How to differentiate vomiting in neonates and infants? Part II. Gastroenterological and allergological causes of vomiting

Abstract

The most frequent cause of vomiting in infants are feeding mistakes. Recognising them need thoughtful analysis of way of feeding and preparing food. Optimal conditions for such evaluation is child observation for few days. Disturbances in mother-child connection can also cause more frequent vomiting. The most of infant vomiting incidents are not result of any disease, but only of physiological immaturity of proximal part of gastrointestinal tract. Gastro-oesophageal reflux is considered normal, temporary, as a consequence of anatomical and functional immaturity of younger infants gastrointestinal tract. The treatment of children with gastro-oesophageal reflux is needed only in case of clinical symptoms appearance such as: physical development disturbances, restlessness, problems with swallowing, wheezing, cough or apnoea, or when it leads to complications as: oesophagitis, narrowing of oesophagus or Barretts oesophagus. Second most frequently diagnosed vomiting cause in infants are variable clinical manifestations of food allergy. Immune reaction to food proteins can cause less than 1% of vomiting and diagnosis need to be confirmed in the elimination and provocation test. Many more diseases of gastrointestinal tract can lead to vomiting. Among them can be found infectious gastritis and inflammation of bowels, non-specific bowel inflammations, food intolerances as well as extrahepatic cholestasis and pancreatitis. © Pediatr Med Rodz 2014.