Patient's question:
Frequent spitting up, occasionally spitting out large amounts, and sometimes the milk vomited out contains sputum-like substances, accompanied by continuous hiccups. Born 2 weeks ago, what kind of assistance is desired: want to understand the reason...Doctor's answer:
Nausea is a common phenomenon in newborns. Some have normal physiological conditions, known as spitting up; others vomit more frequently or in larger quantities than typical spitting up, which may indicate illness and should be diagnosed and treated early. One type of vomiting in newborns is physiological, related to the anatomical and physiological characteristics of newborns and diaper-changing methods. The infant's stomach is slightly horizontal, and the smooth muscles of the stomach are not fully developed. After filling with liquid food, the stomach tends to expand easily. Due to low tone in the cardiac sphincter and fundus of the stomach, while the pyloric sphincter is well-developed, it is prone to pyloric spasms, leading to nausea. Therefore, after diaper changes, slight movements can easily cause milk to reflux from the stomach back into the esophagus and mouth, triggering spitting up. The amount of spitting up is usually small, typically a few sips. Since the milk has entered the stomach and mixed with stomach acid, sometimes vomited milk may contain curds. However, the infant shows no other symptoms and does not interfere with growth and development. Most newborn vomiting, though not spitting up, is also not pathological and is primarily related to improper feeding. For example, excessive diaper changes, large holes in the bottle nipple, insufficiently filled bottles during feeding, or excessive air intake while sucking can cause vomiting. Additionally, small or short nipples that the infant cannot fully cover in the mouth, forceful sucking that leads to air intake, or excessive handling or crying during feeding can also result in vomiting.Correct Practices:
- Practice scientific feeding and enhanced care. For instance, during pregnancy, mothers should pay attention to breast care. If the nipple is inverted, it should be gradually pulled out to facilitate breastfeeding after birth. When using a bottle, ensure the nipple hole is not too large to prevent rapid or forceful drinking. Avoid excessive diaper changes or overly large changes. Do not let the infant cry excessively before changing diapers. Avoid using artificial nipples with holes. Ensure the bottle is fully filled with milk during feeding. Following these steps can prevent excessive air from entering the infant's stomach, causing nausea.
For infants prone to nausea, it is best to elevate the bedside significantly after diaper changes and place them in a side-lying position to prevent breathing difficulties or aspiration pneumonia during vomiting. Encourage the infant to develop a regular feeding habit and address spitting up to ensure feeding quality.
Improve Feeding Methods:
During formal feeding, the mother should sit and place the infant on her lap, slightly angled. Then, insert the mother's nipple or bottle nipple into the infant's mouth. The frequency of diaper changes should align with the infant's age. On the first day, about 30-40 milliliters per feeding, gradually increasing to 75-100 milliliters by one week. This should match the stomach's capacity, though individual differences exist. After each feeding, hold the infant upright, resting their head on the mother's shoulder, and gently pat their back. It is best to wait for the infant to burp before placing them back in bed. For infants prone to vomiting, placing them on their right side may be preferable. Avoid excessive handling or stimulation after diaper changes to prevent milk leakage.
There are countless reasons for newborn vomiting. Therefore, when an infant vomits, the first step is to identify the cause and provide appropriate solutions based on the specific reason. Recurrent physiological nausea does not require special treatment and will gradually improve with proper feeding and care as the infant grows and their gastrointestinal function develops. However, if your infant begins vomiting within 24 hours of birth, vomits frequently after eating, in large quantities, or in a manner, or if they exhibit other abnormal symptoms alongside nausea, this indicates pathological nausea due to illness. Seek medical attention promptly.