Certified Pediatric Nurse (CPN)

What symptom reported by a parent would most likely lead to a suspicion of pyloric stenosis in an infant?

1. My baby spits up a little after every feeding

2. My baby vomits clear fluid before the next feeding

3. When my baby vomits, it is forceful and has bile

4. My baby still wants to eat right after he vomits

The correct answer is: My baby still wants to eat right after he vomits

The symptom most indicative of pyloric stenosis is the report that the baby still wants to eat right after vomiting. Pyloric stenosis is characterized by the narrowing of the pylorus, which leads to obstruction and prevents food from passing from the stomach into the small intestine. Infants with this condition often display an intense appetite and may immediately seek to feed again after vomiting, as they continue to feel hungry despite the vomiting. The other symptoms listed can occur for various reasons and are not specific to pyloric stenosis. For instance, spitting up after feeding can be common in many healthy infants and is not necessarily alarming. Vomiting clear fluid might suggest other gastrointestinal issues but does not directly indicate pyloric stenosis. Furthermore, the presence of forceful vomiting that includes bile, while concerning, is often associated with other conditions such as intestinal obstruction, but the key characteristic of pyloric stenosis is the persistent hunger and immediate desire to eat after vomiting.