Infant Hiccups: The pediatrician explains the causes of hiccups in babies. How to stop hiccups in babies, natural remedies and legends
Hiccups of the newborn
Hiccups in the newborn it is far from rare, and yet it is enough to make parents anxious. A banal spasm of the baby’s throat and mothers, fathers, grandparents, uncles fall into panic. In reality, although annoying and uncontrollable, hiccups are a disorder that affects all ages and is due to a involuntary contraction of the diaphragm, the muscle that separates the thoracic cavity from the organs of the abdomen, resulting in the closure of the laryngeal glottis. It is usually a phenomenon that disappears naturally, is not dangerous and has no impact on breathing, but when babies are affected by hiccups, mothers worry and don’t know how to free their baby from that unpleasant jolt. Well, don’t panic, the remedies are there.
In this article
What is hiccups
Common hiccups are a ubiquitous reflex, we have all had hiccups at least once, but unlike other common reflexes, such as sneezing and coughing, its physiological benefit is not known, many physiologists agree that it is a surprisingly complex reflex to remove air from the stomach. of young suckling mammals. Hiccups is an onomatopoeic name that derives from the sound produced by the abrupt closing of the vocal cords about 35 milliseconds after the forced contraction of the respiratory muscles. In the medical literature, hiccups are singultus, although this term was initially used to describe the strong breathing often associated with long periods of crying. If hiccups continue for more than 48 hours or occur frequently, it can be a sign of illness, but more often it goes unnoticed or is considered an annoying inconvenience that has no value.
Hiccups occurs in most mammals, is studied in cats, rats and rabbits, observed in horses, dogs and humans. The rhythmic movement of hiccups is clearly felt by pregnant women and detected by ultrasound when it occurs in the fetus, before swallowing or in respiratory reflexes. The reflection it is more common in infants and it is estimated that they spend 2.5% of their time sobbing, then decreases in childhood with occasional brief relapses throughout their life. Hiccups have not been documented in reptiles, amphibians and birds.
Causes of hiccups
Hiccups can occur for many different reasons:
- eat too much,
- swallowing air while chewing,
- or even to be anxious or excited.
These same triggers can cause hiccups in newborns, which is usually not a problem if the baby is healthy. However, there are also some more serious causes of hiccups that make it last a long time, and sometimes hiccups can lead to complications on ventilation in newborns, particularly in premature babies who need help to breathe. Once started, hiccups occur at a rate of 4-60 per minute. The frequency can remain fairly constant, but it can also be changed by various conditions.
- Hiccups are suppressed by the increase in carbon dioxide in the blood and can be triggered by gastric distension, eating fast or drinking carbonated drinks.
- In 1899, Ferroni suggested that hiccups were a form of preparation for the fetus to strengthen the muscles involved in breathing, a hypothesis more recently revisited by Kahrilas and Shi.
- Other suggestions related to fetal development have included eliminating meconium, the first stool a newborn produces, and stimulating breastfeeding, but these do not seem plausible in light of the reflex actions, because the strong contraction of the respiratory muscles would move the meconium. deeper into the airways, and most of the muscles triggered by hiccups are not involved in breastfeeding.
- Straus et al. proposed a phylogenetic hypothesis: hiccups are an evolutionary remnant that originated with the ventilation of the gills.
- Others have suggested that hiccups are a reflex for moving boluses of trapped food into the esophagus. The main problem with this theory is that the action of hiccups would move a food bolus towards the center of the chest, the food bolus in the lower esophagus would be moved away from the stomach, where it can be safely digested, towards the airways, where it could become a dangerous obstruction.
The fact that patients who have food stuck in the esophagus rarely associate hiccups and the high prevalence of hiccups in infants who do not consume solid foods do not support this hypothesis. The most important action of this reflex is the sharp drop in intra-thoracic pressure. Closure of the glottis with strong contraction of the respiratory muscles, resulting in a sharp drop in intrathoracic pressure, suggests that the purpose of the reflex is to move something from the outside of the chest cavity to the inside.
There are five ducts between the intra and extra-thoracic areas that contain air, fluids or that may be displaced, namely the arterial, venous, lymphatic vessels, trachea and esophagus.
Why does the diaphragm contraction start?
The mechanism is due to one alteration of the phrenic nerve, deputy just to control the contractions of the diaphragm.
- The phrenic nerve it follows a very long path: it originates in the brain, passes through the cervical area and innervates various organs (the diaphragm, the thin membrane that surrounds the heart, liver, stomach and kidneys). If the nerve is irritated anywhere in its path, an episode of hiccups can ensue.
- The typical “hic” sound, which is repeated in a rhythmic and continuous way for a few minutes, is due to the fact that each contraction of the diaphragm ends with a sudden closure of the glottis, the valve that separates the respiratory system from the digestive one.
- In addition to the phrenic nerve, hiccups also involve some parts of the nervous system: the centers that control breathing and the hypothalamus, a part of the brain that cannot be controlled by the will (this is why hiccups occur suddenly).
Often the reason for the hiccups it is not known, but it has been seen that some situations typical of everyday life can easily cause it:
- stomach dilation, caused by the rapid or excessive ingestion of food and liquids
- sudden changes in temperature, such as switching from hot to cold or drinking a hot or frozen drink
- excessive ingestion of alcoholic beverages, which can damage the gastric mucosa (the lining tissue of the stomach) causing inflammation and indirectly irritate the diaphragm
- episodes of emotionality: when you are in a very uncomfortable condition, you swallow more air than normal; this causes as a direct consequence irritation of the diaphragm and then the appearance of hiccups. In…