Toddler with GERD excessive vomiting

[elana530]

Our 16 month old is teething, but we have been dealing with excessive vomiting on and off for the past 6-9 months. We can't tell if we are dealing with behavioral issues or not, because he will go a month without vomiting and then go for 2 mos vomiting more than twice a day. When he is in a cycle of vomiting, he throws up sometimes more than 4 times a day. Worst times seem to be in the morning and at bedtime. So, he throws up in his bed quite a bit too. He has GERD. He has been tested for gastroenteritis, had done an upper GI, a CT and also endoscopy with normal results. Sometimes he can eat yogurt no problem - but other times he throws it up alot (now). We dont see any patterns with food. We tried him on Pediasure and he did not do well. It did not seem to digest. He is also on Prevacid once a day (am). Any ideas?

[peasantgirl]

Hi,

I'm sorry to hear about your son!

My first thought is that it's food, probably dairy, that may be causing this. Did it start after he weaned from nursing/formula? The fact that he doesn't do well with yogurt and Pediasure is a clue. A very large percentage of children with reflux have allergies or intolerances to dairy. I would suggest that you take dairy 100% out of his diet for a month (it takes at least 3 weeks for dairy to completely exit the system) and see if his vomiting clears up.

What form of Prevacid is he on, how much and how long has he been on it?

April

[ChitChatNIne]

I agree with above poster .. also, is he cutting any teeth when this happens?

Cheryl

[elana530]

We've had him on Prevacid for almost a year. It used to be given to him twice a day. Now we only give it once, in the morning. We are afraid to eliminate milk or Pediasure entirely because he needs the calories. We have taken him off for a few days - but not seen improvement. In February, he had an endoscopy, and the Dr. said she took biopsies to look for allergies to milk or soy. She didn't see any of the cells present that you would see in an allergic child - so she did not think he had allergies. However, the behavior often seems to me like an allergy. I wonder if the only way to test for an allergy is to do a blood test with an allergist? Maybe he is intolerant, but not allergic?

[peasantgirl]

Hi,

It could be an intolerance which would not show up through allergy testing. There are plenty of other foods/drinks that he can be given in place of dairy products. Both of my girls were dairy intolerant and my youngest couldn't have any dairy until she was over 2, and she did just fine. There are lots of soy/rice products on the market and other ways to get calories he needs.

Eliminating products for only a few days isn't enough time, as it takes at least 3 weeks for dairy to completely exit out of his system and sometimes it takes that long to see an improvement. Intolerances are determined by eliminating a food and seeing if it helps. Plus, if it is the dairy, and you take it out, and he starts feeling better, he'll probably eat better and keep more down as well!

April

[ChitChatNIne]

Severe food intolerances will oftentimes test negative in both biopsy, blood and skin tests.  It is more of a delayed reaction or you can google "delayed hypersensitivities" .. sometimes the insides just get so upset that everything ingested causes a viscious cycle and nothing seems to help in regard to any foods and/or meds .. I would ask about a food elimination diet for a specific am't of time under the guidance of your Dr.  Then sometimes after reintro of foods the foods are much better tolerated because the GI tract has had time to calm down.

Another thought is to swithc reflux meds .. maybe try another brand and see if that helps?  And/or ask about Zantac for breakthru reflux since Prevacid is given1X day ?

Those are some thoughts that helped with my son when for 2.5yrs he had similar to your toddler and nothing worked until for a month he went on an elimination diet of just very plain foods (like 2-3 to start) with gradual re-intro's ev. few days.  Finally all calmed down .. and he was negative blood and skin for all milk products but caseine was his trigger until we switched to rice milk .

Your Dr. may allow you to add oil for the calories and fully emulsify it in the liquid he drinks .. but never before a nap or nighttime feed because of risk of aspiration .. we worked with a Pedi Nutritionist who had ways to get extra calories in the rice milk.

Keep in touch .. hope this helps ?

Cheryl