Rumination Disorder

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KEY POINTS

• Rumination disorder is an eating disorder in which a baby or young child brings back up and re-chews food that has already been swallowed.
• In most cases, babies with this disorder outgrow the behavior and return to eating normally.

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What is rumination disorder?

Rumination disorder is an eating disorder in which a baby or young child brings back up and re-chews food that has already been swallowed. The re-chewed food may be swallowed again or the baby may spit it out. This behavior happens in children who had previously been eating normally.

What is the cause?

The exact cause of this disorder is not known. For some children, the act of chewing is comforting. Infants who are neglected, abused, or ill may develop this behavior. It may be a way for your child to gain attention.

What are the symptoms?

Symptoms may include:

• Repeatedly bringing up food from the throat or stomach and re-chewing it
• Weight loss
• Bad breath and tooth decay
• Repeated stomachaches and indigestion
• Raw and chapped lips

Bringing up food starts within minutes of a meal and may last for several hours. It happens almost every day after most meals for at least a month. Bringing up food seems easy for the child and rarely causes retching. Some infants may make unusual movements. These include straining and arching the back, holding the head back, tightening the belly muscles, and making sucking movements with the mouth.

How is it diagnosed?

Your healthcare provider will ask about your child's symptoms and medical history and examine your child. Your healthcare provider may do X-rays and blood tests to check for physical causes for bringing up food. The healthcare provider may also want to observe your child during and after eating.

How is it treated?

Treatment mainly focuses on changing your child's behavior such as:

• Changing your child's posture during and right after eating.
• Giving your child more attention.
• Making feeding time relaxing and pleasant.
• Distracting your child when he or she starts the rumination behavior.

Habit reversal training helps your child become aware of when he or she is about to bring up food and re-chew it. Then your child does what is called a competing response. This means that, for example, when your child feels the needs to bring up food, your child would take a deep breath and feel it expand the belly. The muscles used to do this make it impossible to do the old habit at the same time.

How can I take care of my child?

Follow the full course of treatment prescribed by your child’s healthcare provider. Ask your provider:

• How and when you will get your child’s test results
• How long it will take your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.