# help! projectile vomiting - is it pyloric stenosis?



## seahorsie (Jul 1, 2003)

My ds is 3 weeks old today - for a few days now, he has been projectile vomiting after bf-ng, once or twice a day. Really scary, through his nose & mouth & a pretty large amount. It doesn't happen immediately after bf-ing, maybe 1/2 hour or more. I was thinking it may be that he hasn't burped, or drank too much at once. I have noticed that if he hasn't burped before switching breasts, it's more likely to happen. He seems healthy otherwise, not dehydrated, pooping ok & peeing. I worry though that it could be Pyloric Stenosis, which requires surgery. I've looked it up online, but I'm not clear on how often a baby with this condition vomits like this, more than twice a day? or maybe it's reflux? Did not experience this with dd, so I'm at a loss.


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## hipumpkins (Jul 25, 2003)

I can't diagnose anything and have never heard of that Pyloric Stenosis. I do however have experience wiht projectile vomiting from my DS. He would nurse and than blech...I would be soaked. He once soaked teh entire row of the church pew







It was not pretty. I was told once he learned about being full he would stop. I was told to burp him more. I tried to pump a little off first beofre nursing him b/c my let down was so fast...I think that helped.
Anwway I was told it was solely a laundry problem and he would outgorw it. He did it more than once a day but now I can't recall expactly how often...but some days he didn;t do it all and I would think he was done...only to be soaked another day







:


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## TeaghansMama (Jul 1, 2005)

i'm def not an expert but i've worked with a surgeon on quite a few surgical cases for pyloric stenosis
my impression is that babies with pyloric stenosis get really sick, quick. if he is pooping regularly and a normal amount, gaining weight, isnt dehydrated or extremely lethargic it probably isnt pyloric stenosis
also i believe it happens after every feeding once the pyloris sphincter thickens, not once or twice a day
my dd went thru a period at just a few weeks old of projectile vomiting too
one night the splashing sound woke me up... gross. lol but she was gaining weight, not dehydrated, in no real distress, pooping normally
she is still a spitter (at 3 months) but the forcefulness has abated. get him checked out if you are concerned. it may be GERD or just a phase.
hoping your little one is fine and you find peace of mind...


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## DQMama (Mar 21, 2006)

Quote:


Originally Posted by *seahorsie* 
My ds is 3 weeks old today - for a few days now, he has been projectile vomiting after bf-ng, once or twice a day. Really scary, through his nose & mouth & a pretty large amount. It doesn't happen immediately after bf-ing, maybe 1/2 hour or more. I was thinking it may be that he hasn't burped, or drank too much at once. I have noticed that if he hasn't burped before switching breasts, it's more likely to happen. He seems healthy otherwise, not dehydrated, pooping ok & peeing. I worry though that it could be Pyloric Stenosis, which requires surgery. I've looked it up online, but I'm not clear on how often a baby with this condition vomits like this, more than twice a day? or maybe it's reflux? Did not experience this with dd, so I'm at a loss.











Projectile vomiting can definitely occur w/ reflux. I know it is very scary. My dd started projectile vomiting when she was about 5 days old. It was also not immediately after BF'ing so I was confused--usually 30-60 min. later. Instead of doing an invasive test for reflux (which is not always accurate) I tried a dairy free, soy free diet, which did not work. So then we did a trial of medication (Zantac) which worked very well for a time so dr determined it was reflux. When it stopped working I tried Dr. Sears' total elimination diet which also did not work. Even though we did not do the test, I believe dd's reflux is strictly structural and not related at all to diet. So we switched to Prevacid (I know, not natural at all) and it was like a miracle. Some people suggested a chiro to me and it did work for a friend of mine but we did not do it.

Does your baby also choke, gag, make throaty sounds (well maybe not yet, he's a little young) or have other reflux symptoms?

You could also have oversupply or an overactive letdown. If that is the case, try nursing lying down, and only on one side for a feeding or two.

I'll post more later if you have more ?s or if something I said didn't make sense--I was in a hurry while posting but wanted to try to help--gotta run!


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## USAmma (Nov 29, 2001)

You have gotten some good advice. Some babies are just vomiters. If your baby is growing well and nursing well, just relax.







Maybe try to find out if it's something you are eating. But no matter what, some just vomit because their systems are not mature yet. My oldest was like that. She would vomit and then without missing a beat, feed again. My youngest vomited to the point of dehydration and failure to thrive. Big difference.

Watch for back-arching during or after feedings, a gurgly voice, coughing or choking, mucous in the spit-up/vomit, or a sour breath beyond normal sour milk smell. If the baby is acting in pain or showing back-arching, it's probably GERD and meds will help to lessen the pain. True GERD needs to be treated aggressively. Spit-up and vomiting in an otherwise happy and healthy baby should not be cause for concern.


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## DQMama (Mar 21, 2006)

Quote:


Originally Posted by *USAmma* 
Watch for back-arching during or after feedings, a gurgly voice, coughing or choking, mucous in the spit-up/vomit, or a sour breath beyond normal sour milk smell. If the baby is acting in pain or showing back-arching, it's probably GERD and meds will help to lessen the pain. True GERD needs to be treated aggressively. Spit-up and vomiting in an otherwise happy and healthy baby should not be cause for concern.


I forgot about the back arching. Major symptom for my dd. Don't remember when it started though.


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## Rachel J. (Oct 30, 2005)

Nak, Both my ds have/had GERD symptoms. First one got so bad he refused to nurse and would only eat from a bottle in a vibrating bouncy seat, crying the whole time. Meds helped him. With #2 I was on the lookout for symptoms and as soon as they popped up I started him on infant probiotics. He still spits up but with little or no pain. If your ds has any of the GERD symptoms then I would highly reccomend trying the probiotics (has to be infant, not regular acidophilis) as a natural way to deal with the problem noy just the symptoms.


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## NaomiLorelie (Sep 2, 2004)

All three of my kids were/are very spitty babies. DD2 would projectile vomit several feet many times a day. It could be pretty terrifying. We had her checked for PS just in case and she was fine. We just had to sleep with towels on the bed because after nursing she'd erupt like a fountain. I think the PP is right in that a baby with PS will get noticably sick very quickly. Hopefully your little one is fine. (((hug)))


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## Milkymommi (Aug 29, 2003)

x- posted as a new thread

Not to hijack the thread or anything but...

I'm interested in hearing more about GERD in infants. My dd seems to have these symptoms though not severe. We've had some strange experiences with projectile vomiting. She is 6 weeks old and gaining weight beautifully etc. but at night EVERY night for about a week or two she would vomit either during nursing or shortly after. It came out her nose and everything ...poor baby. I do have a very forceful letdown so I figured that may have been the problem. The only thing is that now that I read this I'm second guessing myself.

She cries EVERY night starting around 9:00 when awake time begins without expaination. I don't know if she's tired or what the deal is. She always eats plenty but still acts like she wants to nurse. I was letting her continue but when I would, she would throw up so now I'm trying to hold her off a bit before nursing again and she hasn't thrown up in a week. When she would try to comfort nurse she would seem like she was in pain or really aggrivated when I letdown again. I thought maybe she was just getting too full kwim?

I have noticed that when I lay her down for dipe changes she does this wierd back arching thing and cries. What is up with that? She really cries hard and I feel terrible because she gets so upset but I don't understand why.

She is definately a gagger, even when we nurse. I'll introduce the breast and she gags, not every time but often. She's very phlegmy every morning, like majorly. When she was projectlie vomiting it was full of phlegm. I thought maybe leftover birth "juices" in there? One time though it was tinged with yellowy stuff. I've never seen such a sensative gag reflex in a baby









Like I said , she hasn't thrwon up in a week but she still has these other symptoms.


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## DQMama (Mar 21, 2006)

I just wanted to add that GERD babies may gain weight fine in the beginning. They haven't figured out yet that it is eating that results in pain. Once they figure it out they sometimes eat less (or stop altogether in my dd's case). So it is very important to get to the root of the problem early before they realize what's going on.


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## lesty (Mar 31, 2006)

My dh and his brother had PS, so the dr. has us watching ds for symtoms. He told us the vomiting is immediately after every feeding. My MIL told me she used to feed the boys right next to the sink, lean them over, and let them puke right after eating. She also said it was violent and they were not gaining weight because the muscle does not let any food pass, which is why they throw up immediately. I hope that helps. Good luck!


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## seahorsie (Jul 1, 2003)

thanks so much everyone - (1 handed typing with ds now) - my letdown is very fierce, and when that happens, ds chokes, otherwise he doesn't. I was surprised to find out that he had gone from 8 lbs 8 oz at birth, to 9lbs. 4oz in 10 days, so he is definitely thriving. I was concerned at first because he didn't seem to be latching on well & was & still is a sleepy nurser so I never thought he was getting enough. his sister was a "champion nurser" the nurses told me that at the hospital when she was born, so, I shouldn't compare them since she was unusually good at nursing. ds doesn't seem dehydrated or distressed, even when he vomits. he's prone to hiccups though. I think he swallows a lot of air, since his latch is not always perfect then if he doesn't burp, he vomits. so should i consider GERD, or would he be more uncomfortable?


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## 2busy2clean (Feb 3, 2005)

My first born really had some royal barfs after I drank coffee. Of course it took me months to put those two together.







5 years later and I'm still finding milk on things...


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## damselfly41 (Sep 21, 2006)

I just want to say that both of my babies were profuse spitter-uppers, and it lasted several months with both. They were never uncomfortable, gained weight, had normal bm's and all that. Some babies are just that way, I guess.


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## NotTheOnlyOne (Oct 23, 2006)

my ds had pyloric stenosis... it was pretty bad. It did progress slowly though. It started out as spitting up, then got worse over the period of 2 weeks until he was violently throwing up every thing he ate within 30 minutes. It would come out of his nose.... he had surgery the day they diagnosed it (with a U/S) and has been fine ever since. He did NOT gain any weight for the first 3 weeks of his life. He was born 7.15 and at 3 weeks he was 8.1. It was pretty awful, because you could tell he was starving, but he couldnt keep anything down. I am so glad that is behind us now.

ETA: just wanted to say that it can take a while for them to start vomitting every time they eat. The bm/formula sits in their stomach as it is unable to pass through to the intestines. The opening to the small intestine is too small to allow the stomach to empty, but SOME milk gets thorugh. My son would be more likely to vomit if he was eating every two hours, because everything from the feeding before was still in his stomach. But occasionally a feeding would stay down. He was peeing/pooping, just not gaining weight. If your babe is only vomitting once or twice a day, I wouldnt suspect pyloric stenosis yet.. By the time Simon was diagnosed, he was vomitting EVERYTHING he ate.


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## unitytree (Jul 29, 2006)

Our doc thought our ds might have Pyloric stenosis at 2 weeks. (we travelled 2 hours to a hospital to see a pediatrition and get u/s) We went through u/s n'such to thankfully discouver it was not. The doc thought maybe gerd and perscribed ranitidine. The thing with ds was that he would choke BADLEY, seemingly suffocating on his vomit. I would need to suction, prepared to resusitate every time. It was horrifically scary. We decided to try the perscription until I could find a natural alternative. He had 2 doses, which made him sick, that was enough for us!! I watched my diet, cut out coffee, tomatoes and peppers, which he reacted to, made sure not to feed him too much in a sitting, burped him right away. Now he is 5 weeks old and doing great. No more projectile vomiting, no more choking. I stopped sleeping with him on my chest after 4 weeks, I'm okay with him being just beside me now. I've stopped carrying a suction in my pocket and jumping 3 feet into the air any time he makes a wierd sound. Yeah!!! He is a champ nurser and is thriving wonderfully.

Sounds like your babe is similar, gaining well, nursing well. I would suggest adjusting your diet and making sure he doesn't nurse to much in a feed.....DS nurses very often, which I feel is better then a lot at once...for him. Every babe is different though, it'll be a matter of trial and error to discouver what works for you guys!! Good luck, sending healthy baby vibes your way!!


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## aileen (Jan 23, 2006)

hi seahorsie -
i just wanted to say that my dear friend's little boy had PS but that the onset was gradual as the spinctor tightened. most everybody thought he had a virus, he had gained well after birth, but then started losing and vomitting more often until he was keeping nothing down. a trip to the er and mention of PS by my friend didn't result in diagnosis. (this took place over three weeks.) hopefully your little guy is just getting tons and tons of milk, more than he needs, or maybe it is some reflux, but i just wanted to tell you my tiny friends story, in case it progresses. my little buddy thrives and is 3.5.

oh - it looks like stories similar to this have been posted since i read the thread! but i'll send this anyway, mostly to say, good luck to you, mama and baby.


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## DQMama (Mar 21, 2006)

Quote:


Originally Posted by *seahorsie* 
thanks so much everyone - (1 handed typing with ds now) - my letdown is very fierce, and when that happens, ds chokes, otherwise he doesn't. I was surprised to find out that he had gone from 8 lbs 8 oz at birth, to 9lbs. 4oz in 10 days, so he is definitely thriving. I was concerned at first because he didn't seem to be latching on well & was & still is a sleepy nurser so I never thought he was getting enough. his sister was a "champion nurser" the nurses told me that at the hospital when she was born, so, I shouldn't compare them since she was unusually good at nursing. ds doesn't seem dehydrated or distressed, even when he vomits. he's prone to hiccups though. I think he swallows a lot of air, since his latch is not always perfect then if he doesn't burp, he vomits. so should i consider GERD, or would he be more uncomfortable?

Your ds sounds just like my dd whom I posted about above.

I forgot about hiccups too--another GERD symptom. The weird thing is, I think dd had signs of reflux before birth. She used to hiccup so much while I was pregnant that it worried me. I'm talking like 8-9 times a day. And it seemed to upset her--she would thrash around and then calm down once they were over. After birth she would nurse, wait a while, burp and spit up, or projectile vomit if she didn't burp (it shot so far that we got good at keeping our clothes clean), usually three times, and then get the hiccups. Once she got the hiccups we knew the spitting up was over for that feeding.

She also had a terrible latch, swallowed a lot of air, and I had overactive letdown and oversupply. It is possible for these things to cause symptoms of reflux. But it is also possible to have both, which we do (did). Once my oversupply was resolved she still had reflux symptoms and still does to this day (10 months).

Does your ds wake up congested, with a stuffy nose?

Dd has always been a super easygoing baby. She has a great personality and never complains, rarely cries or fusses. But you can have severe reflux without a lot of pain: My aunt was dx'ed w/ reflux last year at age 52. She said she never had heartburn and was never in any pain. She just felt like there was something stuck in her throat all the time. She had severe esophagus damage that was revealed by a GI test so they are sure it's reflux. Interesting. If only our babies could tell us how they're feeling!


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## orangefoot (Oct 8, 2004)

My dd was doing this and bringing up a lot of water like milk (foremilk) sometimes while feeding which was very messy and sometimes a while after. She was choking and coughing on my let down and feeding her was not a calm moment. I was a bit worried because I never had this with my other three

I read this at Kellymom and have been block feeding which seems to have solved the problem. She has only been sick once in the last 2 weeks and it wa 'normal' spit up not like before.


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## hikingmommy (May 10, 2006)

I second what the PP said about block feeding. My DD had terrible projectile spit ups a few times a day before I did this. With block feeding her spit ups were much more bearable!

Jennifer


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## cjanelles (Oct 22, 2005)

My nephew had pyloric stenosis and had the surgery when he was about 5 weeks old.

The surgery was quick and without complications, and he has suffered no after-effects from the condition or the surgery. He's almost 10 now.

What does your pediatrician say?


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## seahorsie (Jul 1, 2003)

Quote:


Originally Posted by *DQMama* 
Your ds sounds just like my dd whom I posted about above.

I forgot about hiccups too--another GERD symptom. The weird thing is, I think dd had signs of reflux before birth. She used to hiccup so much while I was pregnant that it worried me. I'm talking like 8-9 times a day. And it seemed to upset her--she would thrash around and then calm down once they were over. After birth she would nurse, wait a while, burp and spit up, or projectile vomit if she didn't burp (it shot so far that we got good at keeping our clothes clean), usually three times, and then get the hiccups. Once she got the hiccups we knew the spitting up was over for that feeding.

She also had a terrible latch, swallowed a lot of air, and I had overactive letdown and oversupply. It is possible for these things to cause symptoms of reflux. But it is also possible to have both, which we do (did). Once my oversupply was resolved she still had reflux symptoms and still does to this day (10 months).

Does your ds wake up congested, with a stuffy nose?

Dd has always been a super easygoing baby. She has a great personality and never complains, rarely cries or fusses. But you can have severe reflux without a lot of pain: My aunt was dx'ed w/ reflux last year at age 52. She said she never had heartburn and was never in any pain. She just felt like there was something stuck in her throat all the time. She had severe esophagus damage that was revealed by a GI test so they are sure it's reflux. Interesting. If only our babies could tell us how they're feeling!

Yes, ds has a very stuffy nose each night, lungs are clear though. But i thought all newborns tended to have stuffy noses? ds is improving after trying some of the suggestions here... limiting length of feedings, propping him upright, not letting him nurse to sleep without burping... etc. he only had 1 episode yesterday & less severe, & it was my fault - i let him overfeed & fall asleep. he seems to not have any sense of being full, & would nurse forever if he could! lol. i think now that he may just have a few minor mechanical issues to work on & this will pass. thanks mamas!


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