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Newborn Gastrointestinal Problems

Newborn Gastrointestinal Problems

What are the common gastrointestinal problems seen in a newborn?

A newborn's ability to eat and digest food is essential to growth and development. Most babies are able to take feedings with normal absorption of the milk followed by normal bowel movements. Difficulty in any of these areas can be a temporary adjustment or a sign of a more serious problem.

Symptoms of gastrointestinal 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 weak and immature.
Reflux: Some babies may constantly spit up all or most of every feeding, or gag and choke during feedings. This may be caused by reflux. Reflux occurs 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 chest and back.
Tips that may help babies with reflux include:

Play with, bathe and/or change diapers before feeding.

Be sure the diaper is loose.

Feed smaller amounts but feed more often.

Feed slowly, holding your baby upright.

Handle your baby gently after the feeding. Avoid feeding before nap or bedtime.

Place your baby on his/her left side (or as instructed by your baby's physician) during sleep.

Raise the head of the bed.

Consult your baby's physician if he/she is fussier, the vomiting seems worse, or your baby has problems breathing during or after feedings, 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 are yellow and formed in formula-fed babies and may occur once or twice a day, sometimes more often. Breastfed babies have soft, seedy, yellow-green bowel movements several times a day, as often as every few hours with feedings.
Babies with diarrhea have watery, very loose bowel movements that occur very frequently. 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 and should be treated immediately.

Consult your baby's physician if there is a change in your baby's bowel movements or your baby develops diarrhea.

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. Physicians 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, is at its worst around 6 weeks, and gradually gets better by about 3 months of age. It is not clear what causes colic.
Some of the reasons babies may have colic include the following:

adjusting to one another: Colic may relate to the adjustments that a new baby and his/her parents have to make to each other. Babies obviously cannot talk. Until they learn to talk, one way they communicate with adults is by crying. Parents have to learn to interpret why their baby is crying, and then determine what to do to make their baby happy. Is their baby hungry? Wet? Cold? Hot? Tired? Bored? A baby will cry for many other reasons as well and parents (often by trial and error) must try to determine what is causing their baby stress. New parents, especially, may have trouble reading their baby's cues and responding appropriately. The baby may continue to cry simply because his/her needs have not yet been met.

temperament and adjusting to the world: Newborns must also make adjustments to the world they are living in. Not all babies have the same temperament. Some adjust to lights, loud noises, and all the other stimulation around them without trouble, while others are not able to adapt as easily. Just like adults, some babies are easy-going, and some are impatient. Crying may be one way for a baby to vent feelings as he or she is adjusting to the world.

oversensitive to gas: Another possible reason for excessive crying in babies might be that they are oversensitive to gas in the intestine. The normal amount of gas that is produced 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.

milk allergy: It is rare for colic to be caused by a true milk allergy. However, some babies may be more sensitive to cow's milk based formulas. Your baby's physician may recommend changing formulas to see if this helps relieve the symptoms of colic.

Dealing with colic:

Learning how to interpret your baby's cry can be helpful in dealing with colic. In addition, you may want to try the following suggestions:

Make sure your baby is not hungry, but do not force feed if he/she is not interested in the bottle or breast.
Change your baby's position. Sit him/her up if lying down. Let your baby face forward if you are carrying or holding him/her facing your chest. Babies like to see different views of the world.
Give your baby interesting things to look at: different shapes, colors, textures, and sizes. Talk to your baby. Sing softly to your baby.
Rock your baby.
Walk your baby.
Place your baby in an infant swing on a slow setting.
Let your baby lay on his/her belly on your lap or on the bed, and rub his/her back.
Go for a ride in the car. The motion of the car often soothes babies.
Try using something in your child's room that makes a repetitive sound, like a wind-up alarm clock or heartbeat audio tape.
Hold and cuddle your baby. Babies cannot be spoiled by too much attention. However, they can have problems later in life if they are ignored and their needs are not met as infants.
Let an adult family member or friend (or a responsible babysitter) care for your baby from time to time so that you can take a break. Taking care of yourself and lowering your stress level may help your baby as well.


		Programs that treat this condition:

		Newborn Medicine, Community


					Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School

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