Diagnostic criteria and algorithms for rumination therapy in infants (literature review)

Rumination is repetitive, effortless regurgitation (regurgitation) of food on time or shortly after eating, followed by chewing, swallowing, or spitting out. Low awareness among pediatricians leads to underdiagnosis of rumination in children and ineffective treatment. Rumination occurs mainly in infants aged 3 to 12 months. In diagnosis, careful collection of medical history and assessment of the clinical picture is of the greatest importance. Most often, parents complain of vomiting and regurgitation in the child. It is optimal to make a video recording of regurgitation episodes for subsequent assessment. Rumination according to Roman criteria IV refers to functional disorders of the gastrointestinal tract. A child with rumination should have no symptoms of organic pathology. Children should be excluded from congenital malformations, surgical pathology, infectious and metabolic diseases. The diagnosis requires laboratory and instrumental examination, and consultations with a surgeon, gastroenterologist, and psychologist are necessary. Timely diagnosis and treatment of rumination plays a key role in preventing complications, ensuring normal growth and development of the child. It is necessary to train parents in child care skills and feeding rules. In infants with rumination, the use of proton pump inhibitors, prokinetics, and antacids is not recommended in routine practice. Behavioral therapy, diaphragmatic breathing training, and family psychosocial support are of the most important importance in the treatment of rumination.