Our paediatric dietitian, David Swain, advises on coping with multiple allergies when a toddler has begun vomiting on purpose.

Raisingkids member's problem
My 3 yr-old is a bright, intelligent boy in a stable, loving environment. However, he's intolerant to egg, cows milk, cocoa powder, some fruits, acids, preservatives, colourings, flavourings and much more (his 15 week-old brother is intolerant to cows' milk and soya).

Every so often, when unsettling things happen e.g. when great-grandad died, when Great Nan was very poorly, and when I went into hospital to have the baby, my son makes himself sick after he eats. He finds this really easy as his reflux valve is very weak.

My son 's god-mother (and ex-nanny) has got a new job so he hasn't seen her this week, and he's made himself sick after every meal since. I'm so concerned about him, and worry that he's developing an eating disorder. What can I do to break the cycle and stop this from happening?

Dave's advice
There are a number of different issues here. Firstly, your son's multiple food intolerances - it must be extremely hard for you to provide a varied and healthy diet avoiding all these foodstuffs and additives, so my first piece of advice would be to obtain a referral to see a State Registered Dietitian to ensure your boy's diet contains enough calories for growth, and to see whether he is meeting his recommended macro and micronutrient intakes.

In addition, it would be sensible to discuss with your Paediatric Consulstant how long your son needs to avoid these foods for, and to come up with a timetable of when he is to be challenged with each foodstuff (i.e. at what age should you try to reintroduce each food).

With regards to his recent vomiting, I agree with you in thinking it's very likely to be behavioural. From your question, it seems like he's missing his god-mother and is making himself sick to seek attention. This is not an uncommon problem and I wouldn't be too concerned with him developing an eating disorder in the future. My advice would be to speak with your GP or Paediatric Consultant and explain your concerns. It maybe that a referral to a psychologist may help. Alternatively some centres have specialist feeding clinics which could also be a possibility.

We also have more specific advice about vomiting on demand in our toddlers' section.

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