Because of their immature digestive systems, it is not uncommon for newborns to spit up after feedings. When a newborn spits up, it is usually a small amount of the feeding, and it usually just rolls out of the baby’s mouth. Projectile vomiting is quite different from spitting up. When a newborn projectile vomits, the stomach contents are ejected from the stomach with such force that the vomit can travel several feet, often hitting the wall or a piece of furniture, not mom or baby.
Projectile vomiting can be scary for a new parent, and it is messy, too. So, when do you need to be concerned if your newborn projectile vomits? If the projectile vomiting is a one-time occurrence, there is usually nothing to worry about. The baby may have fed too fast or eaten too much, or a pocket of the feeding got trapped on top of a big gas bubble. However, if your baby begins to projectile vomit after every feeding, then it is time to see your pediatrician, as your baby may have a condition known as pyloric stenosis.
Pyloric stenosis is a condition in which the muscle between the outlet of the stomach and the small intestine thickens to the degree that it creates a blockage that will allow little, or none, of the stomach contents into the small intestine. Because the stomach contents have no place to go but back out the way they came in, the baby projectile vomits, usually right after a feeding, or even during a feeding. Pyloric stenosis usually begins to make its appearance in a newborn right around the age of four weeks.
Aside from the projectile vomiting, which is hard to miss, your baby may also begin to seem hungry all of the time, because the baby is not keeping much of a feeding down. Also, despite feeding this hungry baby more to meet his or her demands, the baby may begin to look thin, or fail to gain weight because he or she is vomiting up most of his or her food. If this is happening to your baby, your pediatrician will check to see of your baby has pyloric stenosis.
The doctor will begin by taking a medical history of the baby to see how often he is vomiting, and if it is, indeed, projectile vomiting. The doctor will weigh the baby to see if he or she is gaining weight and will examine the baby’s abdomen at a time when the baby is relaxed, to see if there is a small knot, about the size of an olive, in the baby’s tummy where the stomach and lower intestines meet. This knot is the thickened muscle that is restricting the flow of stomach contents into the small intestine.
Treatment of pyloric stenosis requires a small surgery, in which the surgeon cuts the thickened muscle to release the obstruction. Once the surgery is completed, your baby should be able to feed normally in a very short time and will begin to gain weight with no lasting effects from the pyloric stenosis. Pediatric surgeons have a great deal of experience in treating pyloric stenosis, so your baby will almost certainly be in good hands, and back in your arms, feeding happily, in the blink of an eye.
“Projectile Vomiting in a Baby,” Baby Medical Questions and Answers.