After a baby's feeding, many new parents quickly learn, some of what goes down often comes back up. While occasional dribbles of spit-up after meals is common in infants and usually harmless, true vomiting is more concerning. Show
In some babies, frequent projectile vomiting can be a symptom of a condition called hypertrophic pyloric stenosis (HPS); it occurs in 1 out of every 500 or so babies. What is hypertrophic pyloric stenosis (HPS)?Pyloric stenosis is a narrowing of the pylorus―a muscular valve at the bottom of the stomach. When it becomes too thick (hypertrophied), breastmilk or formula can't get through to the small intestines. This leads to excessive, projectile vomiting. Symptoms of pyloric stenosisInfants with pyloric stenosis have a hard time keeping anything down after feedings―usually starting
between 2 and 8 weeks of age. Signs your baby may have hypertrophic pyloric stenosis
Be sure to talk with your pediatrician right away if your baby is vomiting a lot. How is pyloric stenosis diagnosed?Your doctor may diagnose pyloric stenosis by examining your baby's tummy to feel the thick pylorus muscle―an olive-shaped mass in the upper belly, which is the abnormal pylorus. Imaging tests may be ordered to confirm the diagnosis:
Are some babies more likely to get diagnosed with pyloric stenosis than others?The cause of pyloric stenosis is unknown, but researchers point to possible risk factors:
Treatment for pyloric stenosisObservation. Without treatment, pyloric stenosis will not go away on its own. Once a baby has a hard time keeping anything down, observation alone can result in potentially life-threatening dehydration or malnourishment. Medicine. Atropine sulfate is the only currently available medication to treat pyloric stenosis. Using this medication requires staying in the hospital for several weeks and giving the baby special IV nutrition until the vomiting goes away. It does not work 10-25% of the time. For these reasons, it is not widely used and recommended only when surgery would be too dangerous for the baby. Surgery. The only dependable way to fix pyloric stenosis is to open the thickened pylorus muscle with surgery, a procedure called pyloromyotomy. Pyloric stenosis surgery is often done laparoscopically, using a video camera and a few tiny cuts or incisions. Alternatively, it can also be done open with a single longer cut. (Link here to new surgery page.) What to expect after your baby's pyloromyotomy surgeryAfter surgery, your baby will be allowed to eat by mouth. Infants should be given breast milk or formula every 3 to 4 hours, starting around 4 to 6 hours after the surgery. Your surgeon will discuss the feeding plan with you after surgery. Know your baby may still have some vomiting, but it usually gets better after a few feedings. Most babies can go home from the hospital within one day after surgery. However, some may stay longer if they are not eating well. After leaving the hospital, your baby can go back to all normal activities, including tummy time. Once home, be sure you:
Be sure to call the doctor if:
RememberPyloric stenosis is the most frequent surgical condition in infants in the first few months of life. It is important to diagnose pyloric stenosis early, before a baby becomes dehydrated or malnourished. With prompt treatment, babies will soon be able to keep down what they eat so they can grow and thrive. More information
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances. Which family history would the nurse recognize as a risk factor for an infant developing hypertrophic pyloric stenosis?Caucasian babies are more likely to develop pyloric stenosis than other races. Family history. Sometimes, pyloric stenosis runs in families. Siblings of children with the condition carry a 30 times greater risk than the general population.
Why is the vomitus of an infant with pyloric stenosis white rather than bile stained?Persistent vomiting results in loss of stomach acid (hydrochloric acid). The vomited material does not contain bile because the pyloric obstruction prevents entry of duodenal contents (containing bile) into the stomach.
For which condition would an infant born with exstrophy of the bladder be at risk quizlet?Epispadias is a rare birth defect affecting the urethra, the tube that carries urine from the body. It usually occurs in babies with bladder exstrophy, another birth defect. Providers usually diagnose epispadias at birth.
In which position would the nurse place an infant while the infant is receiving intermittent nasogastric tube feedings?8. Position patient sitting up at 45 to 90 degrees (unless contraindicated by the patient's condition), with a pillow under the head and shoulders. This allows the NG tube to pass more easily through the nasopharynx and into the stomach.
|