Vomiting is one of the most common reasons children go to the emergency room or doctor. Throwing up can be protective, as it allows the body to get rid of harmful substances like toxins, poisons or germs. Prolonged or repeated vomiting, however, can be dangerous and indicate a potentially serious underlying medical problem. Vomiting that occurs regularly after eating can occur for many different reasons in children, including harmless "spitting up" in babies, food reactions and structural problems or inflammation in the digestive system.
Reflux and Spitting Up
Reflux refers to the backup of stomach contents into the esophagus -- the tube that carries food from the mouth to the stomach. In babies, the muscle that keeps stomach contents from coming back into the throat is looser than in an older child or adult. This can result in frequent episodes of effortless "spitting up" after feeding, especially if the baby is overfeeding or swallowing a lot of air during feeding. In most cases, spitting up is harmless and the baby will outgrow it. Older children can also have reflux after eating, although it typically does not cause true vomiting -- with retching and forceful expulsion of the stomach contents.
The digestive tract is essentially a hollow tube that moves food from the mouth to the stomach and through the intestines. Slowed or blocked movement anywhere along the digestive tract can cause a backup that may lead to vomiting. For example, narrowing of the stomach outlet or a nerve problem affecting the stomach can cause food to empty too slowly, which may lead to vomiting after meals. Swallowing a foreign object, like part of a toy or a large coin, that partially blocks the stomach outlet can lead to similar symptoms. In babies and young children in particular, vomiting after meals may indicate an abnormality in the structure of the digestive tract.
Inflammation and Food Reactions
Vomiting after meals may indicate inflammation of the stomach, such as with an ulcer. Vomiting that occurs routinely with certain foods -- such as milk, soy, rice, oats or poultry -- can be caused by an allergic reaction to the proteins in the food. This condition is called food protein-induced enterocolitis syndrome, or FPIES 5. It typically occurs in babies and young children. Many children with FPIES grow out of it by age 3 or 4.
Other problems can also lead to vomiting after meals in children 2. For example, children with rare genetic conditions that affect their ability to break down certain types of foods may vomit regularly after meals. Psychological stress and anxiety are factors for some children. An eating disorder is also a possibility among older children and teens.
When to See a Doctor
Vomiting is usually short-lived and goes away on its own. If you child is vomiting after every meal, visit your doctor to determine the cause. Contact your doctor immediately if you have a baby or toddler with symptoms of dehydration, such as a dry mouth, no tears or not wetting normally. Seek immediate medical care if your child experiences severe abdominal pain, has a high fever, vomits blood or the vomited material smells like stool.
- Indian Journal of Pediatrics: Management of a Child With Vomiting
- UpToDate: Nausea and Vomiting in Infants and Children (Beyond the Basics)
- American Academy of Pediatrics Clinical Reports: Gastroesophageal Reflux -- Management Guidance for the Pediatrician
- Gastroenterology: Functional Gastroduodenal Disorders
- American College of Allergy, Asthma & Immunology: Food Protein-Induced Enterocolitis Syndrome (FPIES)
- American Family Physician: Inborn Errors of Metabolism in Infancy and Early Childhood -- An Update
- Pediatrics: Identification and Management of Eating Disorders in Children and Adolescents
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