Gastrointestinal Problems

Gastrointestinal Problems

What might gastrointestinal problems mean
in a newborn?

A newborn’s ability to eat and
digest food is essential to growth and development. Most babies are able to absorb
nutrients and have normal bowel movements after being fed. Trouble in any of these areas
can be a short-term adjustment or a sign of a more serious problem. These symptoms may
indicate the baby is having digestive problems.

Vomiting

Spitting up and dribbling milk with burps or after feedings is fairly common in
newborns. This is because the sphincter muscle between the stomach and the esophagus
(the tube from the mouth to stomach) is not as strong as it will eventually become as
the baby matures. Forceful or projectile vomiting, though, or spitting up large
amounts of milk after most feedings, can be a sign of a problem. In formula-fed
babies, vomiting may happen after overfeeding, or because of an intolerance to
formula. In breastfed or formula-fed babies, a physical condition that prevents
normal digestion may cause vomiting. Talk with your baby’s healthcare provider right
away if your baby is:

  • Vomiting forcefully or often
  • Vomiting green bile or blood
  • Becomes lethargic
  • Has any other signs of distress

Reflux

Some babies may constantly spit
up all or most of every feeding. Or they may gag and choke during feedings. This may
be caused by reflux. Reflux happens when stomach contents back up into the esophagus
(the tube that connects the mouth to the stomach). The esophagus can become raw and
irritated by the stomach contents. When the stomach contents back up into the
esophagus, they may be vomited and aspirated (breathed) into the lungs. You may also
be able to hear and feel “rattling” in the baby’s chest and back. These tips may help
babies with reflux:

  • Be sure the baby’s diaper
    is not too tight.

  • Feed the baby smaller
    amounts, but feed more often. Smaller meals can aid digestion and prevent
    stomach contents from refluxing into the esophagus.

  • Feed slowly, holding your
    baby upright throughout the feeding and directly after.

  • Burp your baby often
    during the feedings.

  • Handle your baby gently
    after the feeding.

  • Hold your baby in an
    upright position for about 30 minutes after feeding.

Talk with your baby’s healthcare
provider if he or she is fussier than usual or the vomiting seems worse. Also check
with the healthcare provider if your baby has problems breathing during or after
feedings, has choking spells, or refuses feedings.

Diarrhea

The first bowel movement of a newborn is called meconium. This is a sticky,
greenish-black substance that forms in the intestines during fetal development. The
baby may have several meconium bowel movements before this substance is completely
gone from the baby’s system. After the first few days, normal bowel movements
become yellow and formed in formula-fed babies. They may happen once or twice a day,
sometimes more often. Breastfed babies tend to have soft, seedy, yellow-green bowel
movements several times a day. They may be as often as every few hours with feedings.
Babies with diarrhea have watery, very loose bowel movements that happen very often.
A baby may or may not have signs of cramping with the diarrhea. Watery bowel
movements and diarrhea in a newborn can quickly lead to severe dehydration. It should
be treated right away. Talk with your baby’s healthcare provider if there is a change
in your baby’s bowel movements or your baby develops diarrhea. If there is blood in
the stool, call your healthcare provider right away.

Colic

Colic is a problem that affects
some babies during the first 3 to 4 months of life. It can be very stressful and
frustrating to parents. Healthcare providers have defined colic as prolonged or
excessive crying in an infant who is otherwise well. The crying can be very loud and
can last for several hours a day. Colic often starts by 3 weeks of age. It is at its
worst around 6 weeks, and it gradually gets better by about 3 months of age. It is
not clear what causes colic. Many people think that colic is caused by belly cramps
or gas. But no one really knows for sure. Treatment for gas or changing formulas has
not been shown to decrease crying in a colicky baby. Talk to your child’s healthcare
provider if you think there is a gastrointestinal problem making your baby
fussy. Some of the reasons babies may have colic are:

  • Temperament and adjusting to
    the world.
    Newborns must make adjustments to the world around them. Not
    all babies have the same temperament. Some adjust to lights, loud noises, and
    all the other stimulation around them without trouble. Others are not able to
    adapt as easily. Just like adults, some babies are easygoing, and some are
    impatient. Crying may be one way for a baby to vent feelings as he or she is
    getting adjusted to the world.

  • Oversensitive to gas. Some
    people think that gas may be to blame for colic. But there is little evidence
    that this is the case. In fact, treating gas has no effect on colic in babies.
    The normal amount of gas that is made as food is digested may be more
    uncomfortable for some babies than others. If a baby with colic seems to pass
    more gas than other babies do, it is probably due to swallowing more air while
    crying for prolonged periods of time. Some adjustment in the nursing mother’s
    diet can be tried. Try to stay away from milk products, caffeine, and
    gas-producing foods. 

  • Milk allergy. It is rare
    for colic to be caused by a true milk allergy. But some babies may be more
    sensitive to cow’s milk-based formulas. Your baby’s healthcare provider may
    recommend changing formulas to a soy-based formula to see if this helps ease
    the symptoms of colic.