How Does Projectile Vomiting Occur?

Projectile Vomiting

New parents are often frightened when they notice their baby projectile vomiting. It can be an infant's way of showing his disgust with a particular kind of baby food, or it can be a sign of a medical emergency. Projectile vomiting can occur in breast- or bottle-fed babies. This type of vomiting causes the contents of the stomach to be expelled with tremendous force. The vomit travels in an arc shape for several feet. It happens often in infants, but projectile vomiting can occur at any age. Projectile vomiting isn't cause for worry if it only happens occasionally. But for peace of mind, it is advised that you bring up your concerns with your pediatrician. Here are some common causes of projectile vomiting.

Gastroesophageal Reflex

Projectile vomiting isn't a diagnosis but a description of the type of vomiting that is occurring. The most common reason an infant projectile vomits is due to gastroesophageal reflex (GER). A muscle between the esophagus and stomach (sphincter muscle) does not function as well as it should in infants. This muscle is responsible for keeping contents inside the stomach until it empties into the small intestine. The sphincter muscle opens up at the wrong time, causing the contents of the stomach to travel back up to the esophagus. Stomach acid is strong and can irritate the throat and esophagus. Breastfeeding is recommended for infants that have GER. Breast milk is less irritating to the esophagus, because it contains less acid. It also leaves the stomach faster than formula. Breast milk is digested rapidly, so it is less likely to come back up. Treatment is usually not needed. This condition disappears as the baby gets older. Your baby just needs time to grow.

Pyloric Stenosis

Pyloric Stenosis is a serious condition that requires immediate emergency care. The pylorus is located in the lower section of the stomach. Anything the infant eats passes through the pylorus and enters the small intestine. An infant with pyloric stenosis has enlarged muscles in the pylorus, which prevents food from emptying out of the stomach. It is estimated that three out of 1,000 infants in the U.S. are diagnosed with this condition. It is common among male infants and tends to develop 4 to 6 weeks after birth. The infant suffering from this condition will projectile vomit almost immediately after feeding, or may vomit several hours later. Vomit may contain blood, but this is usually rare. Symptoms include constant and uncontrollable crying, difficulty swallowing, refusal to nurse, wheezing and slow weight gain. Dehydration is common because the infant suffers an electrolyte imbalance from the constant loss of fluid. Symptoms and signs show up as the muscles in the pylorus thicken and enlarge. Theories as to why this condition occurs include the effect of maternal hormones on the infant, or perhaps a lack of the receptors in the body that detect nitric oxide. This chemical is needed to tell the pylorus to relax. If these receptors are missing, the pylorus muscle is in constant contraction, thus causing the enlargement. Pyloric Stenosis is usually treated with a surgery called a pyloromyotomy, which cuts through the enlarged muscles to relieve the obstruction.

Danger Associated with Vomiting

Infants can dehydrate easily when they vomit continuously. This risk increases when the child has a fever and/or diarrhea. Repeated vomiting that is severe can cause injury to the esophagus and stomach, which could lead to internal bleeding or shock. Vomiting that occurs daily and continues for long periods of time can wreak havoc on an infant's metabolism. His growth rate can be affected, and he may have difficulty gaining weight. Vomit can also aspirate into the infant's lungs, which could cause pneumonia.