The first such reason is mom’s diet. Mom should exclude all exotic fruits, all preservatives, what can cause, in addition to everything, a strong allergic component in a child. No wonder there is a saying: “Cabbage soup and porridge – our food”, you can argue with cabbage soup, this fiber.

    Oksana Mikhailova:

    A kefir and dairy products theoretically should relax?

    Svetlana Popova:

    When we start breastfeeding, and problems with stool begin, I transfer all mothers to buckwheat and boiled chicken, breast, and then little by little we begin to expand the mother’s menu.Of course, you definitely need cottage cheese, kefir, and vegetables, but all this is done gradually. And as soon as we see that there is a violation of the chair, we remove this component. This does not mean that mom will never eat him again, no, it just takes time, a little later. In our business, the main thing is not to rush, slowly, calmly, balanced.

    Yulia Kalenychina:

    As for the bread?

    Svetlana Popova:

    I think that all gastroenterologists will support me, that the best bread is yesterday’s white or rusks.

    Yulia Kalenychina:

    Slightly dried.

    Svetlana Popova:

    Yes, biscuits, Maria biscuits. But we are not fond of it either, we must have a vegetable broth, otherwise my mother will go to bed with constipation, with stomach pains.

    Yulia Kalenychina:

    Let’s let mom eat the egg?

    Svetlana Popova:

    Yes, we will, but it will not be in the first days of breastfeeding, but gradually, when our diet expands.If the child is artificial and has problems with stool, I recommend switching immediately to a lactose-free formula or soy formula. Most likely, this is lactase deficiency, because mom cannot break her diet.

    Oksana Mikhailova:

    How to go? The child was given a mixture, for one reason or another it did not suit him, a different mixture is needed. We gradually reduce the first mixture and introduce the second, that is, at some point the child will have two mixtures, or is it canceled and given immediately?

    Svetlana Popova:

    Canceled immediately and another mixture given.We also change the mixture if, in addition to stool disturbance, skin rashes begin: peeling, red spots, most often they appear on the cheeks, on the flexors, this is a manifestation that the mixture is not suitable, and an allergic reaction occurs. There is no need to panic, this is not an infection, the mixture is changing, but a pediatrician examination is necessary.

    Yulia Kalenychina:

    After all, these are medicinal mixtures, and a doctor should prescribe them.

    Svetlana Popova:

    These are medicinal mixtures, and they should not be used for more than a month without the appointment of a pediatrician.The pediatrician looks, within a month he deals with the reason and then decides whether to leave the child on the treatment mixture before the introduction of complementary foods, or you can still leave it. Children have an immature digestive system, and what is not suitable on the first day of life can be easily assimilated by the child in a month.

    Yulia Kalenychina:

    Please tell me the rules for introducing complementary foods in case the child reacted by thinning the stool.

    Svetlana Popova:

    Any complementary food is introduced in half a teaspoon, we give one product for two days.The child assimilates it, there are no rashes, the bottom is not red, the stool is normal.

    Oksana Mikhailova:

    Is the product given on an empty stomach or after meals?

    Svetlana Popova:

    If after the meal the mother proposes something to the child, I think he will refuse.

    Oksana Mikhailova:

    That is, all complementary foods on an empty stomach?

    Svetlana Popova:

    Children are terrible conservatives, principled.

    Yulia Kalenychina:

    Moreover, vegetables, they are unsweetened, the taste is not quite familiar, he is unlikely to want to try zucchini just like that, when he is well-fed and contented.

    Svetlana Popova:

    Therefore, we gave half a teaspoon on one day, half a teaspoon the other day, the next day we gave half a jar, on the second day half a jar, and there we look at the volume: the product has passed, we have no rash, the stool is normal, the butt is not red, the child feels great, we introduce the second product and suddenly we see that the stool is not the same, and the skin is rough, the same red spots could appear on the cheeks – we immediately remove this product, return to the product for which we have no allergies, we remove all allergic reactions and take a third.We introduced a pumpkin, the pumpkin gave an allergy, we remove the pumpkin, we return to the zucchini and we are already introducing cauliflower into the complementary food, we look how it goes on cauliflower. So we are diversifying little by little. But this does not mean that the child will never eat a pumpkin, in a month we can try again to offer him this pumpkin, and perhaps it will go.

    Oksana Mikhailova:

    It is necessary to try everything gradually.

    Svetlana Popova:

    Gradually, over the course of a week.First, the child gets used to it, and for him it is not new.

    Oksana Mikhailova:

    What if it’s constipation? How to deal with constipation in a child of the first year of life? We talked about the fact that if nothing bothers the child, even up to three days is allowed, then what is considered constipation, when does the mother start to panic?

    Svetlana Popova:

    If there is no stool for up to three days, and nothing bothers the child, then everything is fine. If there is no stool for up to three days, and at the same time the stomach is swollen, the legs tighten, refuses to eat, he is uncomfortable, whimpers, cries, then I am in favor of using gas tubes or enemas.Even mechanical irritation of the intestinal mucosa gives stool in children. Very often I hear the eternal question: “What if he gets used to it?”

    Oksana Mikhailova:

    And he will stop pushing and pooping himself.

    Svetlana Popova:

    Will not get used to it. Just grease the tip of the vent tube with vaseline oil or baby cream, mechanical irritation will not get used to. It’s just that your pediatrician will know that complementary foods will not be porridge, but vegetables.With regards to treatment: no antidiarrheal agents should be given with loose stools. Firstly, if this is an intestinal infection, let the infection come out, the second point, but we do not take babies, these are children somewhere closer to one and a half years, if a child has a liquid stool, the pediatrician is always called, if blood, mucus, temperature – Ambulance. You can give an adsorbent to a baby.

    Oksana Mikhailova:

    Adsorbent – what is it?

    Svetlana Popova:

    “Smecta”, these are drugs that take on toxins.

    Oksana Mikhailova:

    Enterosgel itself is disgusting, it is impossible to feed a child. I heard that in pharmacies there is “Enterosgel” fruit, more adapted for children.

    Svetlana Popova:

    This is a child’s form.

    Oksana Mikhailova:

    If a child does not have allergies, then what difference does it make as long as he ate.

    Svetlana Popova:

    Moreover, Enterosgel should be diluted with some water before giving it.

    Yulia Kalenychina:

    We focused on how parents should behave in case of loose stools in young children.

    Svetlana Popova:

    We found out that we do not treat the symptom, but we find out the reason, we definitely go to the doctor. Once again, let’s say at what moments we call an ambulance and do not self-medicate – this is if a newborn has loose stools in the first year of life, we are afraid of dehydration, and if it is a temperature, blood in the stool and mucus.In other cases, if it is an artificial person, we replace the lactose mixture, do not panic, quite calmly, and go to the doctor. That is, parents can replace the mixture with a lactose-free one on their own.

    Yulia Kalenychina:

    Is it worth offering some kind of diet to a child, if it is no longer a baby, if all complementary foods have been introduced, a child is older than a year, what kind of food should be offered to a child?

    Svetlana Popova:

    You can give young children a hunger break, but be sure to give them water.

    Oksana Mikhailova:

    Can you tell us in more detail what a hunger pause is, how long should it last and what to drink?

    Svetlana Popova:

    It is better to dilute “Regidron”, such a preparation so that the water is better absorbed, you can simply release mineral water, release the gases and water the child with this water. If the child is older than a year, you can use folk remedies such as rice water, a handful of rice per liter of water.

    Yulia Kalenychina:

    Or if the child wants nothing, just water.

    Svetlana Popova:

    Usually children, as soon as it becomes easier, are cheerful and active and immediately ask for food. If you see that the second day, and the child does not want to eat, he is not well, and he drinks by force, through a syringe or through a spoon, an ambulance still needs to be called and examined. There should be ultrasound diagnostics, in addition to the fact that a blood test was taken, we exclude any surgery.

    I would like to convince parents not to prescribe any antimicrobials or enzyme medications on their own.Yes, a young child may have problems with stool after an infection, and the doctor will prescribe enzymes. In no case can you regulate these enzymes on your own, as the doctor prescribed, you drink for so many days. If you drink more, the pancreas will say, “I don’t want to work, I have enzymes.” If you interrupt earlier, this process will disturb the stool again, so no self-medication. Independently – this is the first day, if the child is not a baby. This is rice broth, water, hunger pause and we start with dryers, bagels, biscuits, remove meat, dairy products, fresh fruits.

    Yulia Kalenychina:

    No juice categorically.

    Svetlana Popova:

    All fruits and juices put a load on the pancreas, and we must unload everything as much as possible, and after the child’s stool has returned to normal, it has become easier, you should not again load him with abundant food.

    Oksana Mikhailova:

    As usual, my beloved grandmothers come to the fore here, broth with chicken. Is this also better to push aside?

    Svetlana Popova:

    Yes, nobody canceled vegetable broths.

    Oksana Mikhailova:

    The child does not lose weight in a day, so everything will be fine.

    Svetlana Popova:

    And if we are talking about babies, there can be no hunger pause, we will not stop breastfeeding, we continue to feed on demand, but let’s not forget that this should be no more than at least two and a half to three hours. Why? Milk, entering the stomach, begins its natural processing with hydrochloric acid, with gastric juice it becomes curdled, it must turn into a lump and pass further into the intestines.This process takes two to three hours, if we give fresh curd milk, the baby will swell up in the stomach, regurgitate, and we will not know what is the reason, but the reason is that the feeding rules are simply not followed.

    Oksana Mikhailova:

    So we smoothly moved on to regurgitation. What is regurgitation? When he ate, air got in, and a trickle of glass, if he was a fountain – what is considered regurgitation, and what is vomiting?

    Yulia Kalenychina:

    And up to what age is regurgitation a normal, physiological process?

    Svetlana Popova:

    While undergoing training at the Speransky hospital, we were taught how to clearly determine the rate of regurgitation: two teaspoons is permissible, if more, then the problem with regurgitation must be solved.If this is 1/2 of the volume eaten, then there is already vomiting.

    Yulia Kalenychina:

    If, nevertheless, the child spits up after each feeding, and it is difficult to understand how much it is, because the mother has absorbed into the dressing gown, for example, but the child is gaining weight well?

    Svetlana Popova:

    Soaked into the robe – this is one or two teaspoons, because the profuse regurgitation into the robe will not have time to be absorbed. This will only be due to the immaturity of both the digestive system and the nervous system, we are not worried, especially if this is breastfeeding, we in no way cancel it.If the child spits up profusely, the question here is that you need to see a doctor, perhaps even go to a hospital. If this occurs in a child in the third week of life, this is vomiting in a fountain and everything eaten, then we should think about pyloric stenosis or pylorospasm.

    Oksana Mikhailova:

    And to the surgeon.

    Svetlana Popova:

    If the child does not spit up like a fountain, but simply frequent profuse regurgitation of more than two teaspoons, it is possible to select an antireflux mixture, it is thicker.

    Oksana Mikhailova:

    Again, just a doctor.

    Svetlana Popova:

    Yes, you need to see a doctor. The doctor will look at the nature of regurgitation, correct nutrition, that is, we must not forget that it is imperative to keep the baby in a column after feeding, so that the air can escape.

    Oksana Mikhailova:

    Do not feed every hour.

    Svetlana Popova:

    Yes, do not turn breasts into a nipple, food into tranquility.

    Oksana Mikhailova:

    What kind of help can there be for a baby? When regurgitating, it is only to keep it in a column. If the baby did not take the breast correctly, took in air …

    Svetlana Popova:

    More profuse regurgitation. If regurgitation bothers the parents, it’s okay to go to the hospital and even be hospitalized with the baby, but there will be a full examination. Ultrasound diagnostics, is there a spasm, is there something that can interfere with the baby, narrowing of the esophagus, and so on.

    Oksana Mikhailova:

    A very often troubling question is colic in children. What is it, how to help a child?

    Yulia Kalenychina:

    Parents turn to chats, the child screams, he cannot be appeased, not reassured.

    Svetlana Popova:

    Colic is a normal physiological process in children. At one of the medical conferences, they gave such an example to pediatricians: if we ate in the ratio of our volume and how much children eat, then we would have to eat a bucket, and we would also be swollen and twisted in our stomach, so we just need to go through this moment.Put the same gas tubes for the baby, put them on the stomach before feeding for 20 minutes, let the baby lie on his stomach, do a circular massage of the tummy.

    Oksana Mikhailova:

    Is clockwise or counterclockwise important?

    Svetlana Popova:

    You know, I’m always clockwise, I don’t know, probably more familiar, but it doesn’t change the essence of the matter. Our colleagues from Asian countries gave an example that they have very few children with colic.Why? They are very fond of slings, apply belly to belly.

    Oksana Mikhailova:

    Close contact with a warm parent.

    Svetlana Popova:

    By squeezing the abdominal wall, children suffer less colic.

    Oksana Mikhailova:

    We’re not talking about belly warmers, are we?

    Svetlana Popova:

    No, we’re talking about diapers. Wrap and squeeze a warm diaper. Many babies calm down when their mother puts them on top of her stomach.

    Oksana Mikhailova:

    Or on top of dad.

    Svetlana Popova:

    But mom is better, she smells like milk. Dad, on the other hand, is less nervous. This, by the way, is a very important component – the calmness of the mother. We must remember perfectly well that the baby was in the mother’s tummy for 9 months, he heard her voice, recognizes her intonation, and the whole world passes through the mother. As soon as the mother starts to panic and nervous, the baby also begins to cry and get nervous, and most often not so much because of colic, but because the mother is nervous.

    Yulia Kalenychina:

    Mom is in a panic, rushes about, and the child rushes about.

    Oksana Mikhailova:

    Can Mom’s Diet Affect Colic? If a child is very much tormented by colic, what is desirable to exclude from the diet, if we are talking about natural feeding?

    Svetlana Popova:

    Probably only fiber, something that can ferment.

    Oksana Mikhailova:

    If this is bread, but with yeast, maybe just switch to a hearth or something else?

    Svetlana Popova:

    What are your gourmet mothers.For biscuits, crispbreads, yesterday’s white bread. But I’m not very sure that colic is associated with mom’s nutrition. The gastrointestinal tract should get used to the fact that it has such an amount of food, as a rule, after four months, everyone unanimously forgot about it.

    Yulia Kalenychina:

    One must go through a hundred days of crying.

    Svetlana Popova:

    Someone appoints “Espumisan”, “Bebikalm”, but I try to keep it the very last. All medications should be prescribed only if absolutely necessary, if mechanical means, such as a gas tube and a warm diaper, help, then it is better to do with them.

    Yulia Kalenychina:

    Besides, these preparations of simethicone still give colic.

    Oksana Mikhailova:

    Is dill water the same?

    Yulia Kalenychina:

    Please, you can try dill water, if it helps, then yes.

    Svetlana Popova:

    Many children refuse to drink water, and if you dilute “Plantex”, then it is sweet, they drink it with pleasure.

    Oksana Mikhailova:

    If there is no allergy, individual intolerance to the drug.

    Svetlana Popova:

    “Plantex” is not prohibited by anyone. The only thing we have to remember is that it must always be fresh. If the child has not drunk the bottle in 24 hours, you pour it out.

    Oksana Mikhailova:

    Not to the last drop, but if necessary we dilute and give everything fresh.

    Svetlana Popova:

    Fresh water once a day.Otherwise, there will be problems with the chair.

    Yulia Kalenychina:

    Let’s go back to lactase deficiency. Since this is a complex and important topic, many are concerned about it. How to suspect?

    Svetlana Popova:

    Stools can be greenish, thin, persistent, frequent, regardless of the number of feedings. First of all, mothers always begin to follow a strict diet and see that there is no effect, while the child loses weight, and then lactase deficiency can be suspected.We can make a diagnosis one hundred percent by donating feces for carbohydrates, but since we do not have it, it is not very expensive …

    Oksana Mikhailova:

    In the clinic with a general practitioner it is difficult, in fact …

    Svetlana Popova:

    If desired, if it is not included in the list of compulsory medical insurance. We are switching to a lactose-free formula, this does not mean that the mother refuses to breast, in any case, breast milk is the gold standard.As soon as the baby’s stool is normalized, we start giving breast milk and lactose-free formula in turn. Either it is 50 to 50, or one feeding like this, one feeding like that, and slowly we introduce such drugs as Lactazar and Lactase Baby and leave from a lactose-free formula to completely breast milk from Lactase Baby. As a rule, the process passes quickly and easily, and over time the lactase deficiency goes away, the child again calmly eats breast milk without Lactase Baby.

    Oksana Mikhailova:

    But this is also prescribed only by the doctor, not what my mother bought, she gave herself.

    Svetlana Popova:

    In any case, we must see a doctor. If we see that such a situation with stool, and the mother follows a diet, excludes alcohol and spicy, fatty, fried, eats, poor, one buckwheat, and there is no result, it is imperative to see a doctor, he should look at the nature of the child’s stool, because intestinal infection can also proceed without fever, and with the same stool, but the child will be more lethargic, the stool is offensive. In case of lactase deficiency, it will not, as a rule, be so watery that it is absorbed completely, it is often thinned, greenish in color.This may not be lactase deficiency, but cereal intolerance, they just need to remove the bread. The doctor must determine this.

    Oksana Mikhailova:

    We’re just talking about lactase deficiency so that mothers have vigilance, just understand what it is. Now polyclinics work all 7 days a week, and you can even call a local doctor on Saturday, Sunday, so there is no need to call an ambulance, so anyway, please, mothers, do everything through a doctor, do not self-medicate.

    Svetlana Popova:

    The district doctor calmly, realizing that he cannot understand the situation, can give a referral to the hospital. There are more opportunities in the hospital, and mothers immediately calm down when they get to the hospital.

    Yulia Kalenychina:

    Of course, the responsibility will shift to the doctor.

    Svetlana Popova:

    And the calmness of the mother is transferred to the baby, everyone is happy.

    Yulia Kalenychina:

    Lactase deficiency is over, everything is fine with the child, is it worth relaxing, can she return?

    Svetlana Popova:

    You know, it can be transient, that is, against the background of some past infections, even in older children.Therefore, as I already said, we cancel dairy products and meat for diarrhea in young and older children.

    Yulia Kalenychina:

    I would like to return to this moment one more time: the mother decided to complete breastfeeding for one reason or another, for example, she goes to work, transfers the child to artificial feeding on her own, what changes in the nature of the stool should she expect?

    Svetlana Popova:

    Changing from breastfeeding to artificial stool will change.First, it will not have a uniform consistency, it will be harder, the color of the stool may change, it will be light yellow, and the frequency of the stool also changes. Artificial mixtures will never replace breast milk, they are still thicker, they strengthen the stool, and in this case, when stool once every three days against the background of artificial feeding is an absolute norm, this rarely happens against the background of breast milk. What you need to understand: you need to observe the drinking regime. If the baby has switched to artificial feeding, you should definitely give him water.

    Oksana Mikhailova:

    Drink is required. If, with breastfeeding, a child has the right not to drink until a certain age, then with artificial feeding, a drinking regimen is mandatory, and talking about the fact that we dilute the mixture with water and this is enough, that the child has constipation, is wrong.

    Svetlana Popova:

    In case of an infectious disease, the stool is liquefied, the child has an infection, it is recommended for children who are breastfed, frequent attachment to the breast, and for artificial people with an interval of three hours, give a more liquid mixture.As a rule, children refuse water, and here you can drink water in such a fraudulent way, but this can be done for no more than two or three days, because in no case should babies be kept on a hunger pause.

    Yulia Kalenychina:

    We mentioned that the absence of a chair for up to three days on artificial feeding may be the norm. But if there is no stool for two days, and the feces have taken on a dense, hard character, the child cannot go to the toilet on his own in any way, is this the norm, or are we already talking about constipation?

    Svetlana Popova:

    If this is the case, then give an enema or light a candle, but do not forget that the stool problem is not only related to nutritional problems, it can also be a neurological problem, that is, it is necessary to consult a neurologist.A child may be worried, worried, especially for younger and older children, when they went to school or kindergarten, they are shy, nervous, and these spasms may be associated with this.

    Oksana Mikhailova:

    As always, time flew by quickly, it was very interesting and I learned a lot of new things for myself, thank you very much.

    Yulia Kalenychina:

    The program was very informative, I hope that our listeners have learned a lot for themselves, thank you very much again, we will definitely invite you.Thanks to everyone who was with us, all the best, until we meet again.

    Svetlana Popova:


    Allergy to cow’s milk protein in children

    Food allergy is a side (pathological) reaction caused by food intake, which is based on immune mechanisms. In children under one year old, the most common cause of food allergies is cow’s milk protein (BCM).

    Distinguish between cow’s milk protein allergy and cow’s milk protein intolerance. In the first case, , immune mechanisms are involved, in the second – the baby simply does not have enough enzymes to digest cow’s milk protein (for example, lactase deficiency).

    Cow’s milk protein allergens total 36, but 4 of them most often cause food allergies.

    Casein makes up 80% of the BCM, it is thermostable (does not break down during boiling) and is not a species-specific protein .This means that if you are allergic to it, you may be allergic to the milk of other animal species.

    β – lactoglobulin has the highest allergenic activity, species-specific, does not break down when boiled. This protein is absent in human milk.

    α – lactalbumin is destroyed by boiling, species-specific.

    Bovine serum albumin is not destroyed when boiled, if an allergy to this protein of cow’s milk is detected, the child may also react to beef and veal meat.

    It should be noted that children who are bottle-fed, with formulas based on cow’s milk protein, are mainly allergic to cow’s milk protein.

    Also, this type of allergy can develop in children who are breastfed – if the diet of a nursing mother contains products containing cow’s milk protein (milk, cheese, cottage cheese, sour cream, butter, fermented milk products), especially in large quantities.

    What symptoms suggest that the baby may be allergic to CMP:

    • Skin manifestations (dry skin, dry rash, itching of the skin).
    • Gastrointestinal manifestations (bloating, regurgitation, vomiting, loose stools, possibly stools with mucus and blood streaks).
    • Respiratory manifestations (itchy eyes, cough, nasal congestion and even urticaria and angioedema). These symptoms are rare in babies, but they are still possible.


    It must be said that if the first manifestations of food allergy in a baby appeared after switching to artificial feeding with a “usual” adapted formula based on cow’s milk, then this is a reason to suspect cow’s milk proteins as an allergen.

    Further important is the correct taking anamnesis : the doctor will definitely find out if anyone from your family suffers from allergic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis, hay fever). If there are these diseases in the family, the risk of developing allergies in the baby increases.

    By the decision of the doctor, it is possible to take blood from a child for the presence of immunoglobulin E (IgE) antibodies to cow’s milk proteins, which were mentioned above.In the presence of IgE antibodies to CMP in the baby’s blood, almost 100% confirms the presence of an allergy. Paradoxically, the absence of these antibodies does not exclude an allergy to cow’s milk proteins, but only indicates that the allergy proceeds according to a different type of allergic reaction.

    And the simplest, most important and accessible method is the diagnostic diet with the exclusion of products from the child’s diet (or from the mother’s diet while breastfeeding) containing BCM. The duration of this diet is from 1-2 to 4 weeks.If during these periods the baby’s condition does not improve, then an allergy to CMP is unlikely.

    If the child’s condition improves, it may be necessary provocative test . This means the introduction of dairy products into the child’s diet again. And if the manifestations of allergies return, this will prove an allergy to CMP. This test is carried out under strict medical supervision.

    In children who are fed exclusively with breast milk, it is necessary to exclude products containing BCM from the diet of mothers .

    There are 3 types of mixtures:

    • based on whey protein hydrolysis;
    • based on hydrolysis of the casein fraction;
    • based on amino acids.

    Allergy is possible for the first two options, the reaction for the third option is very unlikely.

    If the baby is artificially fed, then it must be transferred to amino acid mixture or a mixture with a high degree of protein hydrolysis.Most infant formulas are made with whole proteins and therefore are not suitable for babies with CMP allergies. Also, hypoallergenic mixtures are not recommended for them, since the protein in them is not sufficiently broken down and mixtures in goat’s milk (cross reactions).

    Usually, doctors, allergists, first transfer children to a mixture based on complete hydrolysis of BCM or casein, if within 2-3 weeks there is no desired effect, it is recommended to transfer the baby to an amino acid mixture.

    Perhaps, in the presence of severe manifestations of food allergies in a child, the doctor will advise you to immediately transfer the baby to an amino acid mixture.By agreement with the doctor, it is possible to transfer the child to a mixture based on soy protein isolate (from 6 months).

    Amino acid mixtures are more easily tolerated by children with various forms of food allergies, since they are devoid of the bitter taste characteristic of mixtures with a high degree of protein hydrolysis.

    Amino acid mixtures can be used both for a short time to diagnose CMP allergy and as a basis for a diet for long-term use in children with food allergies.

    Duration of the diet – minimum 6 months . Then the question of transferring the baby to a hypoallergenic mixture is decided. In case of recurrence of symptoms, the introduction of dairy products is postponed for another 6 months.

    The prognosis for CMP allergy in infants and young children is favorable with the correct management tactics.

    Approximately 50% of children by the age of 1 year can be introduced to the diet of foods that include BCM.More than 75% of children by 3 years of age and more than 90% of children by 6 years of age do not show CMP allergic reactions.

    Regurgitation and vomiting in children

    The regurgitation syndrome is one of the most common reasons for parents of young children to visit a pediatrician and a surgeon. The reasons for regurgitation in children under 1 year old are different: anatomical and functional features, neurological disorders, infectious processes, malformations or other problems. The mechanism that prevents regurgitation and vomiting in children is very complex and depends on the anatomical structure and physiological processes of the child.The formation of this mechanism occurs in the last trimester of pregnancy and continues in the first months of a child’s life. Although regurgitation and vomiting can be a symptom of various diseases, these processes themselves are physiological, i.e. normal. Abnormal discharge of stomach contents into the esophagus is called gastroesophageal reflux, and the mechanism that prevents vomiting is called the antireflux mechanism.

    Anti-reflux mechanism in children

    In children, the nervous regulation of the antireflux mechanism is very complex and is easily disturbed under the influence of external and internal factors.Regurgitation and vomiting easily occur in children with an immature antireflux mechanism, if the mode or volume of feeding is incorrectly selected, as a reaction to artificial mixtures, at the slightest signs of infectious processes. This is especially often observed in children with intrauterine growth retardation and premature babies, as well as in severe pregnancy and toxicosis, caesarean section, complicated childbirth, etc.

    When to see a doctor

    Despite the fact that moderate regurgitation in a child under 6 months old is considered a variant of the norm, parents must be sure to tell the pediatrician about this during a routine examination.The reason for serious concern and immediate examination of the child is an increase in the frequency or increase in the volume of regurgitation, the appearance of streaks of blood or an admixture of bile, a delay in gaining or weight loss, and a high temperature. In this case, it is necessary to urgently consult a surgeon in order to exclude surgical reasons.


    In most cases, an ultrasound examination (ultrasound) is necessary to establish an accurate diagnosis and select the correct treatment.An experienced doctor of ultrasound diagnostics helps to establish the correct diagnosis in more than half of the cases. Sometimes flexible gastroscopy, X-rays, or computed tomography of the abdominal organs are done for a more accurate diagnosis.

    When surgery is required

    Pyloric stenosis or obstruction of the outlet of the stomach, is the cause of the most severe regurgitation syndrome (vomiting “fountain”) in children under 2 months of age, accompanied by severe weight loss and increasing deterioration in the child’s condition.This disease requires urgent surgical attention. In leading clinics, such operations are performed using a minimally invasive laparoscopic method. The modern level of development of surgery and pediatric anesthesiology makes it possible to use the endoscopic technique of surgery even in children in the first weeks of life.

    There are also other causes of regurgitation that require surgical intervention, such as hiatal hernia, chalasia (dehiscence) of the esophagus, and others. These malformations are characterized by impaired formation of the antireflux mechanism and lead to constant regurgitation in the child, impaired weight gain, loss of appetite, chronic cough, bronchial asthma, and anemia.If drug therapy is ineffective, then gastrofundoplication surgery is indicated, in which an artificial antireflux valve is surgically formed. Like many other interventions, in modern children’s clinics, this operation is performed laparoscopically – with less trauma, minimal blood loss, minimal cosmetic defect and quick recovery of the child after surgery.

    Of course, vomiting and regurgitation can be symptoms of many other diseases and occur at any age of the child.So, vomiting is often noted in acute appendicitis and intestinal obstruction, it can be a symptom of intestinal infection, intoxication, etc. In addition to the disease itself, vomiting and profuse regurgitation are dangerous because the child loses a large amount of water and salts necessary for life, which can lead to dehydration – exsicosis. The younger the child, the faster the breakdown of compensatory mechanisms and the aggravation of his condition occurs. Therefore, the appearance in a child of symptoms of vomiting or severe regurgitation in young children requires immediate medical attention to identify the causes, establish the correct diagnosis and choose the optimal treatment, and, if necessary, surgical.

    Experienced pediatricians and surgeons are on duty around the clock at the EMC Children’s Clinic, who provide emergency and planned assistance to children of different ages, starting from the first days of life.

    If surgical treatment is necessary, the method of choice in our clinic is minimally invasive endoscopic surgical interventions, which in most cases allow the child to go home on the day of the operation. The operation is accompanied by an experienced anesthesiologist who selects modern and safe anesthesia for each child individually.Postoperative wards are equipped with high-tech equipment, where 24-hour monitoring systems are installed, and a separate nurse continuously monitors the condition of young patients.

    In the comfortable hospital of the EMC Children’s Clinic, parents can stay with their child all the time, there is a round-the-clock visit for relatives and friends, which makes it possible to provide maximum comfort for the child and parents.

    The kid spits up yellow.Regurgitation with bile

    The first weeks of a baby’s life, when everything in the house is subordinated to the fact that the newly born child is surrounded by warmth, care and adoration, two feelings rage in the hearts and minds of young parents. Boundless love for this small, warm, dear little man, which sometimes overwhelms so much that it becomes difficult to breathe. This is the first and foremost.

    The second feeling is fear. Fear of an awkward movement to hurt a defenseless baby. Wrong actions to bring discomfort to his so far helpless existence.And if some kind of anomaly arises in the baby’s behavior, half of the mothers panic and run as fast as they can to a more experienced friend, a wise grandmother, or take the child to the doctor.

    Probably the very first such anomaly is regurgitation of milk after eating. I want to say right away that in no case should we invent all sorts of horrors. You just need to calm down and carefully consider what exactly the baby burp up with.

    A completely healthy toddler with a good appetite under the age of one year still does not know how to control either the amount of food eaten or the correctness of its intake.The reason for spitting up may be a banal overeating, especially if he eats breast milk. The breastfeeding process calms the baby, gives him a sense of security and he is ready to do it for hours. A tiny stomach that still cannot stretch and a short esophagus quickly fill up and the body resorts to the only known way to get rid of the excess.

    Causes of regurgitation in infants

    The second reason is the ingress of air into the mouth.Here all the fault lies with the mother. It is necessary to carefully monitor that the baby takes the nipple tightly, and if you feed from a bottle, you must hold it at the right angle and at the same time make sure that after shaking the mixture all the foam rises. And you should also choose the optimal size of the hole in the nipple so that not a single air bubble leaks out.

    After feeding, you should not immediately put the baby in the crib, especially on the stomach, bother, bathe and even change clothes. Active exercise should be done either before meals or about an hour after feeding.It is necessary to hold it in an upright position and lightly massage the tummy.

    If the toddler is cheerful, active, gains weight well and regurgitation, if they occur, then no later than an hour after he has eaten a solid meal, then everything is fine and there is nothing to worry about. An incompletely formed and strengthened gastrointestinal tract is still only adapting and some malfunctions in its work are quite normal. Over time, when the stomach learns to stretch, and the muscles responsible for the work of the esophagus and intestines get stronger, everything will return to normal.

    These reasons are clear to everyone, they do not pose a great danger to the health of the baby and are easily eliminated. However, if a child regurgitates in a mass in which yellow streaks, blotches or all vomit of a pronounced yellow color are noticeable, this is already a reason not only to think about it, but also to consult a specialist. And if it happens periodically and is accompanied by crying, screaming and unnatural movements – even more so. In this case, comprehensive research and prompt correct diagnosis are required.You should start with the appointment of a pediatrician and the child undergoing a diagnostic ultrasound of the abdominal cavity.

    Causes the child to vomit yellow

    There are several reasons and it is worth starting with the most unpleasant one, but immediately calm down – this situation is very rare. Congenital pathology that has arisen during the difficult course of pregnancy, improper behavior of the mother while she was carrying the baby under her heart (smoking, alcohol, harmful food, trauma) or difficult childbirth, can be expressed in intrauterine disorders, which entail the incorrect development of internal organs.This is especially true for premature babies or those born with postpartum asphyxia. The ingestion of food from the stomach into the esophagus can also be caused by the ingestion of amniotic fluid.

    This can affect the overall development of the baby. He may have sudden screams, shudders, and bouts of increased activity. In this case, supervision by a neurologist is absolutely necessary. Symptoms are usually pronounced and leave no doubt about the diagnosis for a good specialist.Treatment consists mainly in changing the life schedule of the little man, ordering all the necessary actions and, in exceptional cases, the use of medication.

    Here are some more reasons why a child may regurgitate a mass of yellow.

    Taking antibiotics is one of the reasons for spitting up yellow

    • Poor lactose tolerance. Occurs in the event of a lack or complete absence of the required enzyme.In this case, after a short and short examination, the doctor usually prescribes lactose-free mixtures and the problem is eliminated very quickly. The child begins to gain weight again, smile and practically stops spitting up.
    • The problem can arise after taking antibiotics that do not have a beneficial effect on the stomach and intestines. It should be emphasized that such drugs should be given to the baby exclusively as prescribed by the doctor and, at the slightest suspicion of their negative influence, consult with your pediatrician.
    • all kinds of infectious diseases against which a small organism has not yet developed a defense mechanism. Meningitis, hepatitis, stomach infections – usually accompanied by colic, unmotivated anxiety, diarrhea and fever.
    • Allergy is also possible, both to the feed mixture and to the products that a nursing mother eats.
    • intestinal obstruction. The main sign is if, during feeding, the baby’s tummy grows, and then drops sharply.In this case, it is necessary to consult a gastroenterologist, examination and prescription of the correct method of treatment.

    But whatever the reasons, if your baby spits up at a dangerous frequency and yellow – this should alert you.

    An unnatural color indicates that bile enters the esophagus, irritates the mucous membrane and can lead to very unpleasant consequences. Part of the contents of the stomach can enter the lungs, and this is an almost one hundred percent guarantee of serious diseases of the nasopharynx and respiratory tract (otitis media, pneumonia and other troubles).

    As scary as it may sound, you shouldn’t despair and panic. After X-ray and clinical examinations and the correct diagnosis, the doctor will prescribe the necessary treatment and, after completing its course, the baby will definitely recover.

    • before feeding the baby, you should put his tummy for a while. This will remove excess gas and strengthen the muscles in your neck and abdomen.
    • do not wait until the child is very hungry.In this case, he will suck greedily and the ingress of air into the stomach will be almost inevitable. It can also lead to overeating.
    • make sure that the baby takes the nipple correctly, completely capturing the areola. If, while sucking, the toddler begins to smack his lips or hear any other sounds, it means that he is uncomfortable and needs to attach him to the breast in the optimal way.
    • When bottle feeding infant formula, ensure that the teat hole is properly sized and that the angle is correct.It should be such that the baby does not choke, but also does not make unnecessary efforts.
    • after the child has eaten, hold it with a column and wait until the excess air, if it does get into the stomach, will go away. This usually happens immediately, but it can take 20-30 minutes. Again, there is nothing wrong with that.
    • The headboard in the stroller and in the crib should be slightly raised. A thin book or a thin pillow should be placed under the mattress, but at the same time make sure that not only the head is raised, but the entire upper body is raised.
    • if the baby is pestered by gaziks, you can give drugs with fennel extract to drink.
    • to feed the baby according to the schedule. The kid will get used to it very quickly, and will not experience a strong feeling of hunger.
    • strictly monitor that the mixture is appropriate for age and personal performance, if any.
    • daily walks in the fresh air and swimming are obligatory. Active, age-related exercises that will lead to strengthening the muscles, including those responsible for the digestive system.

    When a young mother and baby are discharged from the hospital and, accompanied by a loving husband and father, who let a tear from emotion and joy, grandparents come home, all the joys and difficulties can pile up at such a speed that it can shock. You should not be afraid, panic, and even more despair and fall into postpartum depression. It should be remembered that now not only your life depends on you, but also the life of your son or daughter and unnecessary negative emotions, neither you nor the child will benefit.

    Firstly, the baby, no matter how defenseless he looks, is already at this age a rather strong and wayward creature. He will certainly in one way or another inform attentive parents that he does not like something or that he is experiencing some discomfort. And how he will demand to eliminate these inconveniences. And secondly, as for regurgitation – there is nothing overly dangerous in it. The overwhelming majority of the reasons for this are easily eliminated and do not bear any harmful consequences. And it is not difficult to wash a dressing gown or a shirt, on which the baby burped.

    In case of any complications, there is always a children’s clinic and wonderful pediatricians who have come to the profession at the call of the soul. They care about your baby no less and are ready to do everything in their power for him.

    What else you should know about regurgitation in newborns

    The very first months of a baby’s life are the most important period in his development. It is at this time that the baby gradually adapts to the diversity of the environment that surrounds him. The functioning of his internal organs is finally tuned up at this time as well.Feeding problems are likely to arise during this “tuning” process. And if for some time there is profuse regurgitation

    , inexperienced parents may be frightened, not knowing if the child should normally regurgitate food. In addition, this phenomenon is very similar to vomiting

    , which is a symptom of disease. But in fact, the causes of regurgitation are associated with completely different phenomena, and only in rare cases indicate the development of diseases.Why a baby can often and strongly regurgitate, how to distinguish vomiting from regurgitation, will be discussed in this article.

    Is regurgitation after feeding a pathology?

    When, after feeding, the baby spits up, a small amount of food is thrown out from the stomach through the mouth.

    As a rule, the infant will regurgitate some food. At the same time, parents are still worried about why the baby spits up. But in most cases this is a completely natural and normal process, and there is no need to worry about why a newborn baby spits up.Indeed, in this way, excess air simply leaves the baby’s ventricle. That is, this is a kind of signal that the body is working correctly. And if the baby is feeling well, and he does not show other alarming symptoms, there is no reason to worry why the baby is spitting up breast milk.

    According to statistics, very few children do not spit up in infancy. In about 70% of infants, these manifestations occur until they are 3-6 months old. Babies spit up during or after feeding.That is, if a baby at 2 months old has something like this from time to time, this is not a cause for concern. Although up to what age a child spits up is rather an individual question. But in most cases, up to 9 months in most babies, regurgitation disappears by itself.

    The most common regurgitation occurs in children who were born prematurely or in babies with intrauterine growth retardation. In such babies, after birth, for 5-8 weeks, all the functions of the body “ripen”.When this period ends, the child’s body adjusts, and the unpleasant symptoms disappear by themselves. There is no point in worrying about why the baby often spits up after formula or breast milk

    , if at the same time the child feels good, develops normally, smiles and communicates with pleasure.

    However, if a strong regurgitation of the “fountain” is constantly manifested, and the baby is at the same time restless, it is worth telling the pediatrician about such manifestations.After all, such a condition may indicate diseases that can negatively affect the development of the baby.

    How to distinguish: regurgitation or vomiting in a baby?

    It is important for parents to understand exactly what is happening with the baby: does the newborn vomit after feeding, or does it just spit up.

    When regurgitating, food flows out, while the abdominal muscles do not contract. As a rule, the baby spits up immediately after feeding, especially if after that his position is changed dramatically.After feeding, the baby spits up most often once, with water or milk.

    If vomiting occurs

    , the baby is whiny and restless. When food is excreted, spasms appear, a large amount of vomit is released – more than when regurgitating. When vomiting, parents often note that the child vomited with a fountain. Usually, the urge to vomit is multiple, while it joins the ejaculated contents, so the baby vomits yellow.

    Vomiting is a complex reflex act.When it manifests itself, the muscles of the diaphragm, abdominal cavity, and press are actively contracted. As a result, the contents of the stomach are spontaneously excreted. Before vomiting, the baby is worried about nausea – the skin turns pale, strong, rapid breathing appears, saliva is released. If the baby starts vomiting, you should immediately seek medical help. All pediatricians insist on this – Dr. Komarovsky and other famous doctors. It is important that the doctor as soon as possible determine the cause of vomiting in the baby.

    The regurgitation process is physiological if the following symptoms occur:

    • absent gagging

    • 90,024 the amount of food released is small;

    • the baby spits up no more than twice a day;
    • baby is gaining weight within normal limits.

    Over time, regurgitation disappears without additional treatment. It is important to know what color should be the breast milk that the baby has spit up – normally it should not contain any impurities of bile, etc.

    Why does the baby spit up after breastfeeding?

    Thus, the main reasons for regurgitation in newborns after feeding are functional immaturity of the digestive system. If at a certain period the baby spits up after each feeding, or the infant has a belching

    and regurgitation occur periodically, the reasons for this phenomenon may be as follows:

    • The baby just overeat

      .Even if the child is already full, sometimes he may not stop eating. He sucks, gradually calming down and enjoying the closeness with his mother. After that, the baby regurgitates excess food. In this way, it frees the gastrointestinal tract, preventing its overload. In this case, even profuse regurgitation is a kind of prevention of diseases of the digestive system associated with overeating.
    • Aerophagia

      – swallowing air while the baby is eating. A similar phenomenon occurs if the baby is in an uncomfortable position during the feeding process.This is also possible if the baby is receiving too much breast milk or formula (for example, if a very large hole is cut in the bottle), if he does not properly grip the nipple or is too excited.
    • – too much gas formation can also be the answer to the question, the baby often spits up after breastfeeding. It is natural feeding that often leads to the manifestation of flatulence

      , since periodically after feeding intra-abdominal pressure increases

      .That is why a nursing mother should definitely pay attention to her nutrition. Legumes, black bread, cabbage, fresh apples should be excluded from the menu. The latter can be replaced with baked ones.
    • is another reason why a baby may spit up an hour after feeding or even 2 hours after feeding. With constipation, the pressure in the abdominal cavity increases, food moves slowly through the digestive tract, and therefore the likelihood of regurgitation is very high.
    • Indiscriminate feeding can also cause regurgitation.
    • The position of the child is also important: if the baby is held upright, then a bubble of air will form in the stomach, which can push some of the food out of the stomach. As a result, an inexperienced mother may think that the baby has vomited.

    How to prevent physiological regurgitation?

    If the parents are still worried about why the newborn spits up a lot, you can try to apply some preventive measures to prevent this. Initially, the mother needs to carefully observe the baby in order to understand what exactly he spits up a lot.If the cause is established, it must be eliminated.

    If the baby spits up a lot, the following preventive measures can be taken:

    • It is important that both the baby and the nursing mother are calm and relaxed before starting the feeding process. For a while, the child can be laid out on the tummy or patted a little on the tummy. It is important that the baby’s head is not thrown back and that he can breathe freely through his nose. If the nose is blocked, then the child will swallow air through the mouth.It is with nasal congestion that the baby often spits up a lot after breastfeeding.
    • With natural nutrition, it is important to monitor whether the baby is breastfeeding correctly. It should capture the nipple and areola while sucking. In this case, the baby’s lower lip should be slightly turned out.
    • A baby who is given an artificial formula can use special anti-colic bottles and nipples for feeding. With their help, the baby is prevented from swallowing a large amount of air.It is equally important to hold the bottle correctly during feeding: at an angle of 40 degrees if the baby is lying down, and 70 degrees if he is sitting in the mother’s arms.
    • Do not swaddle your baby too tightly after eating. Leave it at rest immediately after feeding. You can lightly pat it on the back to prevent regurgitation. To do this, they sit the baby on their knees, and, holding it with one hand, gently slap it on the back with the other.
    • The reason for regurgitation may be that the nutritional norm is exceeded.If the parents suspect that this is the case, it is necessary to reduce the duration of the feed. To determine if your child has eaten enough, you can weigh them before and after meals. In this case, you need to know what are the norms for feeding with a mixture or the norm of breast milk for a baby of a certain age. Indeed, contrary to popular belief, the answer to the question of whether a newborn can overeat with is positive.
    • Babies who spit up very often should be placed on their side in the crib.So, the masses that “return” from the stomach will not enter the airways. If this happened when the child was lying on the back, you need to raise him and turn him face down.
    • The use of a special antireflux mixture is sometimes recommended

      to help correct regurgitation. A special indigestible additive that contains locust bean fruit is a blend of natural fibers. When they enter the baby’s stomach, they form a clot there that prevents regurgitation.

    Typically, these prophylaxis methods help prevent regurgitation or reduce the frequency of regurgitation. Parents should not be worried if the baby spits up periodically, but in general he is healthy – gaining weight, behaving calmly. As a rule, parents themselves may suspect a pathology, paying attention to the manifestation of other symptoms against the background of regurgitation. In this case, it is important to consult a pediatrician who will help determine the cause of the pathology.

    When is the help of a specialist needed?

    It is important for young parents to know for what manifestations it is necessary to seek medical help:

    • If the child continues to spit up regularly even after the first six months of life.
    • When the contents of the stomach are returned by the “fountain” more than twice a day.
    • When symptoms of dehydration appear – if the baby refuses to eat, his body temperature drops, weakness, rare urination is noted, or he pees more often 10 times a day.
    • The child is developing.
    • The child is gaining weight poorly, lagging behind the norm for his age.
    • If the baby spits up “curd” – that is, a curd mass that has an unpleasant odor, a kind of sour milk. Sometimes, and normally, the child spits up a curdled mass. But if the baby behaves restlessly at the same time, it is better to show him to the doctor.

    In some cases, frequent regurgitation in babies still indicates the development of certain pathologies.Sometimes this is due to violations of the intrauterine development of the fetus due to pathologies. If the parents are still seriously worried about why the newborn spits up often and profusely, the doctor should look for the causes associated with the pathologies described below. Dr. Komarovsky and other experts call the following diseases in which regurgitation may occur.

    Perinatal encephalopathy

    If an infant spits up frequently, the causes of this phenomenon may be associated with a difficult course of pregnancy and childbirth in the mother.Collective diagnosis perinatal

    includes dysfunction of the nervous system, which is characterized by profuse regurgitation. Sometimes the baby can even spit up like a fountain. He also does not sleep well, is often restless, he has limbs and a chin. The risk of developing this disease increases significantly with prolonged
    91,155 fetuses during pregnancy. There is also a high risk of manifestation of this ailment if the baby was born with indicators less than 5 points on the Apgar scale

    if he has experienced short-term respiratory arrest.


    This disease is characterized by profuse and frequent regurgitation. After feeding, the baby spits up almost everything that he has eaten with a fountain. The newborn often cries, worries, and when he sleeps, throws his head back. If a delay in physical and mental development is likely, an increase in muscle tone in the limbs, a delay in the development of a step reflex. Hydrocephalus progresses rapidly and requires immediate treatment.

    Other diseases of the central nervous system

    Constant regurgitation may indicate impaired blood flow to the brain, birth trauma, underdevelopment of the central nervous system.Regurgitation accompanied by belching occurs after each feeding. The child regurgitates undigested food.

    Anomalies and pathologies of the digestive system

    Persistent and frequent regurgitation may result from pyloric stenosis

    or diaphragmatic hernia

    . If the baby has pyloric stenosis

    , the signs of this disease appear almost immediately after birth – on the second day, the baby spits up curd.The newborn loses weight because food is not absorbed and does not pass beyond the stomach. In this state, the baby has no stool, even if the baby is given an enema


    Infectious diseases

    A baby can spit up with sepsis

    , food poisoning

    , hepatitis

    , etc. In addition, the baby’s temperature rises, lethargy is noted, the skin turns pale or yellow.As noted by Dr. Komarosky and other pediatricians, if there is mucus in the contents that the baby has spit up, this is evidence of intestinal dysbiosis

    or gastrointestinal infections

    . In such a situation, doctors prescribe a dose or other drugs.

    Hereditary diseases

    This symptom is characteristic of, adrenogenital syndrome

    . Periodically, the baby may spit up when.

    Causes of regurgitation by a fountain in newborns

    If a newborn spits up with a fountain on a regular basis, this may be evidence of a severe brain pathology, or talk about a dysfunction of the digestive system.In addition, the baby spits up with a fountain in case of severe poisoning. It is important for parents to know that with this manifestation, the baby can be seriously ill, and you need to contact the pediatrician immediately. After all, a baby can develop dehydration very quickly

    , he will lose weight quickly, and the consequences will be very serious.

    It is important to determine as soon as possible why the baby spits up like a fountain after feeding. With this manifestation, the baby can choke in a dream when lying on its back.Therefore, even if this was repeated only a few times, the baby should be laid on its side, fixing its position with the help of rollers.

    For artificial children who regurgitate with a fountain, select a special antireflux mixture

    , which prevents such manifestations.

    But the most important thing is to consult a doctor in a timely manner in order to establish a diagnosis and help the child cope with the disease.

    The appearance of a baby is an important event in the life of every married couple.New parents are alarmed and frightened by every incomprehensible phenomenon. In the first weeks of life, the digestive system, and all other organs, adapt to new living conditions.

    Some babies may regurgitate breast milk after eating. The phenomenon passes over time. However, it happens that the child does not spit up milk, but an unknown substance that has a yellow tint. For some new parents, this phenomenon most often scares, makes them panic and sound the alarm.Others try to calm down and find the cause on their own or together with a pediatrician.

    Causes of regurgitation

    Regurgitation can be caused by several main reasons. Most often, this phenomenon is explained by the fact that a newborn baby with a good appetite does not have the ability to control the amount of food eaten and follow the rules for taking mother’s milk or prepared mixture.

    That is why very often, especially in the first months of a child’s life, banal overeating can be the cause of spitting up.Especially if the baby is breastfed. A newborn baby is able to stay at the food source for hours, because the breastfeeding process allows the baby to feel protected. In turn, the child’s stomach is still very small and cannot contain all the food consumed. That is why “excess” milk is removed from the baby’s digestive system in the only available way.

    Another common cause is air ingestion. The phenomenon is explained by a violation of the feeding technique.Most often, air enters the infant’s mouth if the nipple does not fit snugly against his lips. If the baby feeds on the formula, you need to hold the food bottles at the right angle, while making sure that after shaking the mixture all the foam rises.

    In addition, you should take a responsible approach to the choice of capacity, pay attention to the size of the hole in the bottle. It must be appropriate for the age of the baby. You should also choose the optimal size for the opening in the nipple so that not a single air bubble leaks out.

    After finishing feeding, hold the baby in an upright position. Do not shake it under any circumstances, do not put it on your stomach.

    Regurgitation of white, arising from one of the listed reasons, should not disturb new parents. They will disappear as soon as the baby’s digestive system gets stronger.

    It is worth worrying if the mass resulting from regurgitation is not white, but yellow.

    What the yellow color signals

    It should be understood that the unusual color of regurgitation, one way or another, is associated with the malfunctioning of the alimentary tract, since it is in it that bile is produced.It is she who gives the substance released during regurgitation, a yellow tint.

    The specific color indicates that bile enters the esophagus, irritating the mucous membrane.

    Why spits up yellow

    There can be several reasons for an unusual phenomenon, one of the most unpleasant is congenital pathology. It can occur as a result of a difficult pregnancy or as a result of a woman’s misbehavior while carrying a baby. Deviation from the norm can be expressed in intrauterine disorders, leading to abnormal development of internal organs.The risk group in this case includes children who appeared earlier than the due date. Congenital abnormalities of the esophagus are very rare. Most often, the baby spits up yellow after feeding for another reason.

    Congenital pathology is accompanied by increased activity, shuddering and screaming attacks.

    Ingestion of food from the stomach cavity into the esophagus may be due to the ingestion of amniotic fluid.

    The reasons for a newborn can also be several phenomena.

    1. Lactose intolerance or poor tolerance. This problem arises as a consequence of the lack or complete absence of the required enzyme.
    2. Taking antibiotics. These drugs can have a negative effect on the stomach and intestines.
    3. Infectious diseases that the baby’s body is unable to fight. In this case, regurgitation of a yellow substance may be accompanied by colic, loose stools, as well as a change in the emotional mood of the baby.An increase in basal temperature is possible.
    4. If the baby spits up yellow milk, it is quite possible that the baby is allergic to any product used by the mother. In addition, such a phenomenon may be the result of an allergic reaction to formula milk (if the baby is artificially fed).
    5. Intestinal obstruction. Pathology is accompanied not only by yellow regurgitation, but also by changes in the size of the baby’s tummy. During feeding, it increases in size, and after the end of the process, it drops sharply.

    If an infant regurgitates yellow, you must immediately contact a specialist in a medical institution for an examination and a full examination.

    Yellow regurgitation during artificial feeding

    The reason for the appearance of unusual substances during regurgitation can be a sharp transition to artificial feeding. This usually happens when lactation stops unexpectedly due to some factor. Another reason may be a mother’s illness that is incompatible with breastfeeding.

    If yellow regurgitation does not stop after a week, then X-ray and clinical examinations may be required to make a diagnosis.


    If action is not taken promptly, there is a risk of serious consequences.

    The ingestion of food from the stomach cavity into the esophagus, due to the ingestion of amniotic fluid, can cause sudden screams, bouts of increased activity. In addition, the child starts to flinch.If you do not turn to a pediatrician and a neurologist in time, serious diseases of the central nervous system may occur, which will subsequently provoke disturbances in the development of the baby.

    If some of the stomach contents enter the lungs as a result of inactivity, the child could develop serious nasopharyngeal and respiratory problems.

    Which doctor should I contact

    If the baby spits up yellow after feeding, you should immediately consult a doctor.The very first specialist that the newly-made parents visit together with the baby should be a pediatrician. He will examine the child, give directions for additional examinations. If necessary, he will make an appointment with a gastroenterologist. The infant may need to be seen by a surgeon.

    If the cause of spitting up is the swallowing of amniotic fluid, you cannot do without consulting a neurologist.


    Treatment depends on the cause of the yellow regurgitation. If bile is excreted in milk due to lactose intolerance, the doctor usually prescribes mixtures that do not contain this component.The problem is resolved quickly. After a few days, the spitting up of yellow stops, the child again begins to gain weight, smile.

    If the problem is caused by intestinal obstruction, the pediatrician directs the parents together with the baby for a consultation with a gastroenterologist. The doctor examines the baby and prescribes medication based on the results of the examination.

    Congenital pathologies require more serious treatment. In some cases, surgery is required.

    Regurgitation of milk or formula after breastfeeding or artificial feeding is a fairly common phenomenon that manifests itself in newborns immediately after birth and can last up to 3-6 months.When faced with this problem for the first time, every mom wants to figure out why the child spits up after breastfeeding? When is this phenomenon normal, and in what cases is it necessary to consult a pediatrician?

    It turns out that profuse regurgitation of food from the baby’s mouth can only in rare cases be a symptom of the disease. According to pediatricians, this is a natural physiological process in the development of a child, therefore, parents should not have cause for concern.


    Pediatricians identify 7 reasons why a child often regurgitates the food they eat:

    • due to overfeeding – the digestion process slows down, and he begins to regurgitate excess milk or mixture. Belching may appear immediately or half an hour after the completion of feeding. Its consistency resembles cottage cheese or water with a white bloom.
    • Disorders of the gastrointestinal tract – this can be excessive gas formation or constipation, which interfere with the passage of food.
    • congenital abnormalities or early diseases of the digestive system can also cause the baby to often spit up after each feeding.
    • the food sphincter is underdeveloped – a special valve that is responsible for ensuring that food does not return from the ventricle to the esophagus. In infants, it is in the process of formation and only after 7-8 months it begins to work normally.
    • Allergic reactions to new foods that are not always perceived by the infant’s body.
    • Improper child care immediately after feeding – rolling over on the stomach and back, rocking in a stroller, and so on.
    • improper attachment to the breast during feeding – along with breast milk, the baby swallows a lot of air, which settles on the lower walls of the esophagus and thereby irritates the mucous membrane. Ultimately, after feeding, the baby spits up milk, throwing it out in a fountain.

    Important to know!
    Excess air can be trapped in the esophagus during bottle feeding, so parents need to consider this factor as well.

    The kid often spits up with a fountain

    Such a burp between feedings should alert the parents, and the reason for its occurrence may be the following circumstances:

    • prematurity of the baby;
    • Incorrect transfer from HS to artificial feeding;
    • obstruction of the gastrointestinal tract;
    • pathological diseases of the nervous system.

    Why did the baby vomit yellow?

    Sometimes it happens that after breastfeeding, the baby spits up yellow – this is a wake-up call for parents.Yellow color indicates serious abnormalities in the work of the stomach and the presence of bile in the vomit.

    In case of severe vomiting, the yellow contents together with milk can enter the lungs and cause pneumonia or nasal diseases. This condition of the baby poses an increased danger to his health. Sometimes, surgery may be needed to stop vomiting of bile.

    Preventive measures

    If the baby spits up after breastfeeding or formula feeding (with artificial feeding), it is necessary to carry out a number of preventive measures that minimize bouts of vomiting:

    • a few minutes before feeding, lay the baby on his tummy for 30-60 seconds.This will allow gases to escape from the intestines and normalize the digestion process.
    • Monitor the correct latch of the breast, as well as the position of the baby during breastfeeding. When feeding with formula or milk from a bottle, keep an eye on the filling of the teat.
    • If the baby often spits up after each feeding, pick him up and hold him upright for 1-2 minutes. In this position, the air accumulated in the stomach will go out on its own.

    In cases where the child spits up a lot after each breastfeeding, doctor Komarovsky advises to pay attention to the following features:

    • Stick to proper feeding.Do not feed an infant immediately after burping; give the stomach a little rest. Otherwise, there will be an overflow of the stomach with excess milk and an increased risk of a gag reflex.
    • If a newborn spits up profusely, but this does not affect the weight in any way, then there is no need to worry about his health yet. Otherwise, you need to consult a specialist gastroenterologist.
    • During attachment to the chest, the head of the baby should be slightly raised.
    • After each feeding, place the baby on his stomach.

    How to provide first aid?

    What to do if, after breastfeeding, the child began to regurgitate a lot of cottage cheese or liquid with a white bloom?

    Pediatricians advise parents not to panic and give the following recommendations:

    • to hold the baby in an upright position or lay on the tummy, so that excess food does not create a blockage in the respiratory tract;
    • you can offer boiled water, but only in small quantities;

    If during the day, he sleeps poorly, there are changes in the consistency of the stool, or the temperature rises (over 38 degrees) – urgently call a pediatric therapist.