The Fussy Baby Site

Rare Causes of Infant Fussiness

Sick baby laying on floor

Before you read this post, please be assured that the following conditions are extremely rare. In my 7 years of running this site, I’ve only heard from a handful of parents whose babies have been diagnosed with one of these conditions.

That said, always trust your mama instinct, and if you have any doubts, consult with your physician!

Pyloric Stenosis

Pyloric Stenosis is a rare condition in which infants are unable to move food through their digestive system, resulting in severe, and often projectile vomiting.

Pyloric Stenonis affects only around 2 babies in 1000, and more often affects boys than girls. Another name for the condition is infantile hypertrophic pyloric stenosis.

Symptoms of Pyloric Stenosis in Infants

  • Excessive crying and/or screaming, particularly during and after feeding
  • Severe vomiting after feeding (more than ‘normal’ infant spit-up), usually starting around the third week of life
  • Vomiting tends to get worse over time
  • Need to eat soon after a feeding
  • Stomach contractions across the upper abdomen after feeding, but before vomiting
  • Infrequent, small, mucousy, loose or green stools
  • Poor weight gain (though not always)
  • If left untreated, baby may become less active or sleepy, and show other signs of dehydration

What is Pyloric Stenosis?

Pyloric Stenosis is caused by a thickening of the pylorus muscle, resulting in the body’s inability to pass food from the stomach through to the small intestine. The result is that much of the food that is swallowed is forcefully ejected through vomiting.

Treatment for Pyloric Stenosis in Infants

Treatment for Pyloric Stenosis usually involves surgery to increase the opening between the stomach and small intestines. Babies who receive the surgery are generally able to start receiving and processing regular feedings within 24 hours of surgery.

For more information, please read more about Pyloric Stenosis on the Mayo Clinic website.

Intestinal Malrotation

Intestinal Malrotation in infants is an abnormality in the position of the intestines, occuring while still in utero. Nearly half (40%) of cases present within the first week of life, with the majority of the rest of cases being diagnosed before one year of age. Intestinal Malrotation is a serious condition that must be treated with surgery.

What is Intestinal Malrotation?

As the digestive system is being formed in utero, the intestines make a series of moves and turns, starting out as a straight tube from the stomach to the rectum. By the end of the gestational period, the intestines should have made two turns, and ended up in the proper position. When they don’t, the result is Intestinal Malrotation, which can result in a condition called Volvulus. Volvulus is when the intestine is so twisted, the blood supply is cut off, and/or an intestinal blockage occurs.

Symptoms of Intestinal Malrotation in Infants

  • Abdominal distension
  • Vomiting green or yellow bile
  • Pulling up legs
  • Rapid heart rate and breathing
  • bloody stools

If your baby is exhibiting any of these symptoms, it is important that you see a physician immediately. Intestinal Malrotation and Volvulus are serious conditions that must be treated as soon as possible.

For more information, please visit this page on the Boston Children’s Hospital website.

Sandifer’s Syndrome

Perhaps less rare than the two illnesses mentioned above, Sandifer’s Syndrome (or Sandifer Syndrome) is a rare condition that has a high correlation with reflux. It occurs however, in less than 1% of babies with reflux.

Sandifer’s Sydrome is thought to be brought on by the discomfort the baby experiences during digestion due to the reflux.

Symptoms of Sandifer’s Syndrome

While the symptoms of Sandifer’s can be scary for parents to watch, the condition is generally not serious, and will often disappear once the reflux is effectively treated. Symptoms are sometimes mistaken for infantile seizures. Symptoms often occur immediately following a feeding. They include:

  • Arching of the back
  • Sudden rotation of the head and neck to one side, sometimes with the legs rotated to the opposite side
  • Gurgling noises
  • Possible abnormal eye movements
  • Possible vomiting

Episodes generally last 1-3 minutes, and can occur up to 10 times a day. The baby will typically become quiet during an episode, although sometimes fussiness will occur. Fussiness or crying generally occurs after the episode.

This video is a good example of how Sandifer’s can present.


For more information, please see this article on the Living with Reflux website.


Image courtesy of danibabii08 under CC 2.0


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