my five year old keeps throwing up!

August 17, 2010 7:24 PM

Why is my five-year-old vomiting constantly? And what do I do?

I know YANAD. Just looking for some hive support. We have seen pediatrician and all that, who seems less concerned than I am.

My son, 5yo, has been throwing up with increasing frequency over the past week. Started with once every other day for a few days, then couple times in one day, then a day off, then a couple times the next day, and now -- the past 36 hours -- it's pretty much everything he eats. He managed to keep crackers down this morning, the first meal in 36 hours. Otherwise practically everything -- including Pedialyte -- comes back up.

He had some better luck with a bit of liquid today too.

Other than that: zero symptoms. No fever. No loss of energy. Increasing appetite. He is back to "normal" as soon as he's done vomiting.

Any reasons I should be more or less concerned than the doctor or I am, respectively? Any other commentary? Thanks.

posted by johnchristopher to health & fitness (25 answers total)

See a different doctor, if possible.

What was the first doctor's diagnosis?
posted by Neale at 7:27 PM on August 17, 2010

Seconding getting a second opinion. Consistent, repeated fluid loss in a child is not a good thing, and the situation is worsening.
posted by pecanpies at 7:37 PM on August 17, 2010 [2 favorites]

When did you most recently speak to your doctor?
posted by alms at 7:40 PM on August 17, 2010

Even if your doctor is right and this isn't worrisome, your doctor needs to tell you what is going on. So you need to see another doctor, if only because this doctor isn't telling you what's going on.

Just vomiting? No diarrhea? No fever, and you're not giving him anti-febriles? And no loss of energy, but he hasn't eaten in 36 hours? IANAD, of course, but I can't make heads or tails of it.

Well, I guess that's not true, I did some quick googling and uncovered this: Cyclic Vomiting Syndrome -- and since it's considered a pediatric disease, this might be what your doctor was thinking about?

Anyhow, I stand by my statement that you need a doctor who will be able to answer your questions and tell you why she isn't worried.
posted by Made of Star Stuff at 7:44 PM on August 17, 2010 [1 favorite]

Saw dr this afternoon. Consulted with another pediatrician as well over past two days. Both are of belief this is some random bug -- though lack of any symptoms to me makes it hard to buy off on -- and has likely irritated his stomach lining, etc., thus making vomiting "easier" (my own words here).
posted by johnchristopher at 7:48 PM on August 17, 2010

i have an incredibly weak stomach. a case of needing to poop or having sinus drainage can start my morning off with throwing up. it was way, way worse when i was a kid. i'm not sure which i took, but we kept anti-nausea suppositories around for i just couldn't stop puking. i'm pretty sure you can get them OTC, but call the nurse and ask for a recommendation.

how much pedialyte is he getting? last time i was super sick (see my ask.me history for details) i got to the point where i had to drink a water/gatorade mixture a teaspoon at a time every 10 minutes, no more. i also like freezing my water/gatorade mixtures to suck on when i can't keep anything down.
posted by nadawi at 8:05 PM on August 17, 2010

When I was a kid, one legitimate puking moment would often spur on another day or two of random puking. Especially if the first time was due to an ear issue (including altitude sickness and motion sickness) or mild food poisoning/reaction. I typically spent one and a half days throwing up every single time I went to summer camp; it always resolved itself on the second morning. The same thing happens now, but I'm very cautious about what I do and have only had it happen one time in the last five years. I definitely agree its easier to keep puking once you start.

I'd give it one more day if they say to and he shows no signs of dehydration. Then it's time to ask for intervention anyway - I never needed a saline drip for this issue till I was an adult, but they seemed to be eager to start one as soon as they did any tests at all. By the time I was fully hydrated and the meds had set in, the puking chain was broken - that was a fun weekend, and I am now thinking of trying boxed mac and cheese again, two years later.
posted by SMPA at 8:05 PM on August 17, 2010

and to echo SMPA, once i start puking it is really, really hard to stop. earlier this week i threw up 3 times in one day because i gagged on a cough first thing. the other two puking incidents were just because they wanted to join the party, i guess.
posted by nadawi at 8:08 PM on August 17, 2010

Nthing waiting it out until tomorrow and calling the doctor again (with the caveat that if his situation gets way worse in an hour, say, call the doctor IMMEDIATELY because things changed). I'd also avoid giving him food, or at least too much food, until the situation is under control. If he asks for food, think bland and white -- rice, a couple crackers -- and only a little. As for beverages, ginger ale is a classic "I've been sick" beverage -- the fizz helps settle the stomach, as does the ginger. He can live without Pedialyte for a night.

And to add an anecdotal story that may reassure you about this -- I was your kid once, when I was about six; I had this one weird random stomach bug that made me throw up a whole hell of a lot until i was actually throwing up bile (my mother was a nervous wreck, but I was all, "...huh, I threw up something green. That's new").

My doctor was also nervous, and had me admitted to the hospital overnight with an IV -- and the next morning I was totally fine. We never found out what it was above and beyond "a really nasty bug", and today my mother says that in hindsight she thinks my doctor overreacted a tiny bit. But I bounced back really quick.

The only other thing I can think of that would cause that frequent vomiting is food poisoning, but I don't think you'd have had those first couple days of vomiting as well -- both times I had food poisoning it was a sudden onset and a quick process; I ate hellfood, and then two hours later BAM -- I was throwing up every twenty minutes for the next 3 hours (and then both throwing up AND having the runs for another 2 hours after that), and then after a few hours of total hell it just stopped and I slept for 12 hours straight. IANAD, but I've heard that's kind of typical of food poisoning, so since you say he was throwing up a little before this my hunch is that it's not that.
posted by EmpressCallipygos at 8:21 PM on August 17, 2010

IANYD but the only concerning thing to me is the fact that it's worsening. Something to keep an eye on but not necessarily to panic about.

I would ask your doctor about Zofran ODTs to use while taking the wait and see route. Highly recommended in cases like this where the main issue is vomiting and wanting to prevent dehydration or necessitation of IV fluids that is no fun for the child. Zofran is a prescription anti-emetic (generic: ondansetron) that tends to work quite well and have few side effects. ODT stands for oral disintegrating tablet, and basically this thing just melts in your mouth which is perfect for when you (or your child) can't keep anything down. It can be expensive but I usually just prescribe 3 or 4 tabs, enough to get through the "bad bug" stage.

Generally the only thing we do for kids like this in the ER is keep them around until they either drink or eat a popsicle. Which they almost inevitably will do cheerfully and promptly once you have waited hours and had to suffer through the pain of the middle of the night ER visit. :-)

If other things develop like abdominal pain etc then of course you adjust your level of concern accordingly.
p.s. Cyclic Vomiting Syndrome is a long term chronic thing, not an acute, weeklong thing.
posted by treehorn+bunny at 8:29 PM on August 17, 2010 [2 favorites]

If you're really desperate to get some liquid into him, you can freeze Pedialyte into ice pops. Sometimes that helps.
posted by Sallyfur at 8:34 PM on August 17, 2010

OK. Our pediatrician is awesome - attentive, patient, kind, fun, smart and takes the time to explain what's going on.

The LPN in her office? Oh, christ.

Our baby had a vicious and recurring cough, neon-green boogies, and awful mucus-on-the-eyeball thing going on. We went back to the office three times for this over the course of two months, and were made to feel like idiots for it by the LPN. Meanwhile, she also accused us of starving her, because she's at 20th percentile for her age in weight. (The little one "Eats like a trucker, only more!" according to the people at her daycare.)

Finally, at the fourth visit, I lost my cool, and demanded to see the pediatrician, and not the LPN.

1) Baby is in the top 97th percentile for length (height), and is plump where she should be, and lean where she should be. Just tall and skinny, we should all be so cursed, chuckled the doc, who could pass for a hobbit housewife.

2) Massively bad sinus infection, here's a scrip for a ten-day course of super-bug-kill. It absolutely worked - no more cough, no more cloudy eyes in the morning, no more boogies everyday, no more wet, panicked wheezing in the middle of the night.

In short:

SECOND OPINION. NOW. HOSPITAL IF YOU HAVE TO. GO!!!
posted by Slap*Happy at 8:37 PM on August 17, 2010 [1 favorite]

Serious - that's one weird set of symtoms. If a kid is sick, he is sick - yarfing is part of the package. If the yarf is on its own, without the sleepy, weary, achy, clingy, whiny, cranky-sick-kid-stuff, man, just get to the hospital, 'k? This may be bad advice, but I feel good giving it.
posted by Slap*Happy at 8:47 PM on August 17, 2010

Sometimes when kids get a stomach bug, they will just keep on vomiting. It's like they get used to it and simply can't stop. At that point you need something to end the cycle. Phenergan is the drug that worked for mine; however, they were a bit older (9-ish I think) at the time. You need a prescription; call up your doctor and ask about it. It comes in a suppository which is the only way, at this point, a drug is going to work. With my children and with me on one of those everybody has the stomach flu go rounds, once you take it you sleep for 12 hours and it breaks the vomiting cycle: when you wake up you're fine.
posted by mygothlaundry at 9:01 PM on August 17, 2010

Just a note on Phenergan, I've got nothing against it and think it is a good drug under the right circumstances (which can include suppositories for vomiting), but Zofran is preferred in the younger age groups these days and in fact, really the only thing you can use in age 2 and under - Phenergan now carries an FDA warning for children this age that it can produce respiratory depression and death. I'd be squeamish about using it in kids older than 2 as well just because of the severity of the side effects and the availability of the safer alternative.

Reglan and Compazine are the other, similar older common anti-emetics. Fine drugs for adults but they do have potential side effects that make some people really hate them, and I consider Zofran far more reliable.
posted by treehorn+bunny at 9:19 PM on August 17, 2010

thanks for the continued responses. many are helpful, at least to give me more and varied perspective. really appreciate.

treehorn+bunny I appreciate the medical viewpoint, though for the MeFi record you are not my (nor my son's) doctor. However you seem to mirror the advice of the two we've spoken to -- to that end we did receive a scrip for a handful of ondansetron (not Phenergan, tho thanks for that as well) that we are saving for tomorrow morning. Right now he's kept down 3/4 cup of dry cereal for 20 minutes which perhaps is as good a sign as any for the night. (We gave him a Tums prior to and told him it was medicine to help goose a placebo effect.)

We may solicit a second/third opinion tomorrow however. Doctors are standing by. For those who pointed out dehydration and such, he remains energetic and can still pee a healthy amount. So he's obviously not throwing up all of the liquid he's taking in.

i'll update later in case folks remain interested. thank you again for the responses. i really appreciate your taking the time to contribute.
posted by johnchristopher at 9:39 PM on August 17, 2010 [1 favorite]

It might very well be something else with your son (especially if he's only throwing up once or twice each episode), but when I was a teenager I had about a year and a half of my life when it was like a switch was turned on every couple of months and I'd just throw up for an entire day (first the food I'd last eaten, then the water I tried to drink after vomiting the first time, and then bile, sometimes a few times). I'd feel better briefly immediately after vomiting, but then I'd start feeling terrible again a couple of hours later. I went to the emergency room several times and saw a gastroenterologist repeatedly, and the closest thing they could give me for a diagnosis was Cyclic Vomiting Syndrome (which a few people have linked to above). The good news is that it magically went away on its own eventually, and now I only throw up at appropriate times (stomach flu, etc.). The bad news is that it was really disruptive to my life and the lives of my loved ones who had to take me to the hospital, plus it was terrifying. You should definitely find a doctor who will take this seriously-- there might not be anything he or she can do other than provide anti-emetics and be on call in case your son needs to go to the ER with dehydration, but it would at the very least be good to have a professional know and take seriously his history.

As more general advice, when you're sick to your stomach, lemon sorbet tends to be one of the easier things to keep down and will keep you nice and hydrated.
posted by oinopaponton at 10:31 PM on August 17, 2010

Are you keeping him on a BRAT diet?
posted by k8t at 11:35 PM on August 17, 2010

I suppose you would have already considered this if he'd had any medical treatment lately, but when I got my last MMR booster before starting kindergarten, my arm swelled up to the size of a baseball (at the site of the shot) and I spent about a week throwing up. Because of this, I didn't get the booster I was supposed to get between 5th and 6th grade; I was allergic or hypersensitive to the vaccine.

I hope the little guy feels better soon.
posted by IndigoRain at 11:50 PM on August 17, 2010

Poor little guy... My sister has two sons with some kind of spontaneous vomiting thing (one kid would vomit if he just started coughing, something similar about a weak stomach? He seems to have outgrown it by age 7). I think one of her kids just went through another series of tests, I'll ask her about it later today and report back here.
posted by Wuggie Norple at 12:17 AM on August 18, 2010

Just for the sake of a data point, I went through this with two kids and we all lived to tell. I remember a particular 36 hour period with my son where I slept on the floor next to his toddler bed to try and get pedialyte in him when possible. Eventually he kept my grandmother's cure-all elixir down, known to others as 7-Up, and then on to crackers and bananas.

Both times going through it the kids lost weight so quickly they looked scary. But they also gain it back pretty quickly too.
posted by readery at 7:05 AM on August 18, 2010

i was moments away from posting that he went 24 hours on an extremely bland diet of crackers and chex and rice without an episode, and without the help of ondansetron, and then he went and threw up his last snack of the night -- the one we almost skipped and that I am now kicking myself for allowing him to eat.

this is beyond infuriating and exhausting, but thanks again for the various comments and advice.
posted by johnchristopher at 8:43 PM on August 18, 2010

johnchristopher, sounds like things are getting better.

remember, you've got to be pre-emptive with the ondansetron if you are using regular tablets, because he needs to be able to swallow them and keep them down. it's tough with one his age who may have trouble telling you how he feels exactly...
good luck!
posted by treehorn+bunny at 9:28 PM on August 18, 2010

Argh, sorry this is so rough for all of you and hoping you get some answers soon. My sister is still dealing with the constant puking of her youngest son and they really have no idea what's causing it.

You're probably already doing this, but continue to let your kid know that the vomiting isn't his fault and you're not upset with him. I recall during one bad stomach bug my son sadly commented that I was going to have to change my shirt again, so I made sure he knew I wasn't upset with him.
posted by Wuggie Norple at 1:22 AM on August 19, 2010

just to wrap this one up, we seem to be getting slowly better, and I'm now convinced this is in his head -- for lack of better description. This was his first real foray into vomiting and I suspect he got "used" to the feeling.

Yesterday he had 2-3 bouts of nausea but they were just a couple of minutes in length, and he was able to stop himself. Otherwise he ate normal food all day. And same today only with (as of now) less frequent bouts. I suspect this will just fade away... for now.

thanks for the help. hope this helps a future searcher with a vomiting kid too!
posted by johnchristopher at 1:39 PM on August 22, 2010