Spitting up is a very common occurrence in newborns as well as infants. The baby regurgitates some milk after nursing either immediately thereafter or some time later. It may be that the baby nursed too much and then rids itself of the excess by spitting copiously. When eating voraciously, the baby also swallows a great amount of air and when the air is leaving the body, it pushes the food along with it outward.
At this age, the immaturity and improperly functioning muscle located where the cardiac orifice and the eosophagus meet may also cause spitting up. Healthy babies, though, develop wonderfully, are well balanced and happy in spite of spitting up. No radiological examination is warranted in these instances. The mother should be informed properly and reassured.
In the case of reflux (GER), the stomach contents passively return into the oesophagus. This is a far more serious form of spitting up. The reflux babies usually do not gain weight properly, may even lose weight and the baby may cough excessively during feedings. The acidic contents of the stomach brought up may cause damage to the mucous lining of the oesophagus and reflux may also be the cause of frequent middle ear infection. If you notice similar symptoms, consult a physician who, if indicated, will refer the infant to a gastroenterologist. Another reason for the examination is that GER may also be the cause of infant sudden death.
Stomach ultrasound is excellent for examining the cardiac orifice and for determining the extent of the reflux. The examination is painless and does not cause discomfort to the baby.
Vomiting, on the other hand, occurs when the stomach contents are projected outward with great force. If this occurs often, especially, in the presence of symptoms such as fever, dejection and sleepiness, the baby should be taken to a pediatrician.
If a 4-6 week old baby projectile vomits regularly, feeds with difficulty, does not gain weight, has a worrisome face, cries and fusses a lot then, narrowing of the passage between the stomach and the small intestine (pyloric stenosis) should be considered. This is most prevalent in male infant.
While examining the stomach, we also examine the liver, the gall bladder, the spleen, the pancreas and the pelvic organs allowing us to discover abnormalities and diseases that require treatment or regular monitoring such as dilatation of the renal cavity system and the ureter and cystic kidney disease. Reflux is very easily examined in infants as is pyloric stenosis easily diagnosed.
No advance preparation is required for infant ultrasound; however, it might help the examination if the baby nurses beforehand. Also, a reflux examination requires a full stomach.