How to treat dry vomiting in newborns

Newborns will have symptoms of dry retching after eating. Usually they will not vomit anything, but will continue to retch. This will also affect the physical health of the newborn. Moreover, dry retching is not a separate disease, so it is necessary to do an examination after it occurs. This is likely to be a symptom caused by multiple factors. However, after the examination, mild children do not need to take corresponding treatment, just pay attention to care in life.

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1. Treatment of the cause

First, surgical vomiting should be excluded to avoid delaying the operation, and then treatment should be targeted at the cause, such as proper feeding, infection control, and reducing intracranial pressure.

2. Symptomatic treatment

Patients with mild illness generally do not require special treatment, while patients with severe illness need to pay attention to correcting dehydration and electrolyte imbalance, maintaining acid-base balance, and avoiding aspiration.

3. Fasting

Patients with severe vomiting should fast before diagnosis and be given parenteral nutrition to ensure energy and intake.

4. Body Position

Children with medical vomiting (gastroesophageal reflux) can be placed in the prone or left lateral position with their head elevated 30°.

5. Gastric lavage

Swallowing syndrome can be treated with warm saline or 1% sodium bicarbonate gastric lavage.

6. Antispasmodic and antiemetic

For children with pyloric spasm, 1:1000-2000 atropine should be dripped into them 15-20 minutes before each feeding, and the dosage can be increased as appropriate. In addition, erythromycin and domperidone also have the effect of promoting gastrointestinal motility, but there is a lack of large-sample studies.

7. Gastrointestinal decompression

When vomiting is frequent and accompanied by severe abdominal distension, continuous gastrointestinal decompression can be given .

(1) Vomitus color: Clear or transparent mucus may be esophageal contents; vomitus with sour taste, milk or clots mostly comes from the stomach; vomitus with a lot of milk clots, sour and rotten smell, and persistent regularity mostly indicates pyloric and duodenal obstruction; vomitus with green color may be higher intestinal obstruction, and congenital malformation should be excluded first. If it is uniformly green, intestinal malrotation should be considered, and it may also be caused by sepsis; vomitus with fecal odor mostly indicates low intestinal obstruction; vomitus with blood should first consider gastrointestinal mucosal bleeding.

(2) Vomiting and abdomen: A bulging upper abdomen and a sunken lower abdomen indicate a higher level of obstruction. An abnormally bulging, spherical abdomen with a tense and shiny skin indicates a low level obstruction. The disappearance of bowel sounds is a sign of paralytic intestinal obstruction.

(3) Vomiting and defecation Vomiting accompanied by loose stools, watery stools, egg-drop-shaped stools, etc. is most commonly caused by gastrointestinal dysfunction, indigestion, enteritis, etc.; if vomiting is accompanied by bloody stools, internal medicine should consider intestinal infection, hemorrhagic disease, allergic enteritis, etc., and surgery should consider whether there is necrotizing enterocolitis, anorectal inflammation, anal fissure, intestinal malformation; if defecation gradually decreases to cessation and the distension does not decrease, it may be complete intestinal obstruction, and if defecation is accompanied by incomplete obstruction. If gas escapes during anal examination, it is paralytic intestinal obstruction.