Welcome to HealthcareMagic, You ask a challenging question since cyclic vomiting itself is still under study. A recent 2015 article suggested a relationship between genetically inherited mutations in the processing of functions related to the mitochondria (the power house of the cell). Growth delay is seen with cyclic vomiting in kids with urea cycle defects or organic acidurias, etc. The most accurate way to get to the root of the problem is to have your daughter set up to be tested while she is in the middle of an attack and you may want to go to a metabolic clinic to do so. Note on a daily basis whether your child has triggers. These triggers are typically high protein foods (urea cycle disorder),high carbohydrate (pyruvate dehydrogenase deficiency), high fat, fasting, illness -so keeping a food/symptom diary may unmask some helpful diagnostic clues. If child has true cyclic vomiting that is unrelated to metabolic disorders it may be managed theoretically by: Children with CVS should probably avoid fasting and irregular sleep schedules. This is good advice for migraine sufferers(cyclic vomiting being the migraine of the g.i. tract) in general.Given that there is evidence for efficacy for riboflavin (400 mg daily)and coenzyme Q10 (CoQ10) in migraine prophylaxis, and that the migraine benefit with these agents may be mediated through mitochondrial function even in the absence of a specific identified disorder, it would seem reasonable to offer these relatively benign treatments to children with CVS. CoQ10 supports electron transfer between complexes in the mitochondrial respiratory chain. Riboflavin is a cofactor for complex I of the mitochondrial electron transport chain.Given there is a limit to how much riboflavin the body can absorb at one time,dividing it out to twice daily dosing may optimize absorption. Taking riboflavin with food also improves absorption. l-carnitine supplementation has also been reportedly helpful in pediatric cyclic vomiting syndrome cases.l-carnitine is required for transport of long chain fatty acids across the mitochondrial membranes. Supplementation may be therapeutic in CVS even when pretreatment carnitine levels are normal and in the absence of a specific identified metabolic disorder. In a retrospective uncontrolled chart review study, treatment with combined l-carnitine and CoQ10 supplementation appeared useful for children with CVS. Passages Taken From Recent Research directly from the research library: Stewart J. Tepper, Cyclic vomiting syndrome, inborn errors of metabolism, migraine variants, episodic syndromes that may be associated with migraine, and other unusual pediatric headache syndromes, Headache: The Journal of Head and Face Pain, 2016, 56, 1, 205 Gelfeld, Amy, Cyclic vomiting syndrome versus inborn errors of metabolism: A review with clinical recommendations. Headache: The Journal of Head and Face Pain, 2016,56 As you can see, we are still deep in study of this syndrome and its complexities. Since we health professionals try to practice evidence-based medicine. The answers I gave to you are all possibilities we are studying. Still, finding the true diagnosis helps us find things that work to treat the disorder. The passages I gave you and referenced I researched just for your case. This is research not widely known yet so all I am doing is sharing where we are going with nutritional support of this disease. I hope I have helped you see things from a different standpoint, to give you back control as there are things you can do to help nail down your daughters exact problem and then, utilizing the physicians and current research, develop a treatment program for your daughter that will allow catch-up growth! I wish you luck~ Regards, Kathryn Shattler, MS,RDN