Pyloric Stenosis

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Pyloric Stenosis

Picture 1 Pyloric stenosis can be corrected with surgery

Pyloric stenosis (pie LORE ick sten OH sis) is caused by the thickening of the muscle between the stomach and the small intestine (Picture 1). It is common in infants. The muscle tightens around the opening from the stomach to the small intestine and makes the opening very narrow. This makes it hard for food to pass out of the stomach into the small intestine and vomiting occurs.  Pyloric stenosis can be corrected with surgery.  During surgery the muscle is loosened so food can pass easily out of the stomach and into the small intestine. You can ask your baby’s doctor about the different kinds of surgery available, as well as alternate treatment. The surgery can be done by the open or laparoscopic technique, but recovery from surgery and overall outcomes are the same for both methods.  Your surgeon will discuss the method he or she feels is safest for your child.

Before Surgery

  • An IV will be started. Your baby will receive the needed fluids through the IV. (See the Helping Hand:  IV Therapy, HH-II-17.)  Lab tests may be done to make sure the baby is not dehydrated (dried out).
  • Your baby will have a nasogastric (NG) tube put in, usually about one hour before surgery. This tube is placed into his nose and goes down into the stomach. The NG tube is connected to a suction machine that helps keep the stomach empty.
  • If your baby had a test with barium (a UGI test), the NG tube may need to be placed earlier. This allows the barium to be washed out of the stomach before surgery.
  • Your baby will not be allowed to have a bottle or be breast-fed before surgery.  You may give your baby a pacifier.

If you are breast-feeding, you can pump your milk. We will help you store the milk until your baby is ready to start feeding after surgery.

After Surgery

  • Your baby’s stomach needs rest for 6 to 8 hours after surgery, following which the baby will be given half an ounce of Pedialyte®, to be followed by breast milk or formula.
  • Your baby will be on a strict feeding schedule while still in the hospital. We begin with half an ounce of feeds and gradually build up until your baby can take 2 ounces. Fluids will be given through an IV until the baby is getting enough nutrition by mouth
  • Your baby’s nurse or doctor will tell you when you may begin to breast-feed your baby. (See Feeding Your Baby, below). You may be asked to feed your baby while a nurse watches.  This is to ensure the right feeding technique.
  • Your baby may vomit the first few feedings after surgery.  Be sure to tell your nurse if this happens.  The feeding schedule may change if your baby vomits.  Do not be discouraged if your baby vomits during this early recovery period. The stomach needs a little time to return to normal.

Feeding Your Baby

  • Don’t rock or swing your baby for 7 days after surgery. Rocking or swinging could make the baby vomit.
  • Gently burp your baby after each ounce of formula or several times during breast-feeding.
  • After feeding your baby, hold him upright for 15 minutes to help prevent vomiting, then place baby on his back with his head slightly raised.
  • Your doctor or nurse will give you a schedule for feeding your baby at home. It is very important to follow this schedule for the first 10 days after surgery.

Care at Home

  • Be sure to practice safe sleeping practices at home. See the Helping Hand: Safe Sleep Practices for Babies, HH-IV-69.
  • A small dressing covered by clear tape is often used. This may be removed later at the follow-up visit or allowed to peel off on its own. If skin glue has been used, it will fall off by itself.
  • Keep the incision or the dressing clean and dry for 7 days after surgery.  Give your baby a sponge bath instead of a tub bath.
  • The stitches are under the skin and cannott be seen. They will dissolve in several weeks. They do not need to be removed.

When to Call Your Doctor

Call your child's doctor if you notice:

  • Swelling of the abdomen Underarm temperature over 101 degrees F
  • Baby becomes very irritable. Baby seems to have increasing pain.
  • Signs of infection around the incision – drainage or pus, odor, redness or swelling.
  • Baby continues to vomit.
  • Baby refuses to eat.

Follow-Up Appointment

Your child's follow-up appointment is scheduled with:

Dr. (phone) on (date) at (time)   If you cannot keep this appointment, please call and reschedule.

If you have any questions, please call .

HH-I-118 Pyloric Stenosis (PDF) 10/88, Revised 7/13 Copyright 1988, Nationwide Children’s Hospital

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000