Purposeful Vomiting in Children

My child makes himself vomit. Why does he do this and is it dangerouse?

Things become pretty crazy when a child is able to purposefully make himself vomit. Any event whether it be a party, dinner at a resturant or just a family outing, will come to a complete halt when a child vomits. What is a parent to do?

Well, first of all, all possible medical issues need to be ruled out. Children who have reflux or have had reflux are at an increased risk of aquiring this ability because in general, children with reflux are more sensitive to oral touch. They often present with an easy gag response and are used to vomiting (refluxing). As a child is exploring their world through their mouth, a child with reflux is more likely to gag and vomit.

If your child is purposefully vomiting and has reflux, make sure that your child has not grown out of his medication. If your child is no longer taking medication, make sure that you very carefully observed for other more subtle signs of reflux. Ruling out non-regurgative reflux, will facilitate extinction of his vomiting behavior.

Remember that accidental vomiting or gagging with oral exploration can be part of typical oral sensori motor development. It is not uncommon for a child to be orally exploring with their hands and accidently stimulate a gag response. Sometimes the gag may result in an accidental vomit. If this happens to your child, it is extremely important not to over react. First, ensure that your child is safe and not choking. If he is fine, just act like nothing special happened and take your time cleaning up the mess. Respond without emotion. Have your child help you clean up the mess and if he is old enough, he can clean up the mess with minimal assistance from you. The key is to ignore the behavior and try not show any emotion. By ignoring the behavior, you are not accidently reinforcing the behavior. If your child is purposefully vomiting to get attention, the behavior will most likely increase before it will decrease and become extinguished. This reaction is typical. It is human nature to increase an ignored behavior in order to get attention.

As you are trying to extinguish the vomiting behavior, make sure that everyone in the house is on the same page. Consistency is key. Everyone must agree on how to address the problem. One person that does not follow the plan of action will totally interfere with progress and will reinforce the vomiting.

If you become upset, yell at your child or come to his immediate attention, you are reinforcing his behavior. This is an example of negative reinforcement, you are reinforcing a negative behavior, a behavior that you do not want. All of the attention for his action (vomiting) will give him a sense of controll. Your child will naturally learn the power of the vomit and may start using it to stop bedtime, interupt a phone call, a trip to the store that he doesn’t want to go on or it may be used to obtain a favorite toy at the store.

As you are working to eliminate the vomiting behavior, make sure that you are meeting your child’s “need” requirement. Make sure that he is not using negative behavior because he feels that he is not getting enough attention. Take quality time each day to “play” with your child. During this time give them your undivided attention. I know that this can be challenging especially with multiple children or for working parents. Remember “quality” time vs quantity. The time spent doesn’t need to be hours a day, it just needs to be “quality” time.

Another suggestion for success is to make sure that you are giving attention to the behaviors that you want your child to repeat. Take the time to give attention to behaviors that you want your child to continue. Something simple like a hug or a few words of encouragement can go a long way. Too often parents spend too much time addressing the negative behaviors that they forget to reinforce the postive behaviors.

Hopefully, this FAQ will give you the tools to extinguish purposeful vomiting. The key is to stay calm, don’t react and stay as emotionless as possible as you help your child clean up the mess. Ensure that everyone in your house (including grandparents or other caregivers) understands and follows your plan. By understanding the fact that the vomiting may increase before it is extinguished will help you stay on course. Ignoring a vomit is just like ignoring any temper tantrum, it is just messier.