“If your preschooler vomits only at night, my first thought as a pediatrician would be that it is a behavioral issue,” says Joel Gator Warsh, MD, of Integrative Pediatrics and Medicine, Studio City, CA, and part of the pediatric staff of Cedars-Sinai Hospital.
Dr. Warsh continues, “One of a preschooler’s major drives is attention. Does your child want to go to sleep? Are they fighting you every night?”
This makes a lot of sense. After all, even though you may not be a doctor, you have to admit that it’s unlikely that any medical condition would cause vomiting ONLY at night or overnight.
Though many conditions can cause vomiting overnight, there’d also be upchucking during the day as well.
Plus, your child would have other symptoms such as nausea, stomach pain, loss of appetite. They’d seem sick.
“If your child vomited in the past because they worked themselves up, crying going to bed or were sick with a stomach bug, they probably got a lot of attention,” explains Dr. Warsh.
“They realized they received a lot of comfort and parental time for this, and the behavior continued happening.
“The most important thing to consider in this case, like any sleep training, is to not give too much attention to the issue.
“If they vomit, keep the lights dim, do not interact, change the sheets and put them straight back to bed. Positively reinforce nights without vomiting.”
But CAN it be a medical condition?
Dr. Warsh says, “Something else to consider would be reflux. When you lie down, gravity is not working with you, and stomach contents are more likely to reflux from the stomach into the esophagus.
“If this is a concern, start by restricting any liquids one hour before bed and see if this helps.
“Do not feed them any late night snacks, and if you give them anything after dinner, make sure it does not inflame the gut. No sugar, dyes or preservatives.”
Keep in mind that acid reflux that comes out of the mouth is not the same mechanical dynamic as vomiting, even though the fluid-like gunk may look like vomitus.
If possible, prop your preschooler’s bed up on the head side by 15 degrees to help offset the effect of gravity.