Patient's question:
A 42-day-old infant has been spitting up for the past 3 days, which is a new symptom. They spit up several times a day, including undigested food and curd-like material. The infant is in good spirits, and there are no abnormalities in their stool. The frequency of bowel movements has decreased compared to before, from 4-5 times a day to 3 times a day.Doctor's answer:
Hello:What causes baby spitting up? Is it like the old saying, "overfeeding or poor digestion"? Actually, it's not. Doctors say that baby spitting up is a condition called "gastroesophageal reflux," where the lower esophageal sphincter in newborns doesn't function properly, unable to effectively block the reflux of stomach contents. This is especially true after feeding, when the stomach is fuller and the pressure increases, making reflux more likely. Therefore, when a newborn spits up after eating, the first consideration should be gastroesophageal reflux, and reflux monitoring of the esophagus can be conducted to determine the severity of the reflux.
The incidence of pediatric gastroesophageal reflux is relatively high. Domestic reports indicate that the detection rate in newborns is as high as 60% or more, with 20% experiencing symptoms such as spitting up, vomiting, or regurgitation.
Although gastroesophageal reflux is often considered physiological in infancy, most children's symptoms disappear within 12 to 18 months. However, if left untreated, it can lead to many complications (such as aspiration pneumonia, apnea, suffocation, malnutrition, poor weight gain, and anemia, etc.). Therefore, early recognition and treatment are important for pediatric gastroesophageal reflux.
For infants with frequent spitting up or vomiting, positional therapy, dietary changes, and medication should be considered.
"Positional therapy" involves elevating the head of the child slightly while sleeping and keeping the head in a side position; "dietary therapy" emphasizes small, frequent meals, which can increase feeding frequency but avoid overfeeding (for formula-fed infants, adding rice porridge to milk can thicken the formula); "medication"