American Medical Association Family Medical Guide - American Medical Association [165]
If your baby is vomiting large amounts, if the vomit contains blood or a greenish brown material, or if the vomit is expelled to some distance (called projectile vomiting) more than two or three times a day, contact your pediatrician right away. An occasional bout of projectile vomiting is usually a symptom of a mild disorder such as a cold, motion sickness, or gastroenteritis (see below). In rare cases, projectile vomiting can be a symptom of a serious problem such as an intestinal obstruction (see page 405).
Beginning Solid Foods
Infants are usually ready to begin gradually eating solid foods when they are between 4 and 6 months old. Your doctor will recommend starting your baby on solid foods by spoon-feeding him or her cereal twice a day. You will then introduce your baby to a variety of puréed vegetables and fruits, one at a time, to detect any allergies or other problems. When your baby is older, you can add finely chopped meat and eggs. Try to start your baby off with good eating habits—only give food at meal-times, and do not give foods that are high in sugar, fat, or salt, or that are heavily processed or refined. Also, avoid using food to pacify your baby when he or she is fussing or crying.
Gastroenteritis
Gastroenteritis is inflammation of the stomach and intestines, usually as a result of a viral or bacterial infection or from infestation by an intestinal parasite. The infection usually is acquired by eating contaminated food or by sharing food with an infected person, but it also can be spread by coughing, sneezing, or poor hand washing. In most cases, gastroenteritis is mild, easy to treat, and lasts for just a few days. In some cases, however, the disorder may be persistent or severe. If not treated promptly, persistent or severe gastroenteritis can cause dehydration, which can lead to kidney damage or brain damage, or can be fatal.
Symptoms
The main symptoms of gastroenteritis in an infant are mild to severe vomiting and diarrhea. Other possible symptoms include irritability, weakness, slight fever, abdominal cramps or pain, and loss of appetite. The symptoms of dehydration include a dry mouth, sunken eyes, sunken soft spot, lethargy, irritability, decreased tear production, and decreased urination. If the dehydration becomes severe, the baby’s skin loses elasticity—if you pinch the child’s skin between your thumb and finger, it does not immediately return to its original position. If your baby has symptoms of gastroenteritis, call your doctor. If your baby has symptoms of dehydration and has three large or loose bowel movements and vomits all feedings within a 6-hour period, see your doctor immediately or take your baby immediately to the nearest hospital emergency department.
WARNING!
A Depressed Soft Spot on the Head
If the soft spot on top of your baby’s head seems to be sunken, he or she may be dehydrated, possibly because of a digestive problem. Call your doctor immediately or take your baby to the nearest hospital emergency department.
Diagnosis
To diagnose gastroenteritis, the doctor will ask you about your baby’s symptoms and perform a physical examination. He or she may order blood tests or may take a small sample of the baby’s stool for laboratory analysis to try to identify the organism causing the problem.
Treatment
To treat mild gastroenteritis, continue breastfeeding your baby, and supplement breastfeeding with an over-the-counter rehydration solution. For a baby older than 6 months, you can supplement breastfeeding with a rehydration solution and clear fluids such as broth. Make sure that your baby gets plenty of rest, and give him or her acetaminophen or ibuprofen