Vomiting at Bedtime

Archived Q&A and Reviews

22-month-old vomits after crying for a few minutes at bedtime

Jan 2005

We are having trouble getting our 22-month old son to put himself to sleep. If we put him in his crib awake and we leave the room, he promptly stands up, cries for a few minutes (and I mean like no more than 3), and then throws up. He used to be a great sleeper: from the time he was 6-9 months until 18 months we had no problems putting him down at night. We would give him a bottle, read a story or two, sing a song, lay him down and say ''mama loves you! night-night'', turn a little music box on (that only played for a few minutes), leave the room, and he'd be asleep in like 10 minutes. But then one night last August (at 18 months) all of that just changed. The normal routine just stopped working, and as soon as we left the room and let him cry for a few minutes he promptly threw up. After he threw up 3 nights in a row, I decided I couldn't deal (I am one of those vomit-phobic types) so I came up with a work-around. I now read him a story or two while we snuggle on my bed, then turn out the lights and give him a bottle. He usually falls asleep in my arms drinking his bottle, and if he doesn't, I lay him down in his crip and back away but don't leave the room until he is asleep. This solution has worked for me, and it avoids the vomit episodes, but it does not work for my husband (our son won't go to sleep in his arms and still vomits), and I realize I can't continue putting him to sleep this way forever.

I have read lots of chapters in baby books about sleep issues, but none really address what to do if you have a vomiter. They all say to check on the child after 10 minutes or so to see if they've vomited, but the books don't say what to do if they have vomited and especially if they do it nightly (and seemingly on purpose). Obviously we clean it up, change sheets and jammies as quickly as possible, and we don't pick him up to console or comfort - we don't want to reinforce that if he vomits he will get taken out of the crib. So what do we do? Do we just let him continue to throw up and hope that eventually he tires of it? Do we not clean it up one night, so he knows it really doesn't get any reaction from us? Do I continue putting him to sleep in my arms in order to avoid the whole situation? I really hate dealing with throw up (in fact it was one of my worst fears about motherhood! Luckily my husband is more able to deal with it), and I know there has to be some solution that won't scar my son but will be less nasty and anxiety-inducing for me and my husband. Any and all suggestions welcome!!
frustrated and vomit-phobic mama

My son did the EXACT same thing!! He is now 2 1/2 and ''kind- of'' goes to be by himself. When the vomiting this started, we backed off for a while and did something similar to what you are doing. Then, as few weeks later, my some figured out how to get out of his crib, so we got rid of the crib for fear of him falling on the floor from that height. We got a toddler bed for the crib mattress and started a new routine. One night I asked, ''do you want to lay down and listen to mommy sing, and watch mommy put clothes away?'' and he did it! Now he falls asleep watching me or my husband (or both) clean his room and fold laundry. Again, not the best solution, but better than being trapped with him on the bed until he falls asleep, and we are able to clean his room every night, which is nice :-) But, now he can get out of bed and open doors, so we don't know what to do to make him go to sleep on his own again! oh well...
I don't have any advice for you, but I have a friend whose daughter does the same thing. She is three years old, and still cannot be left to go to sleep by herself! I am hoping that your question will generate some good advice that I can pass along. yuck!

So upset she vomits

I've tried to stay out of the sleeping discussions, because it seems to be one of those areas that people have VERY strong opinions. But this one really tugged at my heart. It seems to me that if she's so upset that she vomits, she's trying to tell you that she NEEDS you. I think you should give in, and *do what works*. If letting her fall asleep in your arms is what works, then *do* it!

Our experience was that our daughter preferred to fall asleep with help. Early on, that was rocking or walking to sleep. Later it was just staying up, in our laps, while she watched a favorite video while falling asleep. Her sleep schedule was so irregular, that *we* finally felt we needed to take action, though, because we weren't getting the time alone that we needed for our relationship, and to take care of the home. We experimented with sleep aids (melatonin, and later tryptophan--I'll be happy to discuss the details if anyone wants to know), but what seems to have been a success is a modified version of cry it out. But I feel it makes a HUGE difference that we waited until she was 2 1/2 to do this, when she could understand that she wasn't being abandoned every night. The whole process took less than two weeks, to go from her not being able to go to sleep on her own, to putting her in her bed, closing the door, and being done with it. Basically, we established a routine (bed time, clean up toys, brush teeth, jammies, story), and then my husband closed the door and let her know that he was in the next room if she needed him. Since she's in a toddler bed, this meant that she got out of bed repeatedly and often the first couple of nights. He'd just reassure her and send her back to bed Within a few days, she was only getting up once or twice. Last night she didn't get up at all. We're ecstatic.

One of my main points here is that we went from a family bed, to a modified family bed, to her being in her own bed and going to sleep on her own Not making your daughter go to sleep on her own at 1 year old is not necessarily going to cause big problems down the road. It may just mean a period of concerted effort on your part when she seems ready to learn to go to sleep on her own. But if she is so upset that she vomits, then it's too early to be forcing this on her. She's not ready, and you should go with your instincts and with what works, and let her fall asleep in your arms. The time will come soon enough when she won't want to anymore! Good luck!

I have heard that Dr. Ferber even covers this in his book, advising parents to clean up the barf, but not to swerve from insisting that your child fall asleep alone in her crib, once you clean it up. And if she vomits again, just repeat the process. To me, this wouldn't sit well with my mothering instincts *at all*. I think you're right to question whether it's necessary to ignore your daughter's level of objection to being left alone to fall asleep. Cry it out is certainly not the only option.

Personally, I've never allowed/required my (now two-year-old) daughter to cry herself to sleep, and feel very good about that decision. We do a family bed, which is working very nicely for us, we all get a good night's sleep most nights. Almost every night, my daughter asks to go to bed, which makes me feel confident that she too feels good about our sleeping arrangement. I can wholeheartedly recommend this arrangement.

If you don't want to get involved in a family bed, there is lots of middle ground, particularly since your daughter falls back to sleep well on her own. For example, I don't see anything wrong with what you are doing -- hold night. Or how about sitting at her side and reading or singing or whatever, until she comfortabley falls asleep in her crib. Or you could try getting her a toddler bed (with side rails to keep her from falling out in her sleep), and lying down with her until she falls asleep. Maybe just knowing that she can get out of bed if she needs/wants to will lessen her objection to getting into bed.

What is your intuition about what bothers her so much about being put into her crib? Is she afraid (I've read that 12 months of age is a peak for separation anxiety)? Is she angry about being left alone? Is she not really tired? Maybe if you can figure out what her objection is, you can respond to that, and she will be able to get back to falling asleep on her own.

By the way, I've talked (live and virtually) with a lot of parents, and it seems to me to be altogether typical that a child's sleeping patterns change over time--good sleepers get wakeful, and wakeful kids get sleepier. Probably it will all even out in a few years.

I hope you have an open-minded pediatrician on this subject. I know for sure that there are lots of theories and options about sleeping arrangements, but I also know that many experts--e.g. pediatricians--get stuck on one particular theory and start to think that everyone must adhere to it. If your ped. tries to insist that you do something that just just doesn't feel right to you--don't do it, you don't have to. At least that's my approach.

Hope this (or something else) helps you get back to sleeping well.

My child also throws up if left to cry for even a few minutes -- and I used to think that she was crying so hard it just happened. Now I'm beginning to fear that she has figured out how to get herself to throw up -- I don't really ever let her cry it out either -- but when she hasn't fallen asleep in my arms or in her crib with some light back patting, I will at times let her cry for a few minutes. I am hoping that what I have heard from some other parents who experienced this is true for me -- this is a phase that will pass pretty quickly. In the meantime, I have started to not have such a big reaction when she throws up. Before, we used to turn on the lights, wash her, change her, etc. etc. Now I don't turn on lights and don't wash her much -- I am hoping that she'll realize she won't get a huge response -- I keep her in the crib, clean up what's necessary, wipe her, change her into something that's easy to put on so it doesn't require a lot of disturbance, and then I lay her down and pat her back. I have tried this the last couple of times, and she has fallen asleep very quickly. I hope this helps.
To the parent whose child is vomiting after crying in the crib for a few minutes...maybe your child now needs a bit more of a transition from being with you to being on her own. You may do this already and it's no revolutionary suggestion, but maybe more of a bedtime routine before you leave her in her crib would help. Reading a book together or whatever you think is relaxing and then maybe singing her a song in the dark while she lies down and/or rubbing her back for a few minutes. As I say you may have tried all this, but if she's been so easy to put to sleep until now you may not have!! The other thing is that you may need to adjust her naps or bedtime a bit to make sure she is really ready to go to sleep, rather than trying to stick to a schedule that she may have had before. Children's sleep schedules keep changing as they grow. Also, I find that a warm bath with lavender ( a few drops of essential oil in the tub) and a massage with lavender oil in the semi-dark (nightlight or candle) helps to relax my very energetic child and helped her to sleep, as well as being a nice way to finish the day. Finally, I have read that this type of vomiting is quite common, and the experts recommend going in , cleaning her up , giving her a kiss and a hug and leaving again!! But I would follow my instincts in this and do what feels right to you. Good luck.
My daughter has had more trouble falling asleep by herself since she was able to turn over and pull up on her crib. Three times prior to this we've successfully used the cry it out method to transition her from our bed to her bassinet, then to her crib, then to wean her off of at least two of her 4 or 5 night feedings. But shortly after the last time, she got a cold and was back to frequent night nursings, and before she was entirely better, she'd figured out how to stand up in her crib. When we tried to let her cry it out again, she would have none of it. It is important that they learn to fall asleep by themselves. However, if your daughter is actually vomiting, I would put it off. Try again in a month or so. At this point, our daughter doesn't fall asleep completely on her own. We have a bedtime routine which helps her to relax, and then we put her down when she's halfway there. She rouses a little but fusses herself to sleep within 10-15 minutes. If she seems to want to stand up, my husband (I have a bad back) will lean over her, one forearm on her chest, one on her thighs, until she relaxes and drifts off. The light pressure is comforting to her. It's not quite putting herself to sleep, but it's a little closer than putting her down once she's already asleep. Another thought: how soon before you put her down are you feeding her? Perhaps if you move the feeding time up by 1/2 to 1 hour the food will have moved out of her stomach by bedtime. Anyway, that's my advice. Good luck!

Spits up when lying prone

May 2000

I am seeking advice on our 20-month-old's sleep problems. At daycare she will lie down for her nap (with binky) without being rocked to sleep. At home, it's a different story. She is rocked to sleep at naptime (I've tried to just put her down, but she won't go to sleep - and yes, she is tired), to go to sleep at night, and if she wakes up in the middle of the night (I know! I know!). My daughter, for those on the list a while now, is the one who used to vomit if she cried for 5 minutes so we didn't let her cry it out and rocked her to sleep to avoid the vomiting. Our pediatrician even said it was OK at the time (she was sleeping through the night no problem - just needed to be rocked to sleep). Anyway, so now we have created a very difficult situation for my husband and me, who are very sleepshort particularly of late, as she gets up several times in the middle of the night (and falls asleep instantly in our arms when we pick her up and sit with her in the rocking chair, but jumps up and cries as soon as we put her back in her crib - aren't you glad you don't live at our house?!?!). Eventually she's out enough that we can put her down again and she sleeps through it. Last night, for example, she went to sleep at 7:40, woke up at 10pm, it took my husband about 45 minutes to get her down again and then she was up at 11pm again. It took me, miraculously, only 15 minutes to get her down again and then she slept through the night and was still sleeping at 6:20am this morning when I left to go to work (my husband does drop off at daycare in the morning). The past two nights have been nightmares of being up for hours with her (2.5-3 hours). So, what type of behavior modification can we do at this late stage to set things on track? Any and all advice appreciated. I realize it will no doubt get worse before it gets better, but we are ready to make it better. By the way, she no longer vomits if she cries for a while, thank goodness. Lori

My 17 mo.old son has recently refused to sleep in his crib. It all began a few months ago. He had been sleeping through the night until Feb. Since then he has been waking earlier (4 am, 2 am, 11 pm) and we've been bringing him into bed with us. Getting him to sleep for the night hadn't been a problem until 2 weeks ago. Now the minute we try to put him in his crib he tenses up and begins to wail. ...
Does your daughter spit up a lot? She could have reflux and this causes her discomfort when she is lying down. The incline of the bouncy seat helps. My son had this problem and we did a few things. First we put him on medication for the reflux. We also put a wedge under the head of his crib to prop him up a little. Since we have done this he sleeps great. You can buy a wedge at Baby World on College.
I had the same thing with my son, he would sleep upright, but would cry shortly after we put him down flat. Turn out he had mild reflux. Not enough that he was throwing up an making it obvious, but it was burning his throat unless he was upright. THe doc put him on medicine which worked great. We also had him sleep in his carseat for months, which worked great, but ended up giving him neck problems because he slept with his head tilted. (We had to do some easy physical therapy--excersises, positioning--which worked very well and he was fine 6 months later) Sounds like you have the same sort of thing, so I would look into reflux and baby Zantac. Good luck.