However much lack of appetite in children may be recognized as of nervous or emotional origin, vomiting always is regarded as having an organic basis, and consequently serious.
On the whole this attitude is proper. Vomiting in a previously well and happy child is usually the sign of the onset of an infectious disease. Scarlet fever, notoriously, may show its first sign as vomiting. In infants, vomiting from birth may be the sign of a closure of the opening of the stomach into the intestines.
But aside from these physical causes of vomiting, the symptoms also appear in children as the result of an upset nervous system. It should be emphasized that the distinguishing signs between the two forms of vomiting are that the organic form appears suddenly in a previously well child, the functional comes on gradually and continues in a child which appears otherwise healthy, and in spite of the vomiting is in good nutrition.
Perhaps most frequently of all the causes is mismanagement of the symptomlack of appetite. When a child has been coaxed, scolded, threatened and bullied into eating a meal, it cannot be wondered that there is a distaste for the food and that the meal does not sit well. Nor that such meals are ejected as a result of the emotional disturbance.
There are at least two wrong ways of regarding such a problem in childhood. One is to insist that it must have a physical basis and by surgical operations, medications, fussy change of diet and other mechanistic procedures, attempt to overcome it. Several children are known to me who were submitted to a surgical operation for “chronic appendicitis” for this condition; invariably they were no better off afterwards than before.
But perhaps even worse is to take the attitude that the child per-forms these acts from “cussedness.” It is not cussedness, but a perfectly definite emotional condition. The problem is to attempt to understand the conditions and remove them.
Closely allied to vomiting is the regurgitation of food by infants. Doctor Douglas A. Thom, whose book, “Everyday Problems of the Everyday Child,” is one of the sanest presentations of the problems we have been considering, says that “children who have this habit of regurgitating food should not be rocked or tossed or handled in any way immediately after meals.”
This is one of the few places in which one is inclined to disagree with Doctor Thom’s ideas. Most children’s specialists would agree with Tisdall (“Home Care of the Infant and Child”) that regurgitation is caused by the swallowing of air, and the proper treatment is to hold the infant on your shoulder and gently pat him on the back until the air comes up.