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If your child needs an appointment for any of the following reasons, call the Scheduling Center at 513-636-4415 to schedule an appointment.Pyloric stenosis is the narrowing of the lower portion of the stomach (pylorus) that leads into the small intestine. The muscles in this part of the stomach thicken, narrowing the opening of the pylorus and preventing food from moving from the stomach to the intestine.
This problem typically occurs in infants between two and eight weeks of age and affects one out of every 500 to 1,000 live births.
Since the stomach opening becomes blocked, food cannot move into the intestine. This causes a baby with pyloric stenosis to vomit forcefully after eating. As a result of this vomiting, several problems can arise.
The most serious problem is dehydration (excessive water loss from the body). A baby who vomits regularly will not get enough fluids to meet their nutritional needs.
Also, minerals that the body needs to stay healthy, such as potassium and sodium, are lost through vomiting. Not having the right amount of both water and minerals can cause infants to lose weight and become extremely sick very quickly.
There is no clear cause of pyloric stenosis, though both genetic and environmental factors are thought to be involved. It is known, however, that there is nothing that can be done to prevent its occurrence.
Pyloric stenosis is considered a multifactorial trait, which means that many factors are involved. In many defects with multifactorial traits, one gender is affected more often than the other. For example, pyloric stenosis is four times more common in males than in females.
In families where one child has pyloric stenosis, there is an increased risk that a future brother or sister could also have this condition. Adults who have had pyloric stenosis when they were infants may pass the trait on to their children.
The most common symptom of pyloric stenosis is forceful, projectile vomiting, which is quite different from a "wet burp" that a baby may have at the end of a feeding. The baby is usually quite hungry and eats or nurses eagerly.
Large amounts of breast milk or formula are then vomited and may go several feet across a room. The milk is sometimes curdled in appearance due to the fact that it remains in the stomach where it is exposed to acid.
Careful physical examination generally reveals a firm mass, the size of an olive, in the mid-abdomen. Your child's doctor may advise other diagnostic procedures to confirm the diagnosis and to rule out conditions with symptoms similar to those seen in babies with pyloric stenosis. These procedures include:
Pyloric stenosis is treated in two stages. First, fluids are given intravenously (in the vein) to treat dehydration and restore the body's normal chemistry.
Once this is done, an operation called a pyloromyotomy is performed. This opens up the tight muscle that has caused the narrowing in the stomach, allowing the passage of food from the stomach to the intestine.
This surgery is performed using either an open or laparoscopic surgical approach.
While in the operating room, your baby will receive a pain medicine injected into the incision. This should allow them to feel and appear comfortable for about six to eight hours after surgery. If necessary, you may give acetaminophen (medicine such as Tylenol®) to help ease discomfort.
Nothing should be given by mouth for the first two hours after surgery. Two hours after surgery, home feeds (breast milk or formula) are started. Feedings are continued even if the baby has two to three episodes of vomiting. If vomiting continues, all feedings should be held for two hours, and then restart feedings. The baby may be discharged when three consecutive goal feedings are tolerated. Goal feedings are usually two to four ounces every three hours and based on the amount advised by your child's primary care physician prior to surgery.
Although a baby sometimes vomits for 24 to 48 hours after surgery, this usually disappears without any further treatment. Small amounts of the feeding being spit up is normal. If the baby vomits most or all of their feeding more than two times daily, contact your surgeon.
Your baby's incision should be kept clean and dry, and you should not bathe them in a tub for one week after surgery. The incision may be closed with tissue glue or steri-strips (bandage-like tape). If steri-strips are used, leave them in place and only remove them according to the instructions of your pediatric surgeon. They are generally left in place for seven to 10 days.
There are no long-term effects of surgery, and there is less than a 1% chance that pyloric stenosis will happen again.
Last Updated 08/2025
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