ABSTRACT
A 6-week-old female with Down syndrome presents to the emergency department with a 2-day history of bilious emesis. The baby was born at 37 weeks of gestation to a 35-year-old G1P1 mother who had a normal prenatal ultrasound at 20 weeks of gestation. She tolerated breast feedings well during the first month of life, but started vomiting soon after formula feedings were added. During the last two days, vomiting occurred after each feeding and between feedings and has been consistently green. She has continued to pass stool and urine.
