🍼🧡 Gastroschisis in Babies: A Parent-Friendly Guide

✅ Gastroschisis is a condition a baby is born with where the intestines develop outside the belly through a small opening near the belly button.
It is not caused by anything a parent did, and it is treatable with surgery.
Babies usually need a NICU stay, careful feeding support, and close follow-up.

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Condition name: Gastroschisis
Common names: Intestines outside the abdomen at birth

Plain-language summary (2–3 lines):
In gastroschisis, the abdominal wall does not fully close during pregnancy, and the baby’s intestines come out through a small opening. Surgery places the intestines back inside and closes the opening. Recovery takes time because the bowel often needs time to “wake up” and work normally.

Who it affects (typical ages):
Present at birth and often diagnosed during pregnancy ultrasound.

✅ What parents should do today:

• If diagnosed during pregnancy: meet the neonatal surgery team and plan delivery at the right hospital
• After birth: expect NICU care and gradual feeding
• Ask about expected timeline and feeding plan
• Learn signs of bowel problems after discharge

⚠️ Red flags that need urgent/ER care after discharge:

• Green vomiting (bilious vomiting)
• Bloated belly with poor feeding
• Blood in stool
• Fever or extreme sleepiness

🟡 When to see the family doctor/clinic:

• Slow weight gain
• Reflux/vomiting concerns
• Constipation or diarrhea problems
• Wound redness or drainage (post-op)

2) 🧠 What it is (plain language)

During pregnancy, a baby’s belly wall normally closes around the organs.

In gastroschisis:

• a small opening remains (usually just to the right of the belly button)
• intestines are outside the belly in the amniotic fluid
• intestines may become swollen or irritated

What part of the body is involved? (small diagram required)

Common myths vs facts

• Myth: “I caused this during pregnancy.”
  Fact: Parents do not cause gastroschisis; it happens during early development.
• Myth: “This means the baby will not survive.”
  Fact: Many babies do very well with modern surgical and NICU care.
• Myth: “After surgery, everything becomes normal immediately.”
  Fact: The bowel often needs days to weeks to start working normally.

3) 🧩 Why it happens (causes & triggers)

Cause

• Not fully known
• Occurs during early fetal development of the abdominal wall

Risk factors (associations, not blame)

• younger maternal age has been associated in population studies
• other factors may play a role, but no single cause

Triggers that worsen bowel irritation

• exposure of bowel to amniotic fluid (before birth)
• swelling and slow bowel movement after birth

4) 👀 What parents might notice (symptoms)

At birth

• intestines visible outside the abdomen
• baby needs immediate stabilization and protection of exposed bowel

During recovery

• feeding intolerance
• vomiting
• slow bowel movement (delayed stooling)
• abdominal distension

After discharge (possible ongoing issues)

• reflux or vomiting
• constipation
• slow growth (some babies)
• adhesions or obstruction risk (rare but important)

Symptom tracker

• feeding amounts
• vomiting (especially green)
• stool frequency and consistency
• belly size changes
• weight gain

5) 🏠 Home care and what helps (step-by-step)

✅ Gastroschisis is treated surgically; home care focuses on feeding, growth, and early detection of bowel obstruction.

First 24–48 hours after birth (what to expect)

✅ Do this now:

• baby goes to NICU
• intestines are protected (covered) to reduce heat/fluid loss
• IV fluids and antibiotics may be used
• surgery plan discussed:
  • primary closure (one surgery) or
  • staged closure with a “silo” (gradual reduction)

After surgery: early recovery

• feeding starts slowly once bowel begins moving
• may need IV nutrition temporarily
• careful pain control

After discharge: home support

• feed as advised (sometimes higher-calorie feeds)
• keep follow-up appointments
• watch for obstruction symptoms (green vomiting, bloating)

6) ⛔ What NOT to do (common mistakes)

• Don’t ignore green vomiting.
• Don’t force feeds when baby is repeatedly vomiting.
• Don’t miss follow-up visits; growth monitoring is essential.
• Don’t assume constipation is always “normal” after surgery—pattern matters.

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

• baby very floppy/unresponsive
• trouble breathing
• signs of shock (cold, pale, weak)

🟠 Same-day urgent visit

• green (bilious) vomiting
• bloated belly + poor feeding
• blood in stool
• fever in a young infant

Example: “My baby vomited green and belly is swollen.”

🟡 Book a routine appointment

• reflux/vomiting that is not green
• slow weight gain
• constipation or feeding concerns

🟢 Watch at home

• stable feeding, normal stools, good weight gain, no red flags

8) 🩺 How doctors diagnose it (what to expect)

During pregnancy

• ultrasound often detects gastroschisis
• monitoring of growth and amniotic fluid

After birth

• visible diagnosis immediately
• imaging may be used if concerns about bowel obstruction or complications

What doctors will monitor closely

• bowel function return
• ability to tolerate feeds
• growth and nutrition
• infection signs

9) 🧰 Treatment options

✅ Main treatment is surgery + supportive NICU care.

First-line treatment

• surgical repair (primary closure or silo + closure)
• IV fluids and warming
• antibiotics (often initially)
• gradual feeding progression
• IV nutrition if bowel is slow to wake up

If not improving (next steps)

• evaluate for bowel narrowing, dysmotility, or obstruction
• adjust feeding and nutrition plan
• sometimes additional surgery if obstruction/complications occur

Severe cases

• short bowel syndrome (if bowel damage is extensive—less common)
• prolonged parenteral nutrition support

10) ⏳ Expected course & prognosis

Typical timeline (varies a lot)

• NICU stay often weeks
• feeding progression can be slow
• many babies eventually feed by mouth normally, but some need support longer

What “getting better” looks like

• less bloating
• feeds tolerated better
• stools become regular
• steady weight gain

What “getting worse” looks like

• worsening vomiting (especially green)
• increasing belly swelling
• dehydration
• fever

11) ⚠️ Complications (brief but clear)

Common challenges

• feeding intolerance early
• reflux
• slow growth

Rare but serious complications

• bowel obstruction (adhesions)
• bowel narrowing/stricture
• infection
• short bowel syndrome (if bowel damage)

12) 🛡️ Prevention and reducing future episodes

Gastroschisis cannot be prevented once it occurs, but outcomes improve with:

• delivery at a specialized center
• careful feeding support
• prompt evaluation of vomiting or bloating
• consistent growth monitoring

13) 🌟 Special situations

Premature infants

May have additional feeding and growth challenges.

Infants with prolonged IV nutrition

Need careful monitoring for liver and line complications (team-guided).

Neurodevelopmental differences

Not typical early on, but long NICU stays may need developmental follow-up.

Travel considerations

Avoid travel early after discharge until feeds and stools are stable.

School/daycare notes

Not relevant for infancy; later may need ongoing nutritional support.

14) 📅 Follow-up plan

• pediatric surgery follow-up (wound and abdominal wall healing)
• pediatrician growth monitoring
• nutrition/dietitian support if needed
• GI follow-up if persistent feeding issues or reflux

15) ❓ Parent FAQs

“Is it contagious?”

No.

“Can my child eat ___?”

Most babies can feed normally over time, but some need higher-calorie feeds or gradual progression.

“Can they bathe/swim/exercise?”

Bathing depends on incision healing and surgeon instructions. Swimming later is usually fine.

“Will they outgrow it?”

The defect is repaired, but some children may have ongoing feeding or bowel sensitivity.

“When can we stop treatment?”

Follow-ups continue until growth and bowel function are stable.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: Gastroschisis One-Page Action Plan

Daily at home:

• Track feeds and wet diapers
• Track vomiting (especially green)
• Track stools and belly size
• Weekly weight checks (as advised)

Call clinic if:

• poor weight gain
• frequent vomiting (not green)
• constipation pattern changes

Urgent/ER if:

• green vomiting
• bloated belly + poor feeding
• blood in stool
• fever or lethargy

🧾 Printable: Feeding & Stool Tracker

Date: ______

• Feeds (amount): ______
• Vomiting: none / small / large / green
• Stools: ______
• Belly: normal / mildly bloated / very bloated
• Wet diapers: ______

🧾 Printable: “Red Flags” Fridge Sheet

⚠️ Urgent: green vomiting, swollen belly, blood in stool, fever, very sleepy baby.

17) 📚 Credible sources + last updated date

Trusted references:

• Children’s hospital pediatric surgery gastroschisis guides
• Neonatal surgical care resources from pediatric centers

Last reviewed/updated on: 2025-12-30
Local surgical approaches and feeding timelines may differ.

🧡 Safety disclaimer

This guide supports—not replaces—medical care. If you are worried about your child, trust your instincts and seek urgent medical assessment.

This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings.

To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca
In the email subject, please write: New Assessment Appointment with Dr. Hussein

Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP