Behavioural vomiting - a bit long and not for the squeemish.

[Mouseface]

Have posted this in children's health too but wondered if any of you could help.

DS, 13m, has always been tube fed (cardiac problems, Pierre Robin sequence and cleft palate amoungst other issues) and has been treated for severe reflux using various medications since being 4 months old.

However, yesterday his Consultant Paediatrician said he now believes that this is "behavioural vomiting", not reflux.

He has likened it to a phobia, saying DS is unhappy/scared when being fed so makes himself sick. hmm

Yet is more than happy to be hooked up to the feeding pump, plays with the feed set when empty, spoons etc, helps himself to food off our plates and plays with that too. He never gets upset before a feed.

DS recently had a barium swallow which showed no 'mechanical' problems, infact, no problems at all.

When he pukes, he screams in what I think is pain, screws his face up, pulls his hair, hits his head and cries. He gets VERY distressed. As soon as he's finished, he's back to playng again.

There is no pattern to his puking at all. It can happen during or as long as 2 hours after a feed and can be with 10ml or 200mls inside him. He can lose 20ml or the whole feed. It can be anytime of the day or night.

I have started to keep a log of times and volumes which I gave to CP for DS's hospital notes.

DS's nurse came again today and saw him puke for the first time as she usually avoids feed time so I can get on with it. She was mortified to see just how much distress he was in and doesn't think it's behavioural at all.

The CP's plan is to get DS's SALT to watch him vomit, no idea why, and a gastro doc at some point. Then take it from there.

Has anyone had anything like this? Or know someone who has? Even in an older child?

This is very familiar to me. My ds was very similar with feeds and being sick. No one believed me as to quite how sick he was being until the hv came over a feed. The hv sat there and watched me do 5 feeds before 1 feed stayed in. He was mortified that no one had taken me seriously. The paed still didn't believe me and it wasn't until my ds did the same in her consulting room that she actually believed me. She appologised and said that she's so used to parents exagerating their childrens symptoms that she hadn't believed it was a bad as I had been saying. At that point she arranged a MRI scan and barium meal, showed nothing. Then at our suggestion my ds was put onto hypoallergenic formula. He was never sick on feed since. He still was suffering with stomach ache and an endoscopy showed he has stomach ulcers (not related to the dairy intolerance).

The key for us was definatly getting professionals to see how bad he was at feeds. Then when everything mechanical had been ruled out insisting in trying the hypoallergenic formula.

My ds (11) has CP and was also diagnosed with reflux from very young.
He has also mastered the art of behavioural vomiting, especially when he gets to school.

I would definatley agree that your ds is showing signs of reflux, as he is still very young to be vomiting on a behavioural level, and especially if he is getting distressed with it too.

rebl

Thank you for posting.

I'm glad your DS is better. We've tried hypoallergenic formula's and cow's milk/lactose free too.

I have a feeling that this new gastro dco will want DS to have an endoscopy and the word did leave the CP's mouth the visit before last but since the barium, he's ruled out the need????

Hopefully, this gastro doc will have more ideas on what to do next!

Should read 'gastro doc' not dco!

Prozac- I thought the same re he's too young. I do think there is still 'something' wrong with/in his tummy.

And luckily, so does his CCN!!!!!

MF - I replied on your otherthread.