Neonatal vomiting is the gushing of the contents of the digestive tract from the mouth and nasal cavity due to retrograde peristalsis of the esophagus, stomach or intestines, accompanied by spasmodic contractions of the abdominal muscles. Neonates have small stomach capacity, poor development and are prone to vomiting in a horizontal position, which is a common symptom in the neonatal period. As vomit is often ejected from the mouth and nose at the same time, the level of reflexes of newborns are relatively low, easy to accidentally inhale, asphyxiation, and even death. Therefore, early diagnosis and timely treatment of neonatal vomiting are necessary. The reason why newborns are prone to vomiting is due to their physiological anatomy. The main points are as follows: ① Neonatal esophagus is more relaxed, stomach volume is small and horizontal, pyloric sphincter is better developed while cardia sphincter is poorly developed, neural regulation of intestinal peristalsis is poor, and abdominal pressure is higher, all of which are anatomical and physiological reasons for neonatal vomiting; ② Abnormal differentiation and development of organs during the embryonic period can easily cause malformation of the digestive tract, so that ingested food or digestive secretions (3) stimulation at birth, such as swallowing large amounts of amniotic fluid, blood, and rapid changes in the internal and external environment after birth, may also induce vomiting in newborns; (4) the neonatal vomiting center is not well developed and is easily stimulated by toxins produced by systemic inflammation or metabolic disorders that cause vomiting. Common diseases] There are many diseases that cause neonatal vomiting, such as improper feeding, gastric mucosa irritation, gastrointestinal dysfunction, infectious diseases inside and outside the intestinal tract, central nervous system diseases and genetic metabolic diseases, and malformations in the development of the gastrointestinal tract can cause neonatal vomiting. 1, improper feeding in the clinic, the most common cause of neonatal vomiting is improper feeding, accounting for about 1/4 of neonatal vomiting. feeding too often, feeding too much milk; pacifier hole is too large or too small, nipple sagging, resulting in the inhalation of a large number of production air; nipple into the mouth too much, stimulating the pharynx; milk is too hot or too cool, the milk side change and concentration is not appropriate; feeding sick after violent crying, milk too much too soon after Turning the child, etc., are likely to cause vomiting in newborns. Vomiting can be light and heavy, not always after each milk. The vomit is milk or milk lumps, not yellow bile-like stuff. These cases mostly occur in the first child, the mother’s lack of feeding experience caused by the improvement of feeding methods can prevent vomiting. 2, pharyngeal syndrome accounts for about 1/6 of neonatal vomiting. refers to the process of delivery, the fetus swallowed too much amniotic fluid, contaminated amniotic fluid, secretions in the birth canal or blood, which can stimulate the gastric mucosa causing vomiting. Vomiting can be manifested as vomiting immediately after birth, aggravated by vomiting after breastfeeding, and is non-jet vomiting. The vomit is foamy and mucus-like, or coffee-colored liquid if it contains blood. Most of the vomiting disappears within 1 to 2 days after birth, after the swallowed amniotic fluid and the contents of the birth canal are vomited up. If there are no other complications, the general condition of the child is normal, not accompanied by cyanosis and choking cough, the milder cases do not require special treatment, the heavier cases can be cured with 1% sodium bicarbonate gastric lavage 1 to 2 times. 3, congenital intestinal atresia, intestinal stenosis is a common cause of gastrointestinal malformations, the incidence of 1/1500 ~ 1/2000. atresia and stenosis can occur in any part of the intestinal canal, the ileum most often, followed by the duodenum, jejunum less often, the colon is rare. Some children have other malformations, such as esophageal atresia and intestinal malrotation. The upper part of the duodenum and jejunum is called high intestinal atresia. The higher the site of atresia, the earlier vomiting occurs. In duodenal atresia, vomiting occurs at the first feeding after birth, and the vomit is gastric contents and duodenal secretions, most of which contain bile. As the number of breastfeeding increases, the vomiting gradually worsens and becomes persistent and repeated. A small amount of fetal stool may be excreted, and the abdomen is not distended or mildly distended. When it occurs in the lower jejunum, ileum and colon, it is called low intestinal atresia. The main manifestation of low intestinal atresia is abdominal distension, and vomiting often starts in the first one to two days of life. The vomit is fecal-like, with a foul odor, without meconium or with only mucus-like meconium. Surgical treatment is the only effective way to treat intestinal atresia. However, the mortality rate is still very high, one of the reasons is that the child is often combined with other malformations, on the other hand, the diagnosis is too late, the child often dies from secondary intestinal perforation, peritonitis, intestinal necrosis, aspiration pneumonia, etc. Therefore, some people advocate that when there is too much amniotic fluid, immediately after birth under the gastric tube, such as aspiration of 15-20 ml or even more bile-contaminated gastric juice, suggesting upper gastrointestinal obstruction, should take active measures. 4, congenital pyloric hypertrophy congenital pyloric hypertrophy is a common disease in the neonatal period, accounting for the third digestive tract malformation, due to congenital hypertrophy and hyperplasia of the pylorus leading to pyloric lumen narrowing, and cause incomplete upper gastrointestinal tract obstruction to symptoms is vomiting. The diagnosis of the disease can be made by three main signs such as gastric peristaltic waves, pyloric masses and ejectile vomiting. The most reliable diagnosis is based on palpation of the pyloric mass. If the mass is not palpable, ultrasonography or barium meal may be performed to aid in the diagnosis. Vomiting appears between 3 and 6 weeks after birth, or earlier, and rarely occurs after 4 months of age. Vomiting is the main symptom, initially as a reflux, followed by jet vomiting. The vomiting is occasional at the beginning, but as the obstruction worsens, vomiting occurs after almost every feeding. The vomit is mucus or milk, and if it is retained in the stomach for a longer time, it vomits curds without bile. Surgical treatment, pyloromyotomy is the best treatment, with the development of modern external science and technology, surgical treatment is effective and less complications. Daily response】 The age of vomiting, the number and nature of vomiting, the contents of vomiting, general condition and abdominal distension are of some value in identifying the cause of vomiting. Newborns with vomiting at any time, accompanied by the corresponding symptoms of these diseases, or poor general condition, should promptly seek medical treatment. There are many causes of vomiting in newborns, and only when surgical diseases such as congenital malformations and infectious diseases are excluded and the general condition of the child is taken into account, can we consider whether it is caused by improper feeding, otherwise treatment is easily delayed and even affects life safety.