A 2-month-old baby is brought to the clinic for evaluation of spitting up immediately after every meal. On examination, his abdomen is soft with no hepatosplenomegaly, stool is neg... A 2-month-old baby is brought to the clinic for evaluation of spitting up immediately after every meal. On examination, his abdomen is soft with no hepatosplenomegaly, stool is negative for occult blood, and he is at the 50th percentile for height and weight. His lab results are normal, including Hb, WBC, platelet count and urinalysis. Which of the following is the most appropriate next step in management? A. Oral proton pump inhibitor B. Reassure the parents C. Surgical referral D. Abdominal CT Read more

Understand the Problem

The question describes a 2-month-old infant presenting with spitting up after meals. We need to determine the most appropriate next step in management, based on the limited clinical information and normal lab results provided. The key is to differentiate between normal infant spitting up (GER) and a more serious underlying condition requiring intervention.

More Information

Spitting up is common in infants due to an immature esophageal sphincter. As long as the baby is growing well, has normal lab results, and no other concerning symptoms (like forceful vomiting, blood in stool, or abdominal pain), it's usually a benign issue that resolves with time.

Tips

It is important to rule out more serious causes of spitting up or vomiting, such as pyloric stenosis, but the details in the question make that diagnosis less likely.

Sources

• Spitting up in babies: What's OK, what's not - Mayo Clinic - mayoclinic.org
• Why Babies Spit Up - HealthyChildren.org - healthychildren.org
• Baby Spit-Up: How Much Is Too Much? - University Hospitals - uhhospitals.org