[25F] Child with projectile vomiting and crankiness

What might be happening

Based on the information you have provided, here are some possible explanations for your child's symptoms:

• Gastroesophageal Reflux Disease (GERD): This is a condition where stomach contents flow back into the esophagus, causing symptoms like vomiting and irritability. Since your child has already been diagnosed with reflux, this is a likely cause. However, the fact that famotidine has not been effective suggests that further evaluation may be needed.

  • Treatment: GERD in infants and toddlers is often managed with medications like proton pump inhibitors or H2 blockers, dietary changes, and feeding modifications. In some cases, more advanced treatments or surgical options may be considered.

• Eosinophilic Esophagitis (EoE): Given your own history of EoE, it's possible that your child could have a similar condition. EoE is an allergic inflammatory condition of the esophagus that can cause vomiting and irritability.

  • Treatment: EoE is typically treated with dietary management (eliminating trigger foods), medications like topical steroids, and sometimes acid suppression therapy.

• Food Allergies or Intolerances: Since you mentioned that oatmeal might be a trigger, it's possible that your child has a food allergy or intolerance. This can cause gastrointestinal symptoms like vomiting and irritability.

  • Treatment: Identifying and eliminating the trigger food from the diet is the primary treatment. An allergist can perform tests to identify specific food allergies.

What you can do

While it's important to consult with your child's pediatrician for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

1. Keep a Food Diary: Track what your child eats and note any vomiting episodes. This can help identify potential trigger foods. You can use MDandMe to journal these symptoms and share them with your healthcare provider.
2. Modify Feeding Practices: Try smaller, more frequent feedings and keep your child upright for at least 30 minutes after eating to help reduce reflux symptoms.
3. Avoid Known Triggers: If you suspect oatmeal or other specific foods are triggers, try eliminating them from your child's diet and observe any changes in symptoms.
4. Hydration and Nutrition: Ensure your child stays hydrated, especially after vomiting episodes. Offer a balanced diet to support overall health and growth.

What you should look out for

Reasons to seek more urgent medical attention include:

• Severe or Persistent Vomiting: If vomiting becomes more frequent or severe, or if your child shows signs of dehydration (dry mouth, no tears when crying, decreased urine output).
• Weight Loss or Failure to Thrive: If your child is not gaining weight or is losing weight.
• Blood in Vomit or Stool: This could indicate a more serious underlying condition.
• Severe Irritability or Pain: If your child is inconsolable or appears to be in significant pain.

Remember, while these suggestions can help manage symptoms, it's crucial to follow up with your child's healthcare provider for a comprehensive evaluation and tailored treatment plan.