Rumination Syndrome

butterflygrooves

At the beginning of 2012 I took Owl in to see the pedi because she had what looked like vomit coming out of her nose in the mornings, the pedi said that she was ruminating and explained that Owl was always anxious and thinking about her past trauma and that's why she had this bit of vomit from her nose.

A few months later she was dx'd FTT and put on Pediasure, this launched her into disordered eating and vomiting multiple times a day for 3 months.  We went to the GI who said that her height/weight were in proportion (just small for her age), ran tests (all clear for GI issues) and said to take her off of the Pediasure, the vomiting tapered off and completely stopped after a month or so and she had been virtually vomit free for 8 months.  She was eating normally and starting to enjoy lots of different foods when...

Three weeks ago we saw a different pedi in the practice, he wanted to rx Pediasure again, I asked him not to because we would have to give it to Owl per foster rules and I didn't want to chance the disordered eating/vomiting again.  I got her to gain 2lbs with a high calorie diet in the following week but the Dr. wouldn't accept that and had the Pedisure delivered to us, we've since had vomit almost every day.

Owl doesn't have an allergy to the Pediasure, it just exacerbates the rumination; the neuropsych, GI, MHT, and our regular pedi all agree it's a behavioral/MH problem.  Owl will say she's hungry and then vomit after she takes a tiny bite, the vomiting comes so much easier when she is on Pedisure.  The vomiting is effortless for her, my DW doesn't see the signs but I have learned them - slightly hunched shoulders, different breathing, the look on her face. 

This past week and a half has been hard, I've been cleaning up vomit covered floors/tables/bathrooms/carseats/child and I don't know what to do to stop the behavior. I've tried lots of praise and encouragement, sitting with her/leaving her alone while she eats, letting her tell me when she is hungry, letting her pick what she wants to eat and drink, etc.  Our MHT has no ideas and says to talk to pedi/GI, pedi says it's MH/behavioral, GI says it's not GI related. I'm meeting with a BT today and feel like this is my last hope, this is obviously a chosen behavior, she can stop it if we catch her in time.

Anyone else in this boat?  What has worked for you?