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Quick reference medical handouts used by Pediatric offices


Hiccups in Babies and Children


Everyone has had them
Everyone has had them. Hiccups occur at funny times and are funny to everyone but the hiccupper! Sometimes it is being tickled, and other times it is drinking too fast, but all have the same outcome...hiccups. So what causes hiccups and what can be done about them?

What Are Hiccups?

Here's a riddle. Someone is hiccuping for a half-hour on a crowded train and only one woman notices, but she is not the hiccuper. Who is hiccuping? Answer: the woman's fetus. Sound unlikely? It isn't.

In the second half of pregnancy, many babies get the hiccups several times a day, and the mother-to-be may feel her baby hic, hic, hiccuping for 20 minutes or more, And the pattern may continue after the baby is born. For the most part, such hiccups are perfectly normal and harmless.

The term for hiccups comes from Latin. It means sobbing while catching your breath. Hiccups occur due to an involuntary spasm of the muscles that help us to breath, including the diaphragm (the large muscle that divides the chest from the abdomen) and the muscles around the ribs. These spasms cause the muscles in the throat to spasm, producing the usual sound. Hiccups may occur up to sixty times a minute, though for most people the frequency is much lower. Hiccups are a common and usually benign problem that will affect everyone at some point in time.

What Can Cause Hiccups?

There are many harmless causes of hiccups. In babies, taking in too much air while feeding is often the cause. In older children, common reasons include over-eating (which causes the stomach to become distended), and drinking too much soda (the carbonation is the cause here). Sudden excitement and stress are also thought to be possible causes. Another common cause of hiccups is gastroesophageal disease (GERD), which occurs when acid leaves the stomach and rolls up into the esophagus (the food tube). Your doctor can determine if GERD is causing your child’s hiccups. Rare, but more concerning, causes include medication side effects, medication overdoses, infections, and multiple sclerosis.

 Like sneezing and snuffling, hiccups are normal in infants and are very rarely due to any health problems. Most babies hiccup from time to time during feeds. Some babies get them even before they are born. If this happens, just keep on feeding the baby, the hiccups will stop on their own, and a baby who is hiccupping will not choke on milk (the epiglottis covers the entry to the lungs when the 'hic' happens, so milk does not go down into the lungs). Babies do not get upset from hiccups, so you do not need to try and stop a baby's hiccups, but if you want to try, give your baby something to drink (a breast feed, or some water). This obviously doesn't work all of the time, otherwise babies would not get hiccups while they are feeding.

Babies do not get upset from hiccups, which eventually go away on their own. You do not have to do anything.

When Should I be Concerned About My Child’s Hiccups?

If your child complains of stomach pain or coughs up blood you should notify your child’s doctor. If the hiccups began after starting a medication or last for more than three hours, you should also notify the doctor.

How Can I Stop My Child’s Hiccups?

If an older child with hiccups is eating, get the child to spit the food out and wait until the hiccups are gone before eating again.

First do nothing. Hiccups will stop by themselves and the home remedies that people try to stop hiccups often coincide with the hiccups stopping on their own. However, if you would like to try something, the following home treatments have been reported to be of help:

1. Drink a glass of water (but not from the opposite rim!);
2. Have your child hold his/her breath;
3. Have your child suck on a lemon wedge;
4. Put some sugar or peanut butter (but make sure there are no peanut allergies) on your child’s tongue; and
5. Have your child sneeze. Although nobody knows for sure why any of these treatments seem to work, they are probably related to influence on the vagal nerve, which is the nerve that controls breathing.
6. Have someone give the hiccuping child a fright.

If hiccups last longer than a few hours or have a medical cause, your child’s doctor may recommend specific treatments to target the underlying problem.

For GERD, the treatment is usually acid suppressants in combination with dietary changes. Medications are sometimes used for chronic hiccups and include muscle relaxants, and anti-seizure drugs. If neither of these works, acupuncture or hypnosis may be tried.

Finally, if all else fails, your child’s doctor may suggest surgery to cut part of the vagal nerve.

The bottom line is that hiccups are a common problem in babies and children, and in the vast majority of cases are not harmful.


posted 12-24-07

 

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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