Differential Diagnosis for 2-Week-Old with Non-Forceful Vomiting after Feeding
Single Most Likely Diagnosis
- Gastroesophageal Reflux (GER): This is the most common cause of vomiting in infants, especially after feeding. It occurs when stomach acid flows back into the esophagus, causing discomfort and vomiting. The non-forceful nature of the vomiting and its association with feeding make GER a likely diagnosis.
Other Likely Diagnoses
- Overfeeding or Incorrect Feeding Technique: Overfeeding or using an incorrect feeding technique can lead to vomiting in infants. This is because the stomach can become overwhelmed, leading to regurgitation of milk.
- Milk Protein Allergy or Intolerance: Some infants may have an allergy or intolerance to proteins in milk (such as cow's milk), leading to vomiting after feeding.
- Infection (e.g., Urinary Tract Infection, Gastroenteritis): Although less common in this age group without other symptoms, infections can cause vomiting in infants.
Do Not Miss Diagnoses
- Pyloric Stenosis: Although typically presents with forceful vomiting, it's crucial not to miss this condition. Pyloric stenosis is a narrowing of the pylorus, the opening from the stomach into the small intestine, which can lead to severe vomiting and dehydration if not treated.
- Intestinal Obstruction: Any condition that causes a blockage in the intestines can lead to vomiting. This is a medical emergency and requires immediate attention.
- Congenital Heart Disease: Some congenital heart defects can present with feeding difficulties and vomiting due to decreased cardiac output and increased energy expenditure during feeding.
Rare Diagnoses
- Metabolic Disorders: Certain metabolic disorders can cause vomiting in infants, such as disorders of amino acid metabolism.
- Food Allergies (other than milk protein): While less common, allergies to other foods can cause gastrointestinal symptoms, including vomiting.
- Anatomical Abnormalities (e.g., Esophageal Atresia, Tracheoesophageal Fistula): These conditions are typically identified shortly after birth but can occasionally present later with vomiting among other symptoms.