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What Is Pyloric Stenosis in Babies?
Infantile hypertrophic pyloric stenosis is a condition in which the muscle surrounding the pylorus, the opening between the stomach and the small intestine, becomes abnormally thick. This narrows the passage and prevents milk from moving easily into the intestine.The condition usually develops during the first few weeks of life, most commonly between 2 and 8 weeks of age, and affects about 1 in 500 babies. It is rare after 3 months of age.
What Are the Symptoms of Pyloric Stenosis in Babies?
Symptoms tend to worsen over days. Look for:- Projectile vomiting: The baby forcefully vomits milk soon after feeding. The vomiting usually becomes more frequent and intense over time.
- Non-green vomit: The vomit is milk-coloured, not bright green.
- Constant hunger: The baby wants to feed again right after vomiting.
- Weight loss or poor weight gain: The baby may gain weight slowly or lose weight because of inadequate nutrition.
- Fewer wet nappies: Reduced urine output can indicate dehydration.
- Constipation: The baby may pass fewer stools because less milk is reaching the intestine.
- Dehydration signs: Dry mouth, sunken soft spot (fontanelle), and unusual sleepiness.
- Visible stomach movements: Waves of muscle contractions may sometimes be seen across the upper abdomen as the stomach tries to push milk through the narrowed opening.
Repeated forceful vomiting in a young baby should never be ignored. Seek prompt medical assessment, particularly if vomiting is persistent, wet nappies decrease, or the baby appears unusually sleepy.
Pyloric Stenosis vs Normal Spit-Up
Many healthy babies spit up small amounts of milk after feeds. This is called regurgitation. Pyloric stenosis looks different:| Feature | Normal spit-up | Pyloric stenosis |
| Force of vomiting | Milk dribbles out gently | Forceful, projectile vomiting |
| Frequency | Occasional, with some feeds | With most feeds, and worsens over days |
| Amount | Small | Large, often the whole feed |
| Hunger after vomiting | Settles after a feed | Hungry again soon after vomiting |
| Weight gain | Normal | Slow, or weight loss |
| Wet nappies and stools | Usual | Fewer wet nappies, constipation |
| Baby’s general state | Comfortable and feeding well | Fussy, with possible dehydration signs |
What Causes Pyloric Stenosis?
The exact cause is unknown. Genes and environment both appear to play a part. Known risk factors include:- Sex: It is about four times more common in boys.
- Family history: Babies of parents who had the condition are at higher risk.
- Antibiotics: Erythromycin or azithromycin given to a newborn, especially in the first 2 weeks, is linked to higher risk. Some antibiotics taken by the mother late in pregnancy are also linked.
How Is Pyloric Stenosis Diagnosed?
The doctor examines the baby’s abdomen. A firm, olive-sized lump of thickened muscle can sometimes be felt. Waves of stomach contractions may be visible after a feed.An abdominal ultrasound confirms the diagnosis. Blood tests check salt and fluid balance. If the ultrasound is unclear, an upper GI series (a contrast X-ray of the stomach) may be used.
What Is the Treatment for Pyloric Stenosis?
Pyloric stenosis does not resolve on its own. Surgery is the only treatment.- Before surgery: The baby receives intravenous fluids to correct dehydration and salt imbalance. This can take about a day.
- Surgery: The standard treatment is a procedure called pyloromyotomy. The surgeon makes a small cut in the thickened pyloric muscle to widen the passage. This allows milk to move from the stomach into the small intestine.
- After surgery: Feeding (breast milk or formula) restarts gradually under the surgical team’s guidance. Some vomiting in the first day or two is common. Most babies go home within a day or two. Risks are low and include bleeding and infection.
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FAQs on Why Does My Baby Vomit After Every Feed? Causes and Treatment
- Is pyloric stenosis life-threatening in babies?
It can become dangerous if untreated because repeated vomiting causes dehydration, electrolyte imbalances, and poor nutrition. - Can pyloric stenosis go away without surgery?
No. The thickened muscle does not return to normal on its own, so surgery is needed. - Can pyloric stenosis come back after surgery?
Recurrence is uncommon after a complete pyloromyotomy. Ask your surgeon about follow-up.