My Baby Cries So Hard She Pukes!

Help! I don’t know how to handle my toddler at bedtime! She cries so hard she pukes!

Ah, Toddlers! Such clever creatures! How on earth did they figure out that they can delay bedtime by massively throwing up all over the crib?

I wonder sometimes if there is an International Toddler Convention at which they come up with ideas like this. Imagine what the brainstorming sessions must be like:
“Ooooh! Ooooh! I know! We could light the house on fire and that would activate the fire alarms and then we wouldn’t have to go to bed!”

“I have an idea! Let’s massively throw up all over the place and then mom has to change the sheets and we don’t have to go to bed!”

“Sheer genius. All in favor?…”

Why She Cries So Hard She Pukes

Appearances to the contrary notwithstanding, toddlers really don’t share ideas. Certainly not at international conventions (but wouldn’t it be neat if they did?) It only seems that way. The truth is more prosaic: babies and toddlers are more likely to throw up when they get upset than adults are.

So when your toddler throws a tantrum in the crib and cries so hard she pukes, it does not mean that something is terribly wrong, or that’s she’s sick, or that you’ve scarred her psychologically. She’s only doing what she tends to do.


But when mom, having heard the retching, rushes in and makes a big scene, the toddler may say something to herself that goes something like this:

“I’m not really sure what just happened, but look at this reaction from mom! I’m gonna do this again!!!”

Secondary Gain

What starts out as a gastrointestinal accident can quickly develop into a habit. This is especially so if mom or dad makes a big show of emotion and pays a lot of concentrated attention to the puker after the event. This is what the psychologists call “secondary gain“. The toddler doesn’t get much benefit from throwing up. Very few people do. However, she gets a fair amount of benefit from the aftermath! She gets to delay bedtime and she gets attention from mom!

The Sears Way

Dr. Sears recommends that you try to identify the trigger for the tantrum and then to engage in “holding therapy”:

Hold your child in a relaxed and comforting way (even if he squirms) and reassure him with the most soothing voice you can muster. The message you’re trying to convey is that he’s lost control and you’re there to help him regain it. Later in life, when your son is past the tantrum stage, his memories of calm during the stormy behavior will prove valuable.

cries so hard she pukes 4
Not sure what I did but I’m gonna do it again!!!

Well… First, we know what the trigger is. The child is ticked off that it’s bedtime and she has to go to sleep. Second, holding therapy is giving the child exactly what he wants: relaxed comfortable holding with a caregiver. Who doesn’t wan’t that? I’m not sure how this solves the “cries so hard she pukes” problem. To the contrary. It’s only likely increase the odds it happens again tomorrow night.

The Obleman Way

My colleague Dana Obleman has a much more practical, and in my view, effective way of dealing with the bedtime puker. Dana recommends standing your ground and insisting that bed time is bed time and no amount of tantrum-induced throwing up is going to cause you to deviate from the routine!

Although you might feel like she will continue doing this forever, creating chaos and piles of laundry, the truth is that when she sees that it doesn’t change what she’s allowed or not allowed to do, she will stop. If the problem occurs at bedtime, just matter-of-factly clean up the mess, change her pj’s and stick with the routine. She should stop within a few nights once she gets the message.

Exactly right.

The trick is to do all this “matter-of-factly” as Dana says. No emotion, no comment, no “holding therapy”. If you avoid all this there will be no secondary gain. And the behavior will go away.cries so hard she pukes 3

Limits setting

I can report from bitter experience that consistent limits setting and enforcement was one of the toughest things I had to do as a parent. And here’s something even tougher to do: understand that your children need you to set and enforce those limits! Without clear boundaries that are guarded by vigilant caregivers, children tend to be more anxious less secure in their world. Don’t set limits for the sake of the laundry, do if for the children!

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Rob Lindeman

Rob Lindeman is a sleep coach, entrepreneur, and writer living in Massachusetts. Ready to Get Rid of the Pacifier? Sign up for our FREE Video eCourse: The Paci-Free Method

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