How to Deal With A Vomiting Toddler

A Pediatrician Weighs in on What Parents Should Do

Sick toddler
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Q. I have a son who is 16 months old. He throws up all the time: on average, once a week. Sometimes he throws up several times a week. My doctor says that he has an oversensitive gag reflex. I wasn't satisfied with this response. Sometimes he has too much food in his mouth and throws up, but other times he has nothing in his mouth. He doesn't appear to be feeling ill otherwise. This has been going on for four to six months now. It is so incredibly frustrating. Why does he do this and how can I help him not throw up? —Nicole; Whitby, Ontario

A. The fact that your son's throwing up has been going on for so long, happens only occasionally, and that he otherwise seems well, are all very good signs that this isn't something more serious or that your doctor is missing something. 

Although I'm sure that it seems like a lot to you, once a week or even two to three times a week, isn't really 'all the time.' Most people would consider 'all the time' to mean several times a day.

Keep in mind that this is a common occurrence in younger children. Some toddlers vomit when having a tantrum or just crying. Others vomit when they have too much food in their mouth. And some vomit for no known reason at all.

What Could Be Causing Vomiting in a Toddler

Since your son's episodes are so infrequent, it likely isn't simple reflux. But here are some other possible causes: 

  • Sensitive gag reflex. He may, indeed, have a sensitive gag reflex, as your child's pediatrician suggested.
  • Food allergy or allergy or intolerance might be another cause, especially if you can link the vomiting to a specific thing that he is eating.
  • Delayed gastric emptying. Children with delayed gastric emptying have slower gastric emptying times than other children. That means that the things that they eat and drink stay in their stomach longer and explains why they may vomit the previous night's dinner the next morning. This condition is sometimes treated with the medication Reglan, although many parents report that their children have side effects when taking it. Another option is the antibiotic erythromycin, which increases gastric emptying time.

    What a Parent Can Do to Help Prevent a Toddler From Vomiting

    • Ask about testing. Ask your child's pediatrician if it's a good idea for some further testing to be done, like an upper-GI series barium x-ray. During this type of exam, the child swallows a liquid that contains barium, which spreads onto the walls of the esophagus and stomach. This coating then shows up on an x-ray and enables a doctor to look for any abnormalities, like strictures, ulcers, hiatal hernias, erosions, or tumors. 
    • Keep a symptom diary. This is where you record the date and time that he vomits, what he was doing just before it happened (like eating or crying), what he last had to eat and drink, and the date and time of his last feeding. 
    • Get a second opinion. If you are not comfortable with what your kid's pediatrician is saying, you might consider getting a second opinion from a pediatric gastroenterologist. Warning signs that would make a second opinion even more important include if he isn't gaining weight well or is losing weight, is often fussy, isn't developing normally, or if his symptoms begin occurring more often.

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