What to do when a child vomits

The sudden vomiting of a baby scares not only the child himself, but also his parents. The main thing in this situation is not to panic, to competently help the baby, and then with the help of doctors to find out the cause.

Spitting up in a child

In many children, immediately after birth and up to about 3 months, there are regurgitation. They are characterized by the release of a small amount, 5-30 ml, of milk or formula soon after feeding the child in the form of a slight leakage of food through the mouth. Regurgitation does not affect the behavior and general well-being of the baby. As a rule, they occur when the feeding technique is violated and when the child is overfeeding. Sparse and infrequent regurgitation, which do not cause deviations in the health of the baby, should not bother parents. However, the appearance of vomiting is always a cause for alarm.

What is vomiting

Vomit- this is a rapid ejection of the contents of the digestive tract, which occurs involuntarily as a result of contraction of the muscles of the stomach, diaphragm and anterior abdominal wall. In infants, this phenomenon is dangerous because vomit is often thrown out not only through the mouth, but also through the nose, which creates a threat of aspiration of vomit - their entry into the respiratory tract. Vomiting in a child may be associated with the pathology of the gastrointestinal tract, and may be one of the symptoms of a number of diseases.

Causes of vomiting

Acute intestinal infections. These diseases are a common cause vomiting in children infancy. The causative agents of intestinal infections are a large group of bacteria and viruses. Infection occurs when the pathogen enters the child's gastrointestinal tract through the mouth. Vomiting with intestinal infections is almost always accompanied by frequent loose stools, abdominal pain, which in young children is manifested by anxiety, a sharp cry, pulling the legs to the stomach.

Acute infectious diseases. Often vomiting in children occurs in the case of a severe course of infectious diseases such as SARS, pneumonia - pneumonia, tonsillitis, otitis media. It is also one of the initial symptoms of infectious lesions of the central nervous system: meningitis- inflammation of the lining of the brain and encephalitis- Inflammation of the brain. In these cases, vomiting is persistent and, as a rule, is accompanied by fever and signs of intoxication - lethargy or anxiety of the child, refusal to eat, sleep disturbance. Then symptoms that are distinctive for each disease appear: runny nose, cough, sore throat, etc. With meningitis and encephalitis, neurological disorders come first - a piercing monotonous cry, photophobia (the child squints and closes his eyes in bright light), convulsions, increased temperatures up to 39–40°C.

Diseases of the central nervous system. Persistent regurgitation and vomiting can be one of the symptoms of diseases of the central nervous system (CNS). In these cases vomiting in children is neurogenic in nature and is caused by damage to the central nervous system. Such diseases include: hypertensive-hydrocephalic syndrome, manifested by an increase in intracranial pressure, intracranial hemorrhage, cerebrovascular accident, perinatal encephalopathy, trauma, in particular brain concussion, and brain tumors. Along with vomiting, the child has neurological symptoms: impaired muscle tone, inhibition of reflexes, general lethargy or, conversely, excessive excitability, sleep disturbances, tremor - trembling of the chin and arms. The severity of vomiting depends on the severity of the CNS lesion.

birth defects gastrointestinal tract. recurring vomiting in children the first months of life, as a rule, is a symptom of congenital pathologies of the gastrointestinal tract. The most common variants of such defects are pyloric stenosis and chalazia cardia.

Violations in pyloric stenosis occur in the pyloric part of the stomach - the pylorus, which is located on the border of the stomach and duodenum. With this congenital pathology the pylorus, consisting of muscle rings, is thickened and, as a result, there are difficulties in the passage of milk into the duodenum and further into the intestine. In the first days, the baby does not experience any inconvenience, since the volume of milk he sucks is small. Difficulties appear as the volume of food increases and, as a rule, begin towards the end of the first month of life.

The main symptom is vomit fountain 1.5-2 hours after eating. Vomiting in this case is curdled sour content and exceeds the amount of sucked milk, which indicates food retention in the stomach. The presence of constant vomiting leads to weight loss.

Pylorospasm- this is another pathology of the pylorus, expressed in its spasm. It occurs with dysfunctions of the autonomic part of the central nervous system, which happens with hypoxia - insufficient oxygen supply to the fetus during pregnancy and childbirth, with trauma to the cervical spine, spinal cord injuries. At pylorospasm there is a violation of the movement of food eaten from the stomach into the duodenum.

From the first days of life, a child has an intermittent vomit, which may be several times a day, or may be absent for several days. The vomit is much smaller in volume than what the child has eaten and has a sour smell. As a rule, with pyloric stenosis, various neurological disorders are noted, most often a syndrome of increased neuro-reflex excitability.

Cardia insufficiency(chalazia cardia) is a congenital disease that is characterized by incomplete closure of the cardiac esophagus - the place where the esophagus passes into the stomach - due to the immaturity of neurogenic regulation. This leads to the reflux of stomach contents into the esophagus.

Vomiting is unaltered milk, it begins from the first days of life and occurs immediately after feeding, intensifying in the supine position. The general condition of the child is often disturbed: he suckles sluggishly, gets tired quickly, gains weight poorly, his sleep is disturbed.

congenital diaphragmatic hernia characterized by the movement of the abdominal organs into the chest through a defect in the diaphragm - the muscular septum that separates the chest cavity from the abdominal cavity. Vomiting occurs immediately after feeding, appears in the first week of life and is combined with respiratory disorders - shortness of breath, cyanosis, tachycardia.

hiatal hernia, one of the most common forms of congenital diaphragmatic hernia, is the underdevelopment of connective tissue structures that strengthen the esophageal opening of the diaphragm. Vomiting appears in the first weeks of a child's life, occurs immediately after feeding, may be mixed with blood.

Stenosis - narrowing of the duodenum - can manifest itself in different ways, depending on the degree of the disease. With severe stenosis, vomiting with an admixture of bile appears in the first days after birth and is persistent. With mildly pronounced stenosis, periodic vomiting is noted.

Acute surgical diseases. Of the surgical diseases that are accompanied by vomiting in infants, the most common are:

acute appendicitis - inflammation of the appendix of the large intestine;
strangulated hernia;
peritonitis - inflammation of the peritoneum;
acute intestinal obstruction;
intestinal invagination - the introduction of one part of the intestine into another.

In these cases vomit accompanied by severe pain in the abdomen of various localization. The child is restless, screams loudly, pulls the legs to the stomach or “knocks” them, worries when changing the position of the body.

Vomit It can also be observed with increased sensitivity of the baby to certain drugs, as well as with their incompatibility or overdose. In this case, vomiting is a protective reaction of the body.

How to help a child

For any child vomiting should be examined by a doctor. Repeated vomiting can cause dehydration, a life-threatening condition for a child. Since this symptom occurs in many serious diseases, including surgical ones, it is impossible to self-medicate a child. It is important to remember that timely action by a doctor will help to avoid more serious health problems.

It is necessary to call a doctor at home if vomit, which occurred no more than twice, is accompanied by liquefied stools no more than 3-5 times a day with a slight increase in temperature - from 37 to 38 ° C. At the same time, the child drinks well, his general condition is not disturbed and does not worsen.

It is necessary to call an ambulance in the following cases:

vomiting more than 2 times is accompanied by loose stools and a temperature above 38 ° C;
in the vomit, bile or blood is visible;
vomiting occurs repeatedly - every 2-3 hours;
the child began to vomit "fountain";
vomiting is accompanied by severe pain in the abdomen;
against the background of the appearance of vomiting, there is a violation of consciousness or increased excitability.

Vomiting always comes unexpectedly for the child and frightens him. Therefore, parents first of all need to calm the baby and be with him in these difficult moments. It is important to remember that a child with vomiting should not be left alone.

To prevent vomit from entering the respiratory tract, the child's head in the supine position should be turned to one side, and if the baby is in an upright position, his head should be tilted down.

At the end of an attack of vomiting, the child should be washed with warm water and given 1-2 sips of boiled or bottled water at room temperature. Do not give the baby to drink a lot of water, as this can cause a new attack of vomiting. Immediately after vomiting, the child should also not be given breast milk, milk formula, juices, compotes. You can breastfeed your baby 1.5–2 hours after vomiting, if during this time there were no repeated attacks.

After an attack of vomiting, the infant should be held upright for 10-15 minutes. Then it can be put into the crib by lifting its head end. To do this, you can put a pillow under the mattress, so the head of the crib will be raised by 15–20 cm.
You can feed the baby no earlier than 1.5–2 hours after vomiting, but it is best to try not to feed him until the doctor arrives.

When vomiting, you can not:

Try to wash the child's stomach on your own. Carrying out this procedure without knowing the reasons vomiting, parents can provoke its strengthening and deterioration of the general condition of the child.
Use antiemetics or any other medications without a doctor's prescription.
Give the child a drink potassium permanganate solution. Many parents are sure that it is a first aid for vomiting or diarrhea in a baby. Indeed, with some intestinal infections that are not accompanied by vomiting, a weakly concentrated solution of potassium permanganate can slightly improve the child's condition due to its antiseptic effect. In this case, it is important to know how to prepare a solution of the correct concentration and how much the baby should drink. Too concentrated potassium permanganate solution or a solution containing undissolved manganese crystals can cause burns to the lining of the esophagus and stomach. A solution of potassium permanganate can provoke a new attack of vomiting and thus only worsen the condition of the child. In addition, with repeated vomiting in a baby, a drunk solution of potassium permanganate does not have time to be absorbed by the stomach and exert its antiseptic effect, therefore, its use in this situation is inappropriate.
Before giving a child any remedy for vomiting, you should consult a doctor and find out its cause. Only in this case, the treatment will be most effective.

Vomiting: Diagnosing Causes

To find out cause of vomiting, the doctor should first of all conduct a detailed survey of parents, who should try to give the most accurate answers to the questions:

When did the child first vomit?
Is vomiting related to food: does it occur during feeding, after it, or out of connection with food intake?
What is the amount of vomit - plentiful, not plentiful, "fountain"?
What is the nature of the vomit - unchanged or curdled milk?
Are there impurities in the vomit - blood, bile or mucus?
Is vomiting characterized by any other symptoms: diarrhea, fever, pain?

Clarification of these characteristics of vomiting will help the doctor in making the correct diagnosis, as well as in choosing an adequate examination. For the final clarification of the cause of vomiting, the child may be assigned the following additional studies:

Complete blood count: increased values of leukocytes, ESR may indicate the presence of an inflammatory process in the body.
Esophagogastroduodenoscopy (EGDS) is a study of the esophagus, stomach and duodenum using an endoscope. This study helps to exclude the presence of congenital and inflammatory diseases of the esophagus, stomach and duodenum.
X-ray examination of the stomach and duodenum with a contrast agent - a barium mixture. This study allows you to evaluate the speed of passage of food from the esophagus to the stomach and from the stomach to the duodenum.

If you suspect a disease of the central nervous system, accompanied by vomiting, the child must be examined by a neurologist. To clarify the diagnosis, he can prescribe an ultrasound of the brain, computed tomography of the brain to the child.

Treatment of vomiting in children

Congenital pathologies of the gastrointestinal tract and acute surgical pathologies require hospitalization of a child and surgical treatment in a hospital setting.

Replenishment of the volume of lost fluid. One of the dangerous complications vomiting is dehydration. This is a condition that occurs with increased loss of fluid and electrolytes, mainly potassium, sodium, magnesium, chlorine. With dehydration, the child has lethargy, drowsiness, thirst, dry mucous membranes (dry bright lips, dry tongue), a decrease in the number of urination to 6 or less times a day.

To prevent the development of dehydration with repeated vomiting, it is necessary to solder the child with special glucose-salt solutions, which include rehydron, glucosalan, gastrolith. Most often, to replenish the volume of fluid - rehydration - the drug is used rehydron. It is sold in powder form in pharmacies without a prescription.

To obtain a solution, one sachet of dry powder must be dissolved in 1 liter of boiled chilled water. The finished solution is stored in the refrigerator and is suitable for use within a day. Child under one year old every 10-15 minutes at first give no more than 5 ml of solution (1 teaspoon), and for children from 1-3 years old - no more than 10 ml. If vomiting does not recur within an hour, the volume is increased by 5 ml. The intake of REGIDRON should be alternated with the intake of boiled or bottled water at room temperature. This avoids oversaturation of the body with salts.

Glucose-salt solution for feeding a child can be prepared independently. To do this, for 1 liter of boiled chilled water, you need to take 1 teaspoon of salt, 0.5 teaspoon of soda and 8 teaspoons of sugar.

Feeding a child with vomiting. General principles infant nutrition with vomiting, they boil down to the fact that the child should continue to be fed with his usual food - breast milk or formula, only it is necessary to reduce the daily amount of food. At the same time, the baby should be fed often - after 2–2.5 hours, but in small portions so that the stomach does not overflow.

On the first day, the volume of sucked milk or mixture should be reduced by 1?/?3. The missing amount of food is compensated by the liquid with the drink. If vomiting does not recur, then from the second day the amount of food is gradually increased and by the 3-4th day is brought to the age norm.

When vomiting all types of complementary foods should be excluded from the child's diet. If vomiting does not recur and the child absorbs breast milk or milk formula well, from the third day you can start introducing complementary foods that he received before the disease. At the same time, porridge is returned first, then vegetable puree, and then the rest of the products in the order they are introduced into the baby's diet.

In some situations, the doctor may prescribe to the child medical nutrition using milk mixtures with thickeners. As thickeners, the mixture may contain casein, rice starch, locust bean gum. These mixtures, when digested in the stomach, form a food bolus of a thicker consistency, and due to this, it is more difficult to reflux into the esophagus. Only the attending physician can prescribe and select the correct therapeutic mixture for the child.

Vomit For one reason or another, it can happen to every child. It is important to consult a doctor in time, find out the cause and prevent the recurrence of this unpleasant phenomenon.

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