Digestion in a child

The digestive system performs many tasks in our body. And the most important of them is to turn nutrients coming from outside into energy and building material for cells. This complex process is established as the baby grows.

The digestive process is provided by the gastrointestinal tract (mouth, esophagus, stomach and intestines) and numerous digestive glands. The largest of these are the liver and pancreas. Food under the influence of saliva in the mouth and digestive juices in the stomach and intestines breaks up into elements, and through the walls of the intestine the beneficial substances from them penetrate into the blood. Then all the ballast plus the liver toxins that have been processed through the liver digest the digestive system. The process of digestion of food in an adult takes 24-36 hours, and in infants - 6-18 hours.

Point of departure: mouth

LANGUAGE and TEETH is the main mechanism for crushing, stirring and impregnating food with saliva. The first teeth of babies appear to 6 months, when their body begins to prepare for the development of more and more solid food.

SALIVA - it is produced by the submaxillary and parotid glands. And even in newborns, it has the composition necessary for the splitting of food. In addition, saliva sterilizes the oral cavity - a place of accumulation of a huge number of microorganisms, including those that are unsafe for the child.

Salivation in babies up to 3 months is very small, but since that time, and especially as new products appear in their diet, it is becoming more and more. Until 1 year the child is not able to swallow all the saliva that is formed, most of it is outside, and that's normal.

There is a problem?

Due to violations of the immune defense, and under the influence of injuries and food irritants (which are any new food at first) infants may have inflammatory diseases of the oral cavity - stomatitis (inflammation of the oral mucosa), gingivitis (inflammation of the gums), periodontitis (inflammation of the parietal tissues ), thrush (fungal infection of the oral mucosa).

STOMATITIS. In children who are breastfeeding, acute stomatitis often causes the herpes simplex virus. In this case, the temperature rises, light and painful rashes appear on the mucosa of the mouth - aphthae, because of what the child does not sleep well and is capricious. Kids start to refuse food because of pain in the mouth, so they need to be fed with semi-liquid or liquid food. Food should not be hot. Among the drugs that help cope with herpetic stomatitis are antiviral ointments that are lubricated with aphthae and mucous around them, the means that support the immune system (for example, Imudon, Solvay Pharma, in fact - a mixture of useful microbial cells and protective factors that protect the oral mucosa and pharynx).

0-4 months: Digestion is OK!

At the kid all goes well, if: he burps not more often 2-5 times a day and the volume of return is small; There is no vomiting, he does not cry after feeding; His stomach is not swollen; it is soft and painless to the touch; there are no diarrhea, no constipation; the contents of the diaper are homogeneous, golden yellow, without a sharp and unpleasant odor; the child is good at gaining weight and developing without problems; He is merry, he can not be called restless or too listless.

Route: from esophagus to stomach

An esophagus is a "corridor" through which a food lump, thanks to the rhythmic contraction of the walls, descends into the stomach, bypassing the respiratory system. On this site, the food passes through the sphincters, "dampers", which prevent it from going on the return journey. At the end of the esophagus is the cardiac sphincter (cardia), it "closes" the main outlet, so that the food lump does not return from the stomach into the esophagus. In babies in the first months of life, the cardia is not completely closed, and since the gatekeeper (the sphincter performing the same blocking task, but only in the stomach), on the contrary, is overstrained, regurgitation occurs.

There is a problem?

FREQUENCY. If a child spews softly (milk simply flows out of his mouth, he does not vomit and he adds weight), you should not worry. The normal phenomenon for most infants will be from 2 to 5 episodes a day lasting no more than 1-2 minutes. Sometimes the contents of the return can show an admixture of blood, and if the young mother has cracks on the nipples (it happens, the woman is not noticeable), you should not worry.

Regurgitations worry not only infants, but also older children. The most common reason is not age-appropriate food! The most striking example - soda, which kids under 4 years old should not drink.

Older children also sometimes spit up excess food. And the reason is often the features of the baby's diet, and not problems with the esophagus or stomach. For example, regurgitation provokes highly carbonated drinks, so children under the age of 4 should not drink them. Infrequently, but sometimes they can be caused by esophagitis (inflammation of the lower part of the esophagus) or gastroesophageal reflux disease (this is a relaxation of the cardiac sphincter, because of which the acid content of the stomach is in the esophagus, causing inflammation of its mucosa-esophagitis).

Stomach is the central gathering point. Depending on the age of the baby the stomach contains a different amount of food.

In a 1-month-old child, its volume is 100 ml, in a one-year-old child it is 250-300 ml. Externally, the stomach is similar to a bag in which food gruel (chyme) is stored and processed with hydrochloric acid and enzymes. In its lower part, the stomach is connected to the intestines with the aid of a doorkeeper - the "door", which opens only one way. The combination of the operation of the dampers is indicated by the fact that the kids cope with the volume of food equal to 1 / 5-1 / 6 of their body weight (for an adult this would be 10-15 kg per day!). In addition, it is more difficult to keep liquid food. Descent of the chyme from the stomach into the intestine occurs regularly and portionwise.

There is a problem?

They appear if the passage of food is difficult (what happens with a congenital narrowing of the gatekeeper) or when it is, on the contrary, open too widely - then the chyme is thrown back into the stomach. This happens due to the fact that the locking muscles of the pylorus are relaxed - this feature is peculiar to children with nervous disorders or chronic gastritis.

ATTENTION! Gastritis and peptic ulcer in infants are rare. These problems are peculiar to children from the age of 6-7, because at this age they spend more and more time outside the home, eat less and less home food, from which the habitual diet and regime are violated.

Support Group

GEL AND ENZYMES. They are necessary for the processing and assimilation of food and come from the liver and pancreas. Bile in newborns is produced little, so their body is still struggling with the assimilation of fat. With age, the production of bile acids in children increases, and the situation is getting better.

The ability to produce enzymes by the pancreas at the time of the birth of the child is also not yet established. In its juice, the children of the first 3 months do not have enough substances involved in the digestion of starch, protein and fat (amylase, trypsin and lipase). Only after the new products gradually appear in the diet of children, the development of the elements necessary for digestion in the pancreas is adjusted and reaches the values ​​peculiar to adults.

There is a problem?

It is because of the peculiarities of the liver and pancreas of children that experts believe that children under 7 years of age can not eat from an adult table. After the violation of the outflow of bile through the biliary tract (dysfunction of the biliary tract) and the violation of the rhythm of secretion of the secretion of the liver and pancreas, when they do not always accompany the appearance of food (reactive pancreatitis) are very common among infants of the first years of life as an answer to food not suitable for their organism.

Journey through the intestines

The small intestine consists of 3 parts: duodenum, lean and iliac. The first section receives bile and pancreatic juice, through which the conversion of proteins, fats and carbohydrates. In the jejunum and ileum, the chyme breaks down into nutrients. The inner wall of the small intestine consists of microscopic villi, which provide the intake of amino acids, sugar, vitamins into the blood. Because of defects in the structure of the villi - temporary (as a consequence of intestinal infections) and, less often, permanent, - nutrient absorption is impaired and a disorder of the stool may begin.

The THICK SURGE surrounds the entire abdominal cavity. In this part of the intestine, water and a small part of the mineral salts are absorbed. By the way, this same territory is called the realm of useful microorganisms, the lack of which leads to the appearance of excess gases (flatulence).

What is the doctor looking for in an intestinal colic? First of all, surgical diseases should be excluded, for example, an inflammation of the appendix or intestinal intussusception (when the site of one intestine was inserted into the lumen of the other). The latter often happens with children from 4 to 10 months.

In the large intestine, the food residue (feces) takes the form and through the rectum and the intestinal outlet (anus) goes out. For the promotion of chyme in this area, the muscles correspond to numerous sphincters, and its outward opening is due to the opening and closing of the rectum. Disruptions in the operation of the sphincter apparatus, caused, for example, by intestinal infections, are manifested by a delay or increased frequency of the stool.

In children, the intestine works vigorously, so in the first 2 weeks of life they go "large" 4-6 times a day. Babies who eat artificial mixes do this less often than babies. After 1 year, the frequency of "large" approaches is 1-2 times a day.

At the time of the birth of the child, his intestines are sterile, but from the first day he begins to be populated with useful microbes. In healthy babies born on time and breastfeeding, the intestinal flora reaches a normal level by the end of the second week of life.

There is a problem?

Intestinal Colic is a common occurrence common to almost all infants whose digestive system is only "ripening". Pain in the abdomen of babies appears due to the fact that in the intestine accumulates a lot of gases (flatulence). Even if the cause of intestinal colic is clear, it is necessary to consult with a doctor who will exclude surgical diseases, for example appendicitis, besides only a pediatrician can prescribe a child treatment. In order to cope with the problem, the baby, in addition to food restrictions (if it is a baby, caution about black bread, potatoes, beans, milk, sauerkraut, touch the mother), prescribe activated charcoal or special preparations (eg Espumizan, Berlin-Chemie, Unienzim, Unichem Lab.)

Diarrhea Disorders of the stool most often causes an infection, although not always. Litters often have lactase deficiency, it arises from the fact that the pancreas and intestinal mucosa, which are responsible for the production of lactase, are not able to work at full strength. Without lactase enzyme, lactose is poorly digested. As a result, lactase is in deficit, provoking the growth of the microbial flora, alien to the intestine of the child, and a dysbacteriosis arises. Signs of lactase deficiency and dysbiosis are similar: the baby cries after eating, he is worried about bloating, foamy liquid stool (frequent or with constipation).

Infectious disorders or intestinal infections are called diseases of "dirty hands". Microorganisms that cause them are diverse, although it is almost impossible to determine what exactly the baby has encountered (dysentery or shigellosis, salmonellosis, roto- and caliciviral infection, and so on). With intestinal infections, one of the greatest discoveries of medicine is related - the idea of ​​the need to weave babies with diarrhea (doctors will call this procedure rehydration) to avoid dehydration. For this use solutions from salts - ready (Hydrovit, STADA, Regidron, Orion, and others) and made at home.

Antibiotics today doctors appoint babies only with severe forms of intestinal infections. In addition, they are prescribed a strict diet for the child, if necessary enzymes, preparations that improve the bowel's ability to contract (for example, Uzara, STADA), enterosorbents - substances that enter the intestines and absorb harmful toxins and microbes (Smekta, Beaufour Ipsen ), probiotics are useful microorganisms, primarily bifido- and lactobacilli (Probifor, Partner, Bifiform, Ferrosan, Bifidumbacterin-forte, Enterol, Biocodex), prebiotics that help the growth of useful flora (Hilak forte, Ratiopharm), and also drugs that strengthen immunity (Kipferon, Alfarm, Bifiliz, Enzyme).

Chronic diarrhea is more often associated with a violation of the assimilation of food: intolerance to milk sugar (lactase deficiency), an allergy to cereals (celiac disease). Although sometimes it is manifested intolerance to cow's milk protein or inflammatory bowel disease (ulcerative colitis, Crohn's disease). In any case, the baby will need a course of examination that will determine if the child has an intestinal infection, worms, congenital disorders of the intestine.

ЗАТРУДНЕНИЯ. Часто случается, что после кишечной инфекции, или лечения антибиотиками (по поводу другой инфекции) работа кишечника ребенка разлаживается, что проявляется чаще всего задержкой стула. При запорах, вызванных расслаблением кишечника, назначают диету, содержащую растительную клетчатку (свеклу, чернослив, хлеб из муки грубого помола). Детям советуют много двигаться, и с помощью массажа живота специалист помогает им восстановить рефлекс освобождения кишечника. Кроме того, врач подберет малышу необходимые препараты. Есть малыши, которым потребуются послабляющие и ветрогонные (снимающие вздутие живота) средства в основном растительного происхождения (Микролакс, Johnson & Johnson; Плантекс, Lek; кора крушины). Детям, страдающим запорами, при которых кишечник сжат, помогают препараты, успокаивающие нервную систему (валериана). Клизму малышам делают в том случае, если результат заставил себя ждать больше 3 дней.


To understand the situation, the doctor-gastroenterologist appoints the baby examination: blood tests, urine, feces, biochemical blood test, skin allergic tests, ultrasound of the abdominal cavity organs. Or directs to other, more serious procedures - gastroscopy (examination of the stomach), sigmoidoscopy (examination of the end section of the large intestine), capsular endoscopy (examination of the intestine with the help of a teleporting capsule), x-ray of the gastrointestinal tract.

Video: digestive problems in a child related to food flaws in the family

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