Medical Questions & Answers » Childbirth

Vomiting In Babies

medicalquestions — Fri, 12 Feb 2010 01:23:32 +0000

My baby is always vomiting, but when I took her to the doctor, he said it was a reflux problem and not vomiting. In what way does reflux differ from vomiting in babies?

Some babies are unlucky enough to have a defect in the muscle ring at the bottom of the oesophagus (gullet). This muscle ring is normally contracted shut, and only opens when food is swallowed. This prevents the acid and food in the stomach from running up into the oesophagus when lying down or bending over.

If the muscle is weak or defective, the acid in the stomach can burn the oesophagus, which causes considerable pain to the infant. This is known as reflux oesophagitis.

Most children will grow out of the problem, but medication must be given in the meantime to prevent the burning and pain. This is usually in the form of a mixture which is given after every feed. More sophisticated treatments are available for intractable cases.

Why do babies vomit so much?

It is important to differentiate between vomiting, positing and reflux. Vomiting is not very common, and may be due to some disease process (eg. infection, food allergy). The vomitus is usually altered food and may be green in colour, indicating the presence of bile. It may occur several hours after a feed.

Positing occurs in most infants, and is the regurgitation of milk and food from the mouth, gullet and upper part of the stomach during or immediately after a feed. It is caused by over feeding, rapid feeding or burping, and it does not require any treatment.

Reflux is the regurgitation of the stomach contents immediately after a meal, and for some time afterwards. It is distressing to the child, as stomach acid is bought up, and this burns the gullet. This can be helped by posture feeding, slow feeding and mixtures (such as Infant Gaviscon) that may be given after a meal.

If you are unsure about the problem, have your child assessed by your GP.

Eager for Second Child

medicalquestions — Fri, 02 Jan 2009 05:37:51 +0000

Kindly suggest some useful exercises that can help me to give a normal delivery after a C-section has been done 4 years back. Currently I am not pregnant but I am eager to have a second child the natural way. The first C-section was done due to fetal distress.
There is no reason why you cannot deliver normally the second time, as your first caesarian was fetal related(i.e. to save of the baby). And you can prepare for natural birth by keeping fit. Regular exercises like walking or yoga helps. After your 4th month of pregnancy, with your doctor’s okay, you can start ante natal exercises, which include Kegels to strengthen the pelvic floor muscle. Swimming is very good — yes, even when you are pregnant; also water aerobics. When you are beginning the ninth month you should start squatting and sitting cross legged on the floor. For more advice on exercise and diet during your pregnancy join an ante natal program. Be very positive that all will be well and you will deliver normally. But keep an open mind, too. Be aware that ultimately your doctor will decide what mode of delivery is best for you and the baby.

Brest freeding essentiality

medicalquestions — Wed, 16 Apr 2008 06:00:43 +0000

Question: Is breast feeding absolutely essential? Can one give top milk or powder formula available in tins, immediately after birth?
The newborn babe must be breast fed. Mother and child who have to turn to any other milk are unfortunate indeed. Mother’s milk is custom-designed by Nature for her child, just as cow and buffalo milk is meant for their respective young ones. Providing food and nourishment is not the only function of breast feeding. It is advantageous to both mother and child. The child feels secure and fulfilled. The touch is as comforting as the food is nourishing. The mother is similarly affected. Physical proximity lays the foundation for a unique bond. A mother who can feed her child acquires confidence. Not only this, she is also gratified about the success of her motherhood. This feeling of satisfaction plays a positive role in moulding the future mental make-up of the child. Breast milk is not just a mixture of protein, sugar and fat but contains the same percentage of white blood cells as is present in the blood. This reduces the danger from infection and viruses and helps to ward off diarrhea, cough, fever and other illnesses. A suckling child is less likely to suffer from ailments like skin diseases, allergies and breathlessness (asthma). The warmth of bodily contact and the magic touch help to create the bond of intimacy between mother and child.

Position while breast feeding

medicalquestions — Wed, 16 Apr 2008 06:00:18 +0000

Question: Should the mother adopt a sitting or sleeping position while breast feeding?
Feeding while lying down and turning over on one side is fairly prevalent in many villages. In the south, there is great insistence on the lying-down posture. The mother is not allowed to sit up and feed. However, it is wise to adopt a sitting position right from the word go. For the first 1-1/2-2 months, the baby’s body is soft and supple and easily bent. The mother should sit comfortably on the floor or the bed with legs crossed and with the support of a cushion. To hold the baby at breast :
(a) Place a pillow in your lap.
(b) Keep the child on a small quilt and lift him towards the breast.
(c) Support the head with the crook of your arm and make sure the body inclines downwards from the head.
(d) Direct the nipple to the child’s mouth.
At around 3 months, the child’s body gets heavier and firmer and is, therefore, easier to handle. The pillow is no longer needed. The mother can sit in a chair and feed the baby.
If the mother wishes to lie down and feed the baby, she must use a pillow, turn on her side and incline her body towards the child. The baby’s head should rest in the crook of her arm. The other hand should hold and direct the breast towards the baby’s lips. Immediately after a feed, the child should be held upright with the head resting on Mama’s shoulder and be made to burp. Hold the child until it burps. This is to prevent vomiting. During breast feeding a little air does enter the stomach. Burping is necessary to get rid of this air.

Breast feeding mothers diet

medicalquestions — Wed, 16 Apr 2008 06:00:14 +0000

Question: How does the mother’s diet affect breast milk?
In a majority of cases, the child gets maximum nutrition from its mother. Although all these nutritive elements may not be present in the mother’s meal, her milk usually contains everything that is present in the milk of a relatively better fed mother. However, a mother who consumes more fatty food is likely to have a greater percentage of fat-soluble vitamins (A,D,E) in her milk than the lesser nourished mother. Medicines also enter the milk. Small doses do not have adverse effects but if the mother has to be on long-term medication, she should consult her doctor about the advisability of breast feeding.

Feeding a child by both breasts

medicalquestions — Wed, 16 Apr 2008 06:00:07 +0000

Question: Is it necessary to feed the child at both breasts? How long should a feed last?
Whether or not both breasts must be emptied while feeding, will depend on the child’s hunger and the amount of milk. If the milk is flowing adequately, the child may be satisfied with a feed from just one breast. If not, the child may wish to continue sucking and appears to ask for more. It should be put to the other breast immediately. A child is usually satisfied after 10 minutes at each breast. Some babies seem to suck greedily and quickly swallow the milk like little gluttons. Their hunger is appeased in less than 10 minutes.
If, even after feeding for 20-25 minutes, the child appears dissatisfied and hungry or continues to make sucking sounds or cries at being parted from the nipple, you may presume that lactation is inadequate. Do not be tempted to start on top milk in such a case. Rather, increase the frequency of breast feeds. The frequency of sucking and the periodic emptying of breasts facilitate the flow of milk. Instead of keeping the child for a long time at the breast and giving widely spaced feeds, reduce the interval between the feeds, making them shorter and more frequent. This serves the dual purpose of fulfilling the child and increasing the flow of milk.

No Breast Milk

medicalquestions — Tue, 15 Apr 2008 06:01:23 +0000

Question: What can be done if there is very little or no breast milk?
Nature usually works miracles within the body during pregnancy whereby, a mother can feed her child soon after delivery because mother’s milk provides a complete and balanced diet for the newborn baby. Breast feeding should begin two hours after the delivery and should continue thereafter at intervals of 2 hours.
The breast should be offered whenever the child is hungry. Adequate food and water ensure adequate breast milk. Physical and mental peace and sufficient sleep are necessary for successful breast feeding.
Do not be in a hurry to switch over to the bottle in case of inadequate or no lactation. Encourage the child to suck frequently by putting him to the breast every now and then. This constant sucking at the nipple facilitates the flow of milk. After the child has been fed, excess milk should be extracted by rubbing the breasts gently, i.e. the breasts should be emptied. Both these (frequent sucking and emptying of breasts) are conducive to the flow of milk. Any kind of worry, such as anxiety over a weak child, apprehension of not getting leave or a hostile atmosphere within the home, may be responsible for reducing or even drying up the milk produced. Thus, family members, friends and relatives must make every effort to keep the mother in good cheer. The mother’s primary duty is towards her child. Everything else takes second place. If for some reason or due to unfortunate circumstances, anxiety is unavoidable, she should try to divert her mind and aim actively at remaining unperturbed.

Milk Bank

medicalquestions — Tue, 15 Apr 2008 06:00:36 +0000

Question: What is meant by a milk bank?
It is the practice in many hospitals to store excess breast milk in sterilized glass bottles and preserve it in a refrigerator.
A mother who has delivered a still-born child may add her milk to this store. Mothers who need to extract excess milk before feeding the child so as to prevent hardening and engorgement of the breasts may also similarly donate the extra milk. Just as extra money is saved in the bank, so extra milk may be stored in a milk bank.
A mother who does not lactate satisfactorily or is in a serious condition following a Caesarean or for any other reason, or has undergone sterilization surgery simultaneously with the delivery could, instead of taking recourse to top milk (cow milk, buffalo milk or milk powders) give human milk stored in the “bank”. This milk can also be given to premature babies or very weak infants who need to be tube-fed.

Breast Feeding

medicalquestions — Mon, 14 Apr 2008 05:45:52 +0000

Question: Is it necessary to take special care of the breasts after delivery?
In earlier times, it was customary to give the newborn child a preparation consisting of ghee, jaggery and water. Now-a-days, the newborn infant is put to the breast as soon as possible. Care of the breasts, therefore, must be initiated during pregnancy.
The breasts start feeling heavy a few hours after delivery. There is a reason behind this. Whether the delivery has been a normal one or a caesarean, the child should be fed after IV2 – 2 hours of birth. This ensures that the milk flow is quickly activated and is adequate. The breasts too remain light. The child should be given a breast feed whenever it is hungry and cries. Pour hot water on the breasts at bath time. This increases the blood circulation and ensures the free flow of milk.
It is necessary to wear a well fitting brassiere to keep the breasts firm and shapely. The bra should be neither too tight nor too loose. Special feeding bras are also available with front clasps and flaps for convenience while breast feeding.
Pain or tenderness and hardening of the breasts are due to the accumulation of excess milk. This should be gently squeezed out into a cup by massaging the breasts with lubricated fingers. Hard breasts are painful for the mother and make it difficult for the child to suck. The pain is relieved if the child is breast fed after some milk has been extracted. Sometimes, due to infection, swelling, pus formation, or an abscess pain is experienced. The skin covering the breasts may turn reddish and fever too may come on. Consult a doctor if any such signs and symptoms are manifested.

Care at Birth

medicalquestions — Mon, 14 Apr 2008 05:40:41 +0000

As soon as the head of the infant is delivered, wipe its eyes clean with sterile saline. Maintain its head lower than the body to allow drainage of mouth secretions and keep the infant lower than the mother until the cord is cut. This way the baby will get more blood and will be stronger.
• Suck infant’s throat with sterile catheter.
• At birth the cord pulsates and it, is fat and blue, wait till it becomes thin and white and stops pulsating.
• Clamp the cord between two artery forceps and cut it with sterile scissors or tie it in two places with ribbon and cut between the ties with clean unused razor blade under aseptic precautions. Always cut cord close to the body of the baby, leaving about 2 cm attached to the abdominal wall. Cover the cut end of the cord with clean beta dine soaked swale on Tincture Benzoicco.
• Baby should cry immediately if its condition is satisfactory. If it does not, it might need resuscitation. Rub his back with towel or a cloth. If still does not breathe then suck the mucus from nose and mouth with suction or clean cloth wrapped around your finger. If he does not breathe within one minute, then start mouth to mouth breathing at once. When spontaneous breathing is established, place infant in a prewarmed cot with head one side tilted down to allow drainage of secretions from respiratory tract. In many hospitals all infants are given one dose of 1 mg of vit. K to prevent hemorrhagic disease of new born but remember, if you give milk in higher doses it can lead to severe jaundice.