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What Causes Vomiting After Every Feed In A Toddler?

Posted on Sat, 22 Aug 2015

Question: Dear Doctor
My son (age: 15 months & 3 weeks, weight: 8.1 kg) was vomiting after each feed since July 28 morning (4 times between 6 AM to 10 AM). On telephonic conversation with one of the paediatrician, gave him Ondem syrup along with Walyte ORS. Thereafter he started passing loose stool after each feed (4 times). Upon physical examination next day (July 29) morning, his regular paediatrician diagnosed as Gastro-entero-colitis and gave Pro-Wel oral suspension and Walyte ORS and asked to stop milk/ baby-food and offer rice, banana, etc. Yesterday (July 29) he vomited once after lunch and passed loose stool thrice but more or less was active. Today (July 30) he passed loose stool and vomit 4 times after each solid feed since afternoon. His regular paediatrician said to continue with Pro-Wel & Walyte ORS for five days and it will be fine. Looking for a second opinion in this forum. Please help me out. Regards, XXXX

Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
I agree with your pediatrician

Detailed Answer:
Hello

Thanks for the query

I have gone through the details and it appears to be viral gastroenteritis.
Although persistent vomiting is a matter of concern,I won't get worried if the baby is passing urine adequately.
During viral gastroenteritis there is transient lactose intolerance and if we give lactose containing items like milk it aggravates the condition.Similarly fruit juice should also be avoided.
It may take 7-8 days for the stool to get back to its normal pattern.
The main aim of management is to prevent dehydration by giving plenty of fluids(ORS).As there is loss of normal absorptive layer of the intestine we should provide easily digestible foods like rice,khichdi,oats etc.Better to give feeds in semisolid form so that it can be digested easily.
In presence of repeated vomiting the oral acceptance may decrease and that may lead to dehydration.
I would like to continue ondem syrup three times a day along with prowel XXXXXXX and ORS.
Also give zinc syrup 5 ml a day for 14 days(20 mg/5 ml)as it helps in rapid recovery.In viral gastroenteritis there may be associated gastritis that can cause vomiting.So adding acid secreting agents like Lansoprazole helps.
Watch for danger signs like decreased urinary frequency,too frequent vomiting,decreased activity or shunken eyes and if you find any abnormality consult your pediatrician immediately.

I hope this helps
Please do ask if you have any more query.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Pradeep Kumar Jain (14 hours later)

Thank you for your response Dr. XXXXXXX However my son is passing loose stools every time consuming food or ORS and looks a bit drowsy. Please suggest.

Answered by Dr. Dr. Pradeep Kumar Jain (2 hours later)

Brief Answer:
Please keep patience and observe for urinary output

Detailed Answer:
Thanks for follow up

I told you earlier it usually takes 7-8 days for the stool pattern to get normal.The passage of stool immediately after feed is due to Gastro colic reflex which get aggravated during diarrhea.
The only thing you have to take care of is to provide fluid adequately and to observe for urinary output.
I won't get worried for little drowsiness if he is accepting orally well and passing urine adequately.
Please keep patience and continue with the medication with ORS as advised earlier.

Please let me know if you have any more doubts.
Wishing for your baby's speedy recovery.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar