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Expert Q&A:
Is it normal for a preschooler to get so upset that she throws up?

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Lawrence Kutner
Answered by Lawrence Kutner Ph.D.
Meet our authors
"I'm a clinical psychologist, a consultant, and a journalist," says Lawrence Kutner, "which is a great combination for someone who's nosy."

Lawrence Kutner, Ph.D. (www.drkutner.com), is a nationally known clinical psychologist who trained at the Mayo Clinic. From 1987 to 1994 he wrote the award-winning, weekly New York Times column "Parent &; Child," which was syndicated globally. From 1991 to 1999 he was the child behavior and "Ask the Expert" columnist for Parents magazine. He's also a former talk show host on KGO radio in San Francisco.

He is on the psychiatry faculty of Harvard Medical School and Massachusetts General Hospital, where he is co-director of the Harvard Medical School Center for Mental Health and Media. In addition, he's on the board of advisors to the Rosalynn Carter Mental Health Journalism Fellowship Program at the Carter Center in Atlanta.

Dr. Kutner has been a consultant to the Children's Television Workshop, the Johann Jacobs Foundation (Zurich), the Sexuality Information and Education Council of the United States, and to major universities and corporations throughout the United States and Europe. He is a frequent guest on national television and radio networks. He received his bachelor's degree from Oberlin College in Ohio and his Ph.D. in clinical psychology from the University of Minnesota. His recent books include Parent &; Child: Getting Through to Each Other, Pregnancy and Your Baby's First Year, Toddlers and Preschoolers, Your School-Age Child, Making Sense of Your Teenager, and Grand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can Do.

Dr. Kutner is the father of a 18-year-old son as well as a 30-year-old foster son from Romania. He and his family live outside of Boston, Massachusetts.
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Question


My 4 1/2-year-old daughter has been having this problem for about year and half now: She cries over something and after a while she throws up. Last night we went to a carnival, where she played a game and lost. The prize was a live goldfish. We explained to her that she lost and couldn't have a fish. After a little hesitation she calmed down. But when she got home she repeated the whole story again and started crying over why she didn't get a fish. Then she threw up all her dinner. Is this psychological or physical? Please tell me what I should do.

Answer


I can see how upsetting this would be to everyone in your family, but I doubt that there's anything physical going on here. Children this age who cry because they're upset can work themselves into a real tizzy. In your daughter's case, the end result is vomiting.

The underlying issue here is not the vomiting, but helping her learn to calm herself down more easily. Some of this will come with maturation. But there are a few things you can do to help avoid the problem — and the mess — in the future:

  • Intervene earlier. Look for signs that she's "revving up" and about to lose control. If you help her calm down more quickly, you should be able to avoid the vomiting.
  • Keep your own emotions in check. Remember that emotional distress is contagious. If you lose control when she starts crying, that will only make matters worse.
  • Be patient. Realize that no matter what you do, this will probably happen a few more times. Keep telling yourself that she'll grow out of it. She will.
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