Patient's question:
Big spit up 16:06Doctor's answer:
Analysis of the condition: Hello, vomiting in newborns often causes great concern for parents and friends. What they are most concerned about is whether the vomiting is physiological or pathological. We know that in the neonatal period, in addition to vomiting caused by improper feeding, many factors, especially diseases of internal and external medicine, are related to neonatal vomiting.Suggestions for guidance: There are three types of vomiting in newborns:
1. Spitting up is most common in infants under 6 months, especially newborns. This is related to a horizontal stomach, relaxation of the lower esophageal sphincter, tension of the pyloric sphincter, and improper feeding. It is characterized by a small amount of milk refluxing into the mouth or spilling out of the mouth. Generally, improving feeding methods or as the child grows older, it can resolve on its own. The second is regurgitation, which occurs due to increased muscle movement in the jaw and pharynx, causing stomach contents to reflux into the mouth. This phenomenon is more common in infants over 6 months and is often accompanied by abnormal mental states, leading to malnutrition and growth and development disorders.
2. Common vomiting often precedes with nausea, followed by vomiting one or several times. Persistent or repeated vomiting is pathological and is more common in gastrointestinal infections, overeating, and recurrent vomiting.
3. Projectile vomiting usually occurs without nausea, with a sudden expulsion of a large amount of stomach contents through the mouth or nose. This is often caused by conditions such as pyloric obstruction, gastric torsion, and increased intracranial pressure.
Neonatal vomiting is one of the common symptoms during the neonatal period:
1. Vomiting with curdled milk is seen in cases of improper feeding, gastric torsion, gastroesophageal reflux, and pyloric spasm.
2. Vomiting with bile is seen in conditions such as congenital annular pancreas, malrotation of the intestine, and duplications of the gastrointestinal tract.
3. Vomiting with abdominal distension is seen in conditions such as congenital megacolon, anorectal malformations, meconium ileus, and meconium peritonitis; neonatal necrotizing enterocolitis.
4. Vomiting with bulging fontanelles is seen in conditions such as hydrocephalus, neonatal hypoxic-ischemic encephalopathy, and intracranial hemorrhage.
5. Vomiting with physical abnormalities is seen in conditions such as congenital adrenal hyperplasia and galactosemia.
Acute vomiting is caused by acute gastritis or enteritis due to viruses, toxic substances, or bacterial infections, often accompanied by diarrhea and abdominal pain.
Periodic vomiting, also known as recurrent vomiting, is a persistent and refractory type of vomiting that often begins between the ages of 2–4 and does not occur after puberty. The cause has not been definitively determined, but it is generally believed to be related to constitutional factors. Upper respiratory infections, emotional fluctuations, fatigue, and irregular diet are common triggers. Its characteristics are repeated sudden attacks of frequent vomiting, which last for 1–3 days before subsiding.
Neurotic vomiting, also known as psychogenic vomiting, is characterized by repeated episodes of vomiting without organic lesions and is often related to psychosocial factors. It is caused by an unpleasant environment or psychological stress, leading to repeated involuntary episodes of vomiting. It usually occurs after meals, with sudden projectile vomiting, without obvious nausea or other discomfort, and does not affect appetite. The child can eat again after vomiting.
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