In this condition the muscle around the stomach outlet becomes thick; because of this milk cannot pass across and a blockage results. It typically affects babies 4-6 wks after birth. The exact cause of this problem is not known. But it is known to run in families affecting mainly the first male child.
Why are the symptoms ?
The baby starts to vomit feeds around 4 weeks after delivery. It gradually becomes forceful. The vomit contains milk or curdled milk mainly. As there is no vomiting and no milk absorption, there is less urine, and less stools. Also the baby gets dehydrated and loses weight.
How is it diagnosed ?
When the baby is examined during a feed, one can see the stomach pushing hard to empty; also the muscle thickening can be felt as a mass. Ultrasound scan helps to confirm the diagnosis.
What is the treatment ?
The baby needs to be admitted for IV fluids and correction of abnormalities in salt content of the body, which is often present because of vomiting. After this a surgery called 'pyloromyotomy' is required. Under general anaesthesia, through a small cut in the tummy, the muscle fibres blocking stomach outlet are divided.
What is the outcome ?
Generally this surgery has a success rate of 98%. Babies can start feeds next day. Wound infection and poor healing resulting in a hernia are some of the well known complications. Complications like perforation, recurrence of the problem are extremely rare.
