4 week old - Pyloric stenosis

[lee12345]

Hi,

My daughter is 4 weeks old and for the past week, she has been vomiting forcefully after feeds. She is formula fed. I assumed this was probably reflux but I have seen a doctor this afternoon expecting to be told this & prescribe Gaviscon.
He completely dismissed it as reflux & said it could be pyloric stenosis. I have since googled this & found it needs an operation to fix.
Has anyone had any experience of this?
I’ve have been told to make another appointment if she continues to be sick & then will be referred to a paediatrician at the hospital.
His reasons for thinking it could be this, is that she is quite forcefully sick & seems ok in herself afterwards & will feed again soon after.
She is always sick after a bottle.. sometimes it seems like the whole bottle & other times it’s not so much. She has also had runny poos for the past few days, I’m not sure if this is related or not.
Any advice would be appreciated.
Thanks

Pyloric stenosis is a possible diagnosis (quite a lot rarer than reflux, common enough that medics will be watching out for it) but it sounds as if your doctor actually thinks reflux is more likely but is giving a safety net and explanation in case things get worse, and a route to get back in to you if it becomes clearer there's a problem? Pyloric stenosis is progressive so if babies have reached a critical point where barely any milk is passing through they tend to look pretty rotten and dehydrated. Having some bigger and some smaller vomits is more of a reflux story.

If your GP thinks there’s a chance it’s pyloric stenosis then he should be sending you to A&E.

I’m a children’s nurse on an infants ward and have looked after lots of babies with pyloric stenosis and they can get poorly quite quickly if it’s not treated. The babies I see tend to need treatment to stabilise their health for 2 days (as an average) before they’re considered fit enough for surgery.

Things may have changed since you first posted, but if they haven’t and your baby is still projectile vomiting then I would be seeking medical attention as soon as you can.

A family member had this as a baby. She would projectile vomit in a very aggressive manner and had to be operated in at GOSH. It was a scary time and she had lost an troubling amount of weight. They operated via her belly button and she made a full recovery. She is now an adult, and post surgery she recovered very quickly and she has had no long term issues. I do hope your little one is ok.

My DS had pyloric stenosis - we had various 'diagnoses' of reflux, upset stomach and none of the doctors ever mentioned pyloric stenosis to us. However, DS never really did the projectile vomiting that seems to be the main symptom - he was sick a lot but never projectile and he always seemed well.

Only had it diagnosed as we took him to A&E eventually as he vomited up blood one night (think they call it coffee grounds). They tested his blood and were able to identify it via a certain pattern of lack of nutrients that is common with pyloric stenosis.

He had surgery at 8 weeks old, recovered well and 15 years later, it is a very distant bad memory

Hope it is reflux but you have my sympathy - we used to dread feeding him and would be covered in towels and have a bowl ready, not how I envisaged those early weeks with my baby