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4 week old - Pyloric stenosis

6 replies

lee12345 · 14/12/2021 22:57

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

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MadisonAvenue · 14/12/2021 23:13

No advice, sorry, but I had surgery to treat this when I was three weeks old and it completely cured it.

If the vomiting continues, please don’t wait for referral. I’d be getting along to A&E. From what I’ve read pyloric stenosis can lead to dehydration.

MadisonAvenue · 14/12/2021 23:14

Oh I suppose I did have some advice after all.

I hope everything works out well for your baby.

Bronzegate · 14/12/2021 23:17

DS had pyloric stenosis.

He started vomiting when he was about 3 weeks old. It was not the classic projectile vomiting, but it was pretty much the whole of every feed. I suspected pyloric stenosis as there was a family history. I mentioned it to the midwife and she said she it was normal for babies to bring up a little milk after feeding (he was my first).

When he vomited a small amount of old (dark red / brownish) blood, I phoned the GP, who arranged for him to be admitted to hospital.

When we got there I explained the family history of pyloric stenosis, but because DS had a fever, they did various other investigations (chest x-ray, lumbar puncture etc). Eventually they did an ultrasound which showed that he had pyloric stenosis.

He was transferred to Great Ormond Street where they did the surgery. He recovered quickly afterwards and was home within a few days.

It caused no trouble after that, and he is now a healthy 6' man with a tiny scar on his abdomen.

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nocoolnamesleft · 14/12/2021 23:26

If they think it's pyloric stenosis, why haven't they sent you up to paediatrics?

Pyloric stenosis is a thickening in the muscle surrounding the exit from the stomach to the rest of the gut. It tends to show up at around 4 to 6 weeks of age, classically in first born boys. When waves of pushing hit the stomach, the milk can't go down, so it comes shooting back up. You tend to see very forceful vomiting (classically hitting the wall, rather than the floor) very soon after each feed. They're then hungry and want to feed again. If left untreated things get worse, as the muscle progressively gets more over thickened, so the baby starts getting dehydrated, and the balance of chemicals in the blood goes out of kilter.

Assessment involves someone who knows what they're doing examining a baby during/after a feed, to look for waves of pushing rippling across the abdomen, feeling for a tiny lump in the upper abdomen, and seeing the baby vomit. Blood tests can show the dehydration/chemical imbalances. An ultrasound scan can actually measure the muscle at the exit of the stomach, to see if it's too big.

Treatment, if it is pyloric stenosis, involves starting the baby on an IV drip, and using it to treat the dehydration and imbalances. The baby would be not fed, and a nasogastric tube inserted, to remove and measure stomach acid that can't drain into the gut, so they know how much of what fluid to add to the drip. The surgery, thankfully, is relatively minor.

Obviously can't tell whether or not it's pyloric stenosis over the internet. Runny poos suggest the possibility of an infection, or of cows milk protein intolerance. But a 4 week old baby with lots of vomiting, and loose poos, could dehydrate very quickly. I agree that if things aren't improving quickly, then an A&E trip is likely to be necessary.

nicky2512 · 14/12/2021 23:31

It was diagnosed quickly and easily in my Ds at 7 weeks with a simple ultrasound (during which he projectile vomited everywhere).
Our main problem was getting someone to take it serious. He vomited so much from shortly after birth but we kept feeding him so he was still gaining weight. Therefore doctor insisted it couldn’t be pyloric stenosis.
The operation is straightforward and Ds is now a brilliant big boy who will be 16 on Christmas Day.
Hope everything goes well for you.

Newnamefor2021 · 15/12/2021 17:35

My eldest had PS. They dismissed it a lot until he ended up seeing a random doctor after a massive weight loss and they saw it straight away.

He has surgery and it fixed it.

What is the GP doing about it? Have you been referred for a scan? You feed the baby and they watch on ultrasound what happens if remember rightly. It was almost 12 years ago though!

Surgery was straight forward and he was great afterwards. Some mild reflux remained but nothing in comparison.

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