Projectile Vomit: Pyloric Stenosiss

So your baby is forceful projectile vomiting up to two feet across the room. Now you've seen it all. While most babies 'spit up' a bit after each feeding, forceful projectile vomiting signals that there is a problem with your baby's pylorus, the circular muscle at the end of the stomach. This happens to about 1 in 500 babies, but mothers who themselves had pyloric stenosis give birth to infants that are at a greater risk. If a baby has pyloric stenosis, it will only become apparent between three and four weeks of age.

What is Pyloric Stenosis?
Pyloric stenosis, or projectile vomiting, is when the food in your baby's stomach is blocked from entering the intestines. The blockage occurs towards the end of the stomach, where a muscle named the pylorus gradually grows thicker until the end of the stomach is tightly squeezed shut. When your baby eats, the stomach will forcefully try to push the food down the pylorus, and will succeed in getting a bit of the stomach contents through. However, the rest of the food goes back up your baby's esophagus and out his mouth onto unsuspecting targets.

Symptoms of Pyloric Stenosis
There are several symptoms to watch for if your baby is projectile vomiting:

  • persistently hungry
  • dehydrated: has dry mouth, dry eyes, skin is wrinkling and has a decreasing number of wet diapers
  • weight loss
  • peristaltic wave: looks like a balloon in your stomach that occurs before the projectile vomiting

It is important to note that there are some infants who can projectile vomit once or twice a day, but they do not have pyloric stenosis. This is because they are underburped, overfed and usually because they're bounced around too much. You'll know your baby has pyloric stenosis if the projectile vomiting is consistent and if vomiting is accompanied by the other signs of pyloric stenosis.

Treatment of Pyloric Stenosis
There is a surgical procedure that treats pyloric stenosis; it's called pyloromyotomy. It's a very simple procedure and should cause no worry to anxious new parents. Your baby will receive fluids through an IV to rehydrate him before the surgery. A tiny incision will be made through laparoscopy into the pylorus and dissolving stitches close the small opening. Although your infant will projectile vomit the first few times immediately after this surgery, the success is immediate after that.

Nurses will instruct you on how to feed your infant after the surgery. Feedings need to begin slowly, and the amount of milk your infant drinks will gradually increase with each feeding.