{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T13:32:41Z","timestamp":1746711161394,"version":"3.40.5"},"reference-count":7,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7,1]]},"abstract":"<jats:p>Rumination is the effortless regurgitation of food, with subsequent spitting out or rechewing and reswallowing. In developmentally delayed children, rumination is a pleasurable, self-stimulating habit. For 3 years, we evaluated and treated 2 nonambulatory, nonverbal 4-year-old children who ruminated frequently while awake. The social isolation caused by a child covered in regurgitated food prompted caregivers of these children to find a solution. We hypothesized that rumination would cease if the stomach stayed empty of food. We intervened by placing gastrojejunostomy tubes and then initiated continuous drip jejunal tube feedings over 12 waking hours to reduce hunger; the children\u2019s oral diet was also stopped. In both cases, these changes reduced episodes of rumination to 3 to 5 times daily. To eliminate rumination, unpleasant tasting substances (N-acetylcysteine or cayenne pepper\u2013based hot sauce) were given through the gastrostomy tube every 4 hours while the children were awake. Within 1 week of adding the unpalatable substances, rumination ceased. After 2 months of no rumination, 1 mother restarted oral feeding. There was no recurrence of rumination, and 3 months after gastrojejunal tube placement, the tube was removed. In 1 year of follow-up, rumination did not recur. The second mother was pleased with the outcome with jejunal feedings and chose not to resume oral feedings. These results showed that jejunal tube feeding in combination with insertion of unpalatable contents into the stomach eliminated rumination in these developmentally delayed children.<\/jats:p>","DOI":"10.1542\/peds.2014-4100","type":"journal-article","created":{"date-parts":[[2015,6,30]],"date-time":"2015-06-30T00:20:16Z","timestamp":1435623616000},"page":"e249-e251","source":"Crossref","is-referenced-by-count":5,"title":["Eliminating Rumination in Developmentally Disabled Children: A Case Report"],"prefix":"10.1542","volume":"136","author":[{"given":"Amber","family":"Severio","sequence":"first","affiliation":[{"name":"Louisiana State University Health Science Center, New Orleans, Louisiana;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Monagas","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Children\u2019s Hospital of San Antonio, San Antonio, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Adam","family":"Noel","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Children\u2019s Hospital of San Antonio, San Antonio, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul E.","family":"Hyman","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Science Center, New Orleans, Louisiana;"},{"name":"Children's Hospital of New Orleans, New Orleans, Louisiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2015,7,1]]},"reference":[{"key":"2021120820373006900_B1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/978-1-4614-3794-9_53","article-title":"Rumination syndrome","volume-title":"Principles of Deglutition","author":"Hyman","year":"2013"},{"issue":"11","key":"2021120820373006900_B2","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1177\/0009922812460429","article-title":"Gastrointestinal issues and dental erosions in children.","volume":"52","author":"Monagas","year":"2013","journal-title":"Clin Pediatr (Phila)"},{"issue":"1","key":"2021120820373006900_B3","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1542\/peds.111.1.158","article-title":"Rumination syndrome in children and adolescents: diagnosis, treatment, and prognosis.","volume":"111","author":"Chial","year":"2003","journal-title":"Pediatrics"},{"issue":"2","key":"2021120820373006900_B4","first-page":"117","article-title":"Rumination syndrome.","volume":"7","author":"Talley","year":"2011","journal-title":"Gastroenterol Hepatol (N Y)"},{"issue":"6","key":"2021120820373006900_B5","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1016\/j.ridd.2011.06.011","article-title":"Behavioral interventions for rumination and operant vomiting in individuals with intellectual disabilities: a systematic review.","volume":"32","author":"Lang","year":"2011","journal-title":"Res Dev Disabil"},{"key":"2021120820373006900_B6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0016-5107(96)70264-X","article-title":"Percutaneous endoscopic gastrojejunal tube placement.","volume":"43(1)","author":"Berger","year":"1996","journal-title":"Gastrointest Endosc"},{"issue":"1","key":"2021120820373006900_B7","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1177\/0884533610392236","article-title":"Percutaneous endoscopic gastrojejunostomy tube feeding in children.","volume":"26","author":"El-Matary","year":"2011","journal-title":"Nutr Clin Pract"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/1\/e249\/1094076\/peds_2014-4100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/1\/e249\/1094076\/peds_2014-4100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:40:12Z","timestamp":1639010412000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/136\/1\/e249\/29282\/Eliminating-Rumination-in-Developmentally-Disabled"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2015,7,1]]},"published-print":{"date-parts":[[2015,7,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2014-4100","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2015,7,1]]}}}