My 4 year old is making himself throw up

[apesfordana]

Hi,

My husband and I just feel lost and out of options. My four year old son is very much a picky eater. We've worked not to make too many special adjustments for him, but there are times when we give him different choices to find what he does like. Since going back to daycare in August, my son has had several instances where he has stuck his hand in his mouth and made himself throw up.

For a while, the boy would get him self so worked up about anything being on his plate that he didn't like that he wouldn't touch lunch at all. He'd cry when he saw what it was, then cry harder when they pulled lunch away. Then he threw up from throwing enough of a fit. After that, we think he figured that throwing up could get him out of lunch, maybe even get him home. So he'd do it on the way to lunch - not even knowing what they were serving.

We have been working very closely with the school to try to fix the behavior. It got much better for a while when we talked about relaxing and just leaving on the plate what you don't like. We discuss the menu each day and if there are things that he just can't deal with he knows to leave it on the plate & eat what he does like. If the whole meal is 'bad', I let him bring a lunch. My husband doesn't even want to allow that - he believes in eat or starve...then severe punishment if he throws a fit. But the school and I just think it is too bad for him to skip lunch each day.

Then last week, when we tought it had gone away, the boy did it several times in one day. Instead of comforting him or talking through it, we finally punished him. A night in time out and lot of discussion and a missed field trip to the pumpkin patch. We've had him repeating that throwing up is bad. He had to apologize to all of his teachers and several more things to hammer down the point.

Just got a call from school - he's done it again. They are getting discouraged. It hasn't been said that they will kick him out if it happens again, but it is clear in their tone. I don't blame them. The vomit gets everywhere. They've caught him with his hand in his mouth. Its bad for him and for the other kids around him.

We've ignored it. We've been sweet. We've talked through it. We've made accomodations. We've punished. We have no idea what to do.

I'm desparate. I don't want food to be such an issue.

Any advice? Anyone else been through this? I want to go to the doctor, my husband is against it. I'm not against spanking per-se.. but this seems like such a bigger issue than spanking him hours after it actually happened. I try to get him talk about it, but husband thinks we should send him to his room alone. This ONLY happens at school. I feel so terribly lost.

 

[AnnieO]

My son is a picky eater, too, and tried this a few times.

First... Throwing up isn't bad per se, but it does mean the person is ill. So... Natural consequence... If you are ill, you don't get to do fun things like field trips.

Let him not eat lunch every so often... Refusing to eat = hunger.

Is there an issue with letting him take his lunch most days, and eat at school when it's something he wants? It's more hassle, but less expensive - usually.

Is this a single behavior, or is there more? When did this start? Has he been diagnosed with anything (such as Sensory Integration Disorder (SID))?

Welcome to our little world!

 

[Malika]

Hello, welcome to the forum. My son is also a very picky eater although he hasn't made himself sick (yet). Personally - but it's always easy to say, hard to do - I would take your son seriously and respect the fact that this is causing him such distress. I would try to get to the bottom of what is going on and why. I think punishing him will only reinforce the anxiety and the neurosis about food. I'd let him not eat what he doesn't want to eat and wait for him to be hungry and eat - not providing sweets and snacks, obviously. That is hard at school. I think special arrangements might need to be made.
More importantly, is this a sign of something else going on? Does your son have any other "issues"? I'm sure other people will come with more pointers and advice.

 

[apesfordana]

the only other issues that my boy has is a mild stutter. Something that only appears when he's excited or in the middle of a major growth spirt.

The pediatrician also said he may end up with some attention/focusing issues, but for now... no worries there.

Food, however has always been an issue. A fight. I don't like making a constant deal out of it.. and I know his anxiety about it grows & grows... clearly to the point of being physically distressing. That is why I was happy to start looking at the menu with him, coming up with days that what they served would just be too much to deal with to bring a lunch and letting him talk about his favorites and what he doesn't like and why. It's amazing how 'not making such a big deal out of it' has consumed so much of your lives. He hovers in the kitchen and objects at every moment of the cooking process. At first we involved him in cooking so he could better understand & enjoy... more often he just gets banned from the kitchen because it gets so frustrating.

But sticking his hand in his mouth to throw up. Hasn't even come close to doing anything like that with us or his grandparents. This is strickly a school thing. I have talked to him - he points out a teacher that he isn't fond of... but frankly she's growing a bit unfond of him too as she is always having to clean up his vomit.

We can't get kicked out of this preschool. We want to address it now. I want to work with the teachers. I want to avoid bad and destructive habits. It feels like there is no right answer and when his dad and I pick him up from school... well I want to be gentle and rational, his dad wants to spank him & send him to his room for the night. I was abused as a child, my husband was spanked exactly one time... so we have very different perspectives on decipline. Expecially in this case when I think that my boy is deeply internalizing things.

I deeply appreciate the advice. Please please please keep it coming.

 

[Josie]

We have food issues in our house, too. My daughter is now almost 16 and she is still very limited in what she will eat. I tried everything from ignoring what she ate and having only healthy options around, to saying she had to try everything to get dessert, to bribing her to try different things. She wanted the dessert but she just could not make herself eat the food she supposedly didn't like (that she hadn't even tried).

She is not my daughter with Obsessive Compulsive Disorder (OCD), but I think her food issues are OCDish. If she were younger, I would probably make her go to therapy to get over it. She and her dad both think this is a ridiculous idea, so I'm not going to make it happen. In a few years, she will be on her own anyway and I have used up my battles on more important issues.

I would let him take his own lunch to school and work on the eating issues away from school if you are going to. I don't think it is as simple as a deliberate choice to not eat what they serve so I wouldn't punish him. When I talked to him, I would be trying to figure out what he didn't like about it and try to figure out how to solve the problem from his perspective.

Maybe the way he acts in your kitchen is a clue to the problem. Is he a germaphobe concerned with contamination, or not like a particular ingredient, etc.? Does he not want his food that he likes to touch a food that he doesn't? Those kinds of issues would be OCDish, but I'm sure there could be other types of issues, too.

 

[InsaneCdn]

I'm seeing school anxiety written all over this.
This kid is absolutely desperate to do whatever it takes to not be at school.

Your job, as a parent, is to get to the bottom of it.
Yes, that means doctors and specialsts and therapists and whoever else.
But this is serious.

Stutter... frequently = serious bullying.
He's young enough that learning disabilities may not have hit the teachers' radar, but the other kids pick up on these really fast, and it results in... more bullying.
Add to that the major self-esteem issues that develop really fast...

He needs professional help, in my opinion.

 

[buddy]

When i was very young I had an eating disorder. I had a rule that I could only eat 500 calories and of that 500 I had to throw up at least half. (you would never know now...food is NOT an issue as an adult, other eating too much at times... and right now, too anxious to eat) Anyway, very different scenario EXCEPT I will share that anxiety over food (well over anything really) was relieved psychologically by throwing up. The reward was the chemical release that doing it had on my brain...some kind of calming effect. So, even if I was caught, punished whatever...didn't matter. The anxiety was too bad and the vomiting was reinforced by my feeling so much better.

I realize it may not seem like a typical eating disorder his being so young and all but I wonder if a psychologist who deals with boys and eating disorders could give you some advice???

Just throwing it out there....

 

[BusynMember]

Hello, welcome to the forum. My son is also a very picky eater although he hasn't made himself sick (yet). Personally - but it's always easy to say, hard to do - I would take your son seriously and respect the fact that this is causing him such distress. I would try to get to the bottom of what is going on and why. I think punishing him will only reinforce the anxiety and the neurosis about food. I'd let him not eat what he doesn't want to eat and wait for him to be hungry and eat - not providing sweets and snacks, obviously. That is hard at school. I think special arrangements might need to be made.
More importantly, is this a sign of something else going on? Does your son have any other "issues"? I'm sure other people will come with more pointers and advice.

I agree with this 100%. He isn't trying to be difficult. Maybe he has sensory issues that make it impossible for him to eat without feeling so disgusted that he throws up. My son is on the autism spectrum and even when he got older if forced to eat certain textured foods, he would throw up. I would NEVER EVER punish this behavior. He is not being bad. Something is wrong. I don't get why your husband "won't let" him see a doctor. Sounds like husband is into "there is NOTHING wrong with my kid"...but something is wrong and you need to find out what it is. Spanking, punishing...it will probably only make his anxiety worse and make the problem worse. It is like bedwetting. it is not a decision a child makes to bother you. It is a symptom of a problem. Perhaps he is nervous when away from you or in the company of a lot of children. That still doesn't make his behavior "bad." As he is so young, it is unlikely to be an eating disorder.

Could you maybe give us a more detailed history of this child? You call him "the boy." Is he adopted? What were his very early months like? Did he cuddle? Did he like to look into your eyes? Did he coo a lot or scream a lot. Any stomach problems? How were his motor skills? How does he play with his little peers? Does he sleep well? Does he have any other sensitivities, such as clothing or loud noise or crowds?

Again, this is just my opinion, but it is a very strong opinion: This child is NOT misbehaving. Do NOT punish him for this. Find out what is wrong. I hate to say to take him for help even if your husband disapproves, but I would do it, whether his father liked it or not. He needs to get this issue resolved...and other ones too if he has any. Burying ones head in the sand helps nobody...

Hugs and please keep us posted.

 

[apesfordana]

In response to some more info on 'the boy'
- He is my husband & my biological son. I was saying 'the boy' because most forums seem to avoid the use of names & I'm not savvy with all of the abbreviations. This is no indication of lack of intimacy with him. His is very much a cuddler, a happy, active, incredibly social little guy.
- Infancy was as normal as I think could be expected. No colic or incidents. He got the flu at 5 months - before he could get any time of flu vaccine... but there were no dangerous fevers or hospital runs.
- We are very lucky with our son. I've read a lot of threads in this forum and I know things could be much worse. But there are things I worry about - the stutter, focusing issues, heavy food issues... but you hit it on the head.. my husband is heavy into 'there is nothing wrong with my son'. No speech pathologist 'that'll come free and can be addressed in kindergarten'. Sticking his hand is his mouth to vomit is 'acting out for attention' and 'even if there is something wrong, he has to know the way he is expressing himself if wrong and will not be tolerated', the attention issues are 'he's 4!'... in his exact words, 'I am not about to tell my son that something is wrong with him'...

I try to have a united front with my husband, and perhaps, as a mom, I worry to much... but I don't like the 'wait and see' approach. Especially because something above that was mentioned - stutters, vomiting, being a loner - I've already overheard kids being passively mean to my son. Again, to my husband 'kids will find something no matter what, they are mean no matter what' - my husband is a subsitute teacher by the way. I agree to an extent - I was heavily bullied and so was my husband.

For other questions - my son doesn't like to draw or color. He isn't a fan of loud noise - but he deals fine. No freak outs or heavy fears. he is incredibly social on the playground - looking for friends the moment we arrive. But I usually find him alone when I pick him up from school. I pick up that he tends to play with younger kids... Sleep is fine, affection is wonderful - but not overbearing. No clothing issues or no stomach issues.

The vomiting is only if he shoves his hand in his mouth, fingers down his throat, only until he throws up. When asked by a teacher why - his only answer is that he wants to go home. In a way, I do feel like he's acting out. Only in that he has found a way to not get food he doesn't want. He doesn't want anything he classifies as a veggie - doesn't taste it.. if it is on his plate, mixed in with the food.. he'll have none of it. He doesn't oppose things that are good for him because he'll drink V8.. happily. To me, it is a texture thing and YES I admit that I allow him to not like foods. If they cause him anxiety of if he truly doesn't like the taste.. I let him skip it because I don't want the fight & I'd rather work with him to find other ways to eat healthy.

I feel like I could go on forever. Everything above, I've brought up with the pediatrician... she doesn't really seem to think anything is a problem. He hasn't been tested for anything, but I feel like I'd have to go behind my husband to do so. He insists that once our son hits kindergarden in the fall - all of these worries will be addressed... that is what the public school system does. I don't think we can wait...

sorry - correction - we have not talked about the throwing up with the pediatrician. Again, my husband says no. That is why I'm here... I need advice. I don't want to break my little boy and I don't want to create more of a gap with my husband.

 

[keista]

'I am not about to tell my son that something is wrong with him'

What your husband is not realizing is that you SON is telling the two of you that something is wrong with him. The boy already knows and he's "acting out" because of it.

Yes, he's learned that if he throws up, he gets to go home. The question is, WHY does he want to go home so badly? What is so horrible, so uncomfortable for him at day care that he can't stand being there?

Speech - you don't have to wait until kindergarten. Most school districts have early intervention programs. I have a friend in NY whose pre-k son was "flagged" as having a speech problem. Instead of paying $30 for the private evaluation offered by the private school, she called the school district. She just has to register him and ask for an evaluation - free, through the public school system.

Oh, and WELCOME!

 

[Malika]

Hello again. Can I ask how long your little boy has had his stutter? Opinion seems to be that the longer this goes untreated, the harder it is to treat. Surely this in itself is a clear indication that something is not quite right?
I do understand your husband's attitude. Nobody wants their child to be different or to have problems. However, I think accepting reality is like a process; it comes gradually. Your husband is adamant now but if there really is something "wrong" (and of course, as you say, there is an awful lot that is right with him) with your son, then this will just make itself increasingly obvious and your husband will have to start on the journey of acceptance and finding solutions.
I am personally not an alarmist - I tend not to see problems everywhere in terms of children's behaviour and I am loathe to label. However, what you said about your son does actually make me feel concerned. He stutters, he has some problems socialising and socialises with younger children, does not like drawing or colouring, seems to be suffering from anxiety at daycare sufficient to make himself vomit, seems to have some obsessiveness or anxiety around food generally. Something is going on... I do agree that is your joint parental responsibility to find out what it is. Please do try tackling your husband again about getting your son evaluated - you may be very grateful that you did.

 

[HaoZi]

As the pickiest eater I know with my daughter a close second, there is an issue and to be blunt your husband needs to remove his thinker from his sitter. There is a problem. What problem? The possible list is long, and y'all need to get together with the teachers, pediatrician, etc., and start narrowing down that list. If you want to try to spook the kid in the meantime, take him to the dentist and let the dentist talk to him about what all the throwing up will do to his teeth.

You mention a focusing problem in conjunction. So focus, anxiety, and a finickiness that could fall under Sensory Integration Disorder (SID), Obsessive Compulsive Disorder (OCD), etc. Time for professional testing to see if it's anxiety/trauma related, or something else, like a neurological or physical disorder or allergy. You don't have to tell him there's something wrong with him, stick with a need to know basis. How's his intelligence level? Highly intelligent people are also notoriously finicky (and many could fall under the Aspie label, too).

More accommodations are needed in the meantime. Find a healthy diet that he will eat. This might mean cereal at dinner and PB&J on whole grain bread for breakfast. My kid has Carnation Essentials or a vegetarian corndog for breakfast these days. One year it's all pancakes/waffles, one year it's all about toast. Go with what works at the time that is a healthy choice. And give him a choice - two choices that are healthy and okay for him to have. If he would be happy eating PB&J all day, as long as he's getting the nutrients he needs (which might mean buying different brands of everything) then let him. Always offer new foods, but don't push. He'll be more interested if they're on your plate or the plate of the kid next to him.

Was I a PITA for my parents? Absolutely. But even so, I managed to grow up pretty healthy (had a multi vitamin every day to catch shortfalls). If my ex and I were still together I can just imagine the fights we'd have over me accommodating Kiddo's eating habits and how picky she is. Trying the "go hungry" method doesn't work with us, we'll find something else we do like when you're not looking, and often it'll be something that we shouldn't eat, like chocolate in huge amounts (just speaking from experience here).

Your husband needs to work with you or stay in the corner. His denial isn't going to help matters, it's going to make things worse for everyone involved.

 

[buddy]

As he is so young, it is unlikely to be an eating disorder

oops, sorry, wasn't suggesting that. Just meant that the anxiety first and chemical release making him feel better could be reinforcing the behavior in that setting.

 

[buddy]

Hello again. Can I ask how long your little boy has had his stutter? Opinion seems to be that the longer this goes untreated, the harder it is to treat. Surely this in itself is a clear indication that something is not quite right?

Young children, especially when in phases when their language is really growing often have a developmental "stutter". It can look just like any other long term stutter. Some even develop secondary characteristics (like eye blinking, head shaking etc. to try to get rid of it, if you see these secondary things do for sure get help so you can avoid his getting more of these). It is a conflict with rate of growth in language and the minute intricate motor skills needed for speech expression. It usually does come and go away by itself and treatment is typically to just be very patient and intent when listening so pressure is reduced. But not to mention it or specifically say slow down, relax, ask them to start over, or anything like that which could accidentially call attention to it and increase the frequency. (Obviously we can't see him and dont have a full developmental history or family background so, it is great to have someone check it out to make sure whether it is developmental or not, hard to tell though...but since you have other issues worth a check and you can get advice on how to handle it).

My 2 cents worth, smile!

 

[nvts]

Hi! My youngest has food issues BIG TIME...it's a sensory thing as well as an extremely forward facing gag reflex. Have you tried writing down a food diary for a week or so and see which foods really set him off? Mine will not eat ANYTHING with a mixed consistancy. For example...she absolutely LOVES yogurt. BUT, she'll only eat the ones that are absolutely smooth. If there's a chunk for apple or a tiny bit of strawberry - she'll throw up. Condiments are never consumed...she won't eat chips and dip. Only the chip. She won't eat any form of vegetable, because no matter how fine you grind it, it still has a "consistancy" that she can't/won't tolerate. She's just about to turn three and has had speech and feeding services all year.

I would look into the sensory issue with the foods...it might help! Any way you slice it, it seems like you're trying your best and that's fantastic!

Beth

 

[apesfordana]

Hello all.

1) thank you so much for the thoughtful and honest replies. I have taken everything to heart and I appreciate having found this board so much.

- short term solution that has worked wonderfully is having my son take his lunch every day. We work together on what goes into his lunch each day and we always make sure the meal is balanced. Not a single instance at school since - it's only been since 10/26 - but I consider it a win... so far. If there is more of an issue than just the school's food, I have no doubt that this issue will resurface. But for now, I've chosen to listen to my son & let him have choices & see them through. My husband is unhappy with me. But the solution has been working and my son has been very happy when we pick him up each day, so he can stay quietly unhappy until he finds an 'i-told-u-so'.

- as for the stutter and focusing issues. My husband and I sat down with his teacher last night. My son is in a pre-k program and they have already worked up to the public school curriculum that he'll see next fall. His teacher had great things to say about most everything. Just that he has some issues working independently (when he has to sit alone & work, he tends to look around the room or to the person next to him to see what he's doing). And he also does great with most class work except for coloring. So she agrees that there isn't anything developmentally that we need to fret about.. just to work with him on some things. As for the stutter, she's noticed at and sees it as something we can just work on - get him to slow down, to focus, to relax.

i will add that my husband was very reluctantly there, but sat through and asked his own questions. My husband is determined to show that nothing is wrong with our son, but once the teacher brought forth some concerns (unpromted by me), he did pay more attention. I thank God for that and for his teacher!

I've read this board - so I know I am very blessed. I know that my problem may seem small compared to some. So I really appreciate your attention.

PS - I love the dentist idea. I hadn't thought about pulling the dentist in - I'm sure he'd have PLENTY to say! But dental fear is a whole other issue and we're still working on that visit being pleasant. My father, who passed away recently, had just awful teeth. So bad that my son asked me about them. I use eating right & brushing/flossing as reasons for those bad teeth. I'll add throwing up as something that can rot them away. My son isn't vein, but he really really doesn't want his teeth to look like his Opa's did!

 

[soapbox]

Not trying to stir the pot, here, but... I see major red flags with two of the points the teacher made, even if the teacher doesn't see it!

Just that he has some issues working independently (when he has to sit alone & work, he tends to look around the room or to the person next to him to see what he's doing).

There is a very high chance that this is related to ADHD, Auditory Processing Disorders (APD), or both. The two can look very similar, AND can co-exist. But I'd be guessing Auditory Processing Disorders (APD) is more likely. There are a number of different APDs... anything from trouble making sense of verbal language, to not being able to pick up the important sounds if there is background noise (like teacher's voice in classroom). This means... they do not receive the instructions, so have to "follow" what the other kids do. been there done that. Major, major red flag... and from what I understand, almost always MISSED by schools.

And he also does great with most class work except for coloring.

THIS is a major red flag for motor skills issues... Occupational Therapist (OT) evaluation is probably called for. Problems with coloring is often a precursor to problems with writing... how is he with scissors? tieing shoes? using knife and fork? dressing? what about gross motor skills like riding a bike, throwing a ball? If there is ANY hint of a motor skills issue, the sooner you can get Occupational Therapist (OT) interventions, the better (they didn't tell us, and it was almost non-available at that point anyway, but... sure wish we had.)

So she agrees that there isn't anything developmentally that we need to fret about.. just to work with him on some things

Developmental Coordination Disorder (DCD) is a developmental issue. It is suspected that Auditory Processing Disorders (APD), on some level, is too.
What she probably means is that he likely (in her opinion) not going to be Pervasive Developmental Disorder (PDD). That might be closer to the truth. But the less-severe developmental issues are just as important to catch... and are more likely to be missed.

Just something to think about.
We saw the same issues at that age, and even tried to get help.
We were told - by school and medical staff - that we were "just over-anxious parents".
NOT.
Still undoing the damage years later.
Including significant secondary issues (like depression and anxiety) that do NOT need to come into play at all.

 

[apesfordana]

Not trying to stir the pot, here, but... I see major red flags with two of the points the teacher made, even if the teacher doesn't see it!


There is a very high chance that this is related to ADHD, Auditory Processing Disorders (APD), or both. The two can look very similar, AND can co-exist. But I'd be guessing Auditory Processing Disorders (APD) is more likely. There are a number of different APDs... anything from trouble making sense of verbal language, to not being able to pick up the important sounds if there is background noise (like teacher's voice in classroom). This means... they do not receive the instructions, so have to "follow" what the other kids do. been there done that. Major, major red flag... and from what I understand, almost always MISSED by schools.


THIS is a major red flag for motor skills issues... Occupational Therapist (OT) evaluation is probably called for. Problems with coloring is often a precursor to problems with writing... how is he with scissors? tieing shoes? using knife and fork? dressing? what about gross motor skills like riding a bike, throwing a ball? If there is ANY hint of a motor skills issue, the sooner you can get Occupational Therapist (OT) interventions, the better (they didn't tell us, and it was almost non-available at that point anyway, but... sure wish we had.)


Developmental Coordination Disorder (DCD) is a developmental issue. It is suspected that Auditory Processing Disorders (APD), on some level, is too.
What she probably means is that he likely (in her opinion) not going to be Pervasive Developmental Disorder (PDD). That might be closer to the truth. But the less-severe developmental issues are just as important to catch... and are more likely to be missed.

Just something to think about.
We saw the same issues at that age, and even tried to get help.
We were told - by school and medical staff - that we were "just over-anxious parents".
NOT.
Still undoing the damage years later.
Including significant secondary issues (like depression and anxiety) that do NOT need to come into play at all.

Hi - is there any way you could elaborate on these abbreviations? Developmental Coordination Disorder (DCD)? Auditory Processing Disorders (APD)? been there done that?

 

[soapbox]

been there done that... you'll see a dotted underline under it? if you put your mouse over it, it will tell you what it means. (been there done that = been there, done that)

I thought Developmental Coordination Disorder (DCD) and Auditory Processing Disorders (APD) were on that list, too, but not... so...

Developmental Coordination Disorder (DCD) - Developmental Coordination Disorder, previously and/or in other parts of the world known as developmental dyspraxia, or "clumsy child syndrome". Its a disorder where the brain can't put together all the pieces in the right order and fast enough, to perform complex tasks efficiently and effectively. Can affect
gross motor skills (bike riding, playing ball, pumping on a swing...) or fine motor skills (buttons, tieing shoes, writing, scissors, etc.), or both. Interferes with "daily living". Has a HUGE impact on school - often doesn't really show up its seriousness until they get to school. One good site with info on this is www.canchild.ca - there are others.

Auditory Processing Disorders (APD) - Auditory Processing Disorders - includes Central Auditory Processing Disorder (CAPD) (central auditory processing disorder), which typically involved issues with how spoken language is processed... often shows up later as a major gap between reading comprehension and verbal comprehension... They have a verbal procdesing disorder rather than a language disorder... although, if it is severe enough, language can be affected as well. More recently, other APDs are showing up on the radar... including associated testing. One of those is "auditory figure ground" - best described as being able to sort through competing sounds (background noise) and figure out what to listen to, and send the rest to the "background". If you can't do that... then you do much better learning one-on-one in a quiet setting, than in a class of 20-30 kids. The APDs often show behaviors similar to ADHD. Kid is not engaged (how can you be if you can't make sense of what the teacher is saying... ), so fidgets, looks away, doesn't follow instructions, and so on.

 

[apesfordana]

wow. thank you so very much. You kind of just described my boy in a nutshell...