miércoles, 21 de julio de 2010

Regurgitación del bebé. el test de la cuchara

Tengo la suerte de que muchas editoriales médicas me envían libros para revisar la parte técnica de las traducciones y hacer algunos prólogos. Aunque ello me hace pasar muchas horas leyendo aprendo un montón y, en muchas ocasiones. me obliga a repasar temas que tenía olvidados o aprendo trucos fruto de la experiencia de los autores.

Acabo de revisar un libro para padres de la psicóloga, Penélope Leach, una de las escritoras más conocidas en el mundo por sus libros de divulgación, tanto en Inglaterra como en EEUU, de los que se han vendido millones de ejemplares. En éste que próximamente saldrá al mercado me ha enseñado una truquillo muy sencillo para tranquilizar a los padres respecto a las regurgitaciones del recién nacido.

Los bebés regurgitan porque su aparato digestivo no ha alcanzado su plena madurez. El esófago está dotado de una fina musculatura gracias a la cual los alimentos pueden avanzar hacia el estómago. En su parte final, el esófago dispone de un pequeño músculo circular llamado "esfínter esofágico inferior". Normalmente, dicho músculo se contrae impidiendo que el contenido alimentario vuelva "en sentido contrario" al esófago. En el caso del bebé que regurgita a menudo, dicho músculo todavía no funciona correctamente y se relaja dejando pasar de vez en cuando el contenido del estómago al esófago. Es tan común que es considerado casi como algo normal.

Algunos bebés lo hacen en forma habitual, otros no tanto y es función del pediatra distinguir entre una regurgitación y un reflujo -dependerá de su frecuencia y de su intensidad, así como de los síntomas que provocan. Este fenómeno preocupa a los padres por si se puede tratar de algo anormal, por la molestia de cambiar constantemente su ropita cuando lo hemos dejado limpio y pulcro y porque los padres tienen los hombros de su ropa empapados de leche constantemente y pueden oler como el requesón.

Fisiológicamente, 1 de cada 2 lactantes regurgita, 1 lactante de cada 5 regurgita en exceso y la mayoría de las regurgitaciones desaparecen completamente entre los 12 y los 18 meses, edad en la que empiezan a andar. En ese momento, el esfínter esofágico inferior alcanza gradualmente su madurez, el esófago se estira y la evacuación gástrica mejora.

Como la leche es blanca y muy visible -como ocurre con la sangre- las cantidades que regurgita un bebé algunos padres les parecen muy grandes. Para tranquilizarlos la Dra. Leach propone la prueba de la cucharada de leche/requesón, sencillísima: Una vez el niño ha regurgitado en el hombro del padre o de la madre y lo ha puesto perdido han de llenar una cucharada de postre con leche y derramársela por el otro hombro -ya que se ha de lavar, ensuciarlo un poco más no molesta. Si la mancha es parecida de tamaño ha regurgitado sólo unos 3 ml de leche, si les parece que mancha más se tiran una cucharada sopera de leche y si es similar la cantidad regurgitada es de unos 13 ml, miseria comparada con la cantidad de leche que ha tomado.

Este test me parece tan ingenioso que parece tomado del CSI Miami y Horatio haya sido el promotor.

6 comentarios:

Kasandra dijo...

Mirad qué bebé más guapo, cabe en una sandía!

http://bit.ly/9dkqX7

Se acaba de acelerar el ritmo de mi útero!!

Natàlia dijo...
Este comentario ha sido eliminado por el autor.
Natàlia dijo...

Doctor gracias por este sencillo truco!!! mi bebe de 6 semanas regurgita muy a menudo (yo cariñosamente le llamo el vomiton). Los otros 2 no lo habian hecho nunca. Cuando alguien de la familia me diga que regurgita demasiado les hare la prueba de la cuchara a ver si a si no se alarman tanto.

Anónimo dijo...

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