Regurgitation

Regurgitation is an overflow, a spontaneous return of undigested and odourless milk that, usually, is brought back up in the hour after feeding. In terms of scientific knowledge in 2023, it is said that regurgitation is in fact a normal physiological reflux in infants linked to the immaturity of the sphincter at the entrance to the stomach.

This frequently occurs in babies that drink quickly without taking a break, or when moved after feeding, especially during the day when awake and very little at night when sleeping. Gastric emptying (of the stomach) would be slower in these babies or delayed and influenced by food (caloric density).

Regurgitation is diagnosed if milk is regurgitated twice or more a day for at least three or more weeks and there is no digested milk (vomiting), no blood nor associated breathing difficulty (aspiration).

The latest studies have shown that regurgitation is the most frequent symptom in young babies and that 40% still regurgitate at 3-4 months of age, but this percentage drops to 5% when the baby eats solid foods and walks.

Note that the baby can regurgitate up to the age of 12 months without having an impact on his weight or development. It is time that will improve the situation and no medication can prevent regurgitation.

Vomiting

Vomiting is an upbringing of partially digested milk. It has curdled and has a stronger smell. Spray vomiting frequently occurs in very young babies, once or twice a day, due to the immaturity of the sphincter, a muscle located at the entry of the stomach. However, spray vomiting after every feeding is abnormal in a young baby and can lead to dehydration, less urine, drying of the skin, irritability, drowsiness – in short symptoms of pyloric stenosis, an illness that requires emergency care.

In the first year of life, vomiting can also appear in babies, in connection with the start of solid food and the integration of different textures and chunks, but also during a cold, a prolonged period of fasting, a very present gag reflex or a delay in development. Behavioral vomiting, which is not a health problem, can also be observed if the child is unhappy and throws a tantrum.

There are many causes of vomiting, depending on the baby’s age and overall clinical picture. In the case of a young baby, one might think of possible intolerance, esophagitis (irritation due to acidity rising from the stomach into the esophagus), achalasia (difficulty in moving the esophagus in children) or other causes.

Reflux

Reflux refers more to pathological regurgitation, that is to say, abnormal which causes inflammation which can lead to tissue damage. Reflux is seen in 5 to 9% of babies. When we talk about pathological regurgitation (reflux), the cause is also the relaxation of the lower esophageal sphincter (entrance to the stomach), but there is a component related to slower and delayed gastric emptying. The baby may always swallow after feeding, or swallow even if nothing is in their mouth. Frequent discomfort when the baby is lying down, and they may cry more during the two hours following feeding because, rather than travelling to the intestine, their milk, mixed with an acidic digestive enzyme, moves up from the stomach to the esophagus, which becomes irritated. In contrast to vomiting, reflux is more regular: it occurs after almost all feedings.

Again, it is the time that makes the difference, when your baby will mature but, if the baby has reflux which affects his growth or which causes respiratory problems, esophagitis, difficulty in breastfeeding, treatment is possible in these conditions.

Reflux peaks around four months and gradually dissipates and disappears around 8-12 months.  As a reflex, babies will likely drink less per feeding, but more often to protect themselves from the pain and discomfort caused by the acidity that continually moves up from the stomach. When we look at family medical history, we often find parents or grandparents known to have been treated for reflux problems, even when adults. However, it is not a hereditary problem but more a family trait.

Reflux will not start at six months. If this seems to be happening, visit your doctor as it is symptomatic of other causes.

How can you comfort your baby? Here are a few ideas that can help.