Gastrointestinal Problems

New Parent Guide

What Might Gastrointestinal Problems Indicate in Newborns?

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. The following symptoms may indicate the baby is having 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.

  However, forceful or projectile vomiting, or spitting up large amounts of milk after most feedings, can indicate a problem. In formula-fed babies, vomiting may occur 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. Discolored or green-tinged vomit may mean the baby has an intestinal obstruction. Consult your baby's physician immediately if your baby is vomiting frequently, or forcefully, or has any other signs of distress.

• 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 diaper is loose.
  • Feed smaller amounts but feed more often.
  • Feed slowly, holding your baby upright.
  • Burp your baby often during the feedings.
  • Handle your baby gently after the feeding.
  • Place your baby on his/her side, or as instructed by your baby's physician.
  • 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 three to four 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 the reasons their baby is crying, and then determine what to do to make the baby happy. Is the baby hungry? Wet? Cold? Hot? Tired? Bored? A baby will cry for these reasons as well as for other problems, and parents must try to determine what is causing their baby stress, often by trial and error. 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 with no 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 getting adjusted to the world.

    Babies have been noted to cry for specific lengths of time every day, as they are getting used to the world and as their parents are learning to interpret their needs.

  • 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 a soy-based rather than cow's milk based formula to see if this helps relieve the symptoms of colic.