A 9-month-old baby came to the hospital with vomiting after meals for a week. Doctors discovered the real problem wasn’t his stomach—it was a serious lack of vitamin D and calcium causing his bones to weaken. This case is unusual because vomiting is rarely the first sign of this bone disease. The baby got better quickly after receiving calcium and vitamin D treatment. This story teaches doctors to think about bone health when babies have unexplained vomiting, especially in families from certain parts of the world where vitamin D deficiency is more common.

The Quick Take

  • What they studied: Why a 9-month-old baby kept throwing up after eating, and what doctors discovered was actually causing it
  • Who participated: One male infant, 9 months old, from an Afghan family who came to the emergency room with vomiting
  • Key finding: The baby had severe vitamin D and calcium deficiency (a condition called rickets), which was causing vomiting and dangerous changes in blood chemicals. Once treated with calcium and vitamin D, all symptoms went away
  • What it means for you: If a baby has unexplained vomiting, especially after meals, doctors should check vitamin D and calcium levels. This is particularly important for families from certain regions or those with limited sun exposure. Early detection prevents serious bone problems

The Research Details

This is a case report, which means doctors are describing what happened with one specific patient in detail. A 9-month-old boy came to the emergency room because he kept throwing up after eating for a whole week. The doctors did blood tests, heart tests, and X-rays to figure out what was wrong. They found that the baby’s calcium levels were dangerously low, which was causing the vomiting and other problems.

The doctors gave the baby calcium through an IV (a tube in the vein) right away, which stopped the vomiting quickly. Then they discovered the root cause: the baby didn’t have enough vitamin D, which helps the body use calcium. This caused a bone disease called rickets. They started the baby on vitamin D and calcium pills, and everything got better.

Case reports are important because they describe unusual situations that doctors might not see very often. This case is special because vomiting after meals is not the typical way rickets usually shows up in babies.

This case matters because it shows doctors something new. Most babies with rickets show signs like soft bones, delayed growth, or skeletal problems. This baby’s first symptom was just vomiting, which could easily be confused with a stomach problem. By sharing this case, doctors around the world can learn to think about vitamin D deficiency when they see babies with unexplained vomiting, especially in families at higher risk

This is a single case report, which means it describes one patient’s experience. While case reports are valuable for teaching doctors about unusual presentations, they cannot prove something is true for all patients. The strength of this report is that the doctors documented everything carefully with blood tests, heart recordings, and X-rays. The baby’s quick recovery after treatment supports their diagnosis. However, we cannot know how common this presentation is without studying many more patients

What the Results Show

The main finding was that a baby with severe vitamin D and calcium deficiency presented with vomiting after meals as the primary symptom. Blood tests showed the baby’s calcium was dangerously low (severe hypocalcemia), which caused the vomiting and also created an abnormal heart rhythm pattern. The baby also had low potassium and high alkaline phosphatase (an enzyme related to bone health).

When doctors gave the baby calcium through an IV, the vomiting stopped within hours and the heart rhythm returned to normal. This rapid improvement showed that the low calcium was directly causing the vomiting. Further testing revealed the baby had severe vitamin D deficiency and high parathyroid hormone levels, confirming nutritional rickets.

X-rays of the wrist showed the typical bone changes seen in rickets. Once the baby started taking vitamin D3 and calcium supplements by mouth, all symptoms resolved completely. At follow-up visits, blood tests returned to normal and the baby remained healthy.

The baby also had mild low potassium levels and metabolic alkalosis (the blood was too alkaline). These electrolyte imbalances contributed to the abnormal heart rhythm seen on the EKG. The large soft spot on the baby’s head (anterior fontanel) was also larger than normal, another sign of rickets. Interestingly, the baby didn’t show obvious skeletal deformities on physical exam, which made the diagnosis less obvious at first

Rickets is a well-known disease caused by vitamin D and calcium deficiency, but it typically presents with bone-related symptoms like soft bones, delayed growth, or skeletal deformities. Vomiting is not commonly reported as the first symptom. This case is unique because gastrointestinal symptoms like vomiting are rarely the main presenting complaint. The doctors explain that low calcium can affect how the stomach works, potentially causing vomiting. This case adds to medical knowledge by showing that rickets can present in unexpected ways

This is a single case report, so we cannot know how often this presentation occurs or whether it applies to all children with rickets. We don’t know details about the baby’s diet, sun exposure, or family history that might have contributed to the vitamin D deficiency. The case describes what happened after treatment but doesn’t provide long-term follow-up beyond the initial recovery. We also cannot determine from one case whether this presentation is more common in certain populations or under specific circumstances

The Bottom Line

Healthcare providers should consider vitamin D and calcium deficiency (rickets) in babies with unexplained vomiting, particularly those from at-risk populations or with limited sun exposure. Checking vitamin D and calcium levels is a simple blood test that can reveal this treatable condition. Once diagnosed, vitamin D and calcium supplementation is effective and safe. Confidence level: High for diagnosis and treatment approach, based on this case and existing medical knowledge

Parents and doctors should care about this finding, especially those caring for babies from regions where vitamin D deficiency is common, babies with limited sun exposure, or those on restricted diets. Babies exclusively breastfed without vitamin D supplementation are at higher risk. Healthcare providers in emergency departments should be aware of this unusual presentation. This is less relevant for babies with adequate sun exposure and balanced diets including vitamin D sources

In this case, the baby’s vomiting stopped within hours of receiving calcium treatment. Complete resolution of all symptoms and normalization of blood tests occurred within days to weeks of starting vitamin D and calcium supplements. However, bone healing and complete recovery may take weeks to months. Parents should expect to see improvement in vomiting quickly, but ongoing supplementation is needed for full recovery

Want to Apply This Research?

  • Track daily vitamin D and calcium supplement intake (dosage and time taken) and monitor for vomiting episodes after meals. Record any changes in feeding patterns, energy levels, or growth measurements at regular intervals
  • Set daily reminders for vitamin D and calcium supplementation at the same time each day. Keep a simple log of meals and any vomiting to share with your pediatrician. Ensure adequate sun exposure (15-30 minutes daily when safe) and include vitamin D-rich foods in the diet
  • Schedule regular follow-up blood tests (every 4-6 weeks initially) to confirm vitamin D and calcium levels are normalizing. Track symptom resolution weekly. Once levels normalize, transition to maintenance supplementation and monitor quarterly. Keep records of growth measurements and developmental milestones

This case report describes one patient’s experience and should not be used for self-diagnosis. If your baby has unexplained vomiting, persistent symptoms, or you suspect nutritional deficiency, consult with a pediatrician immediately. Vitamin D and calcium supplementation should only be started under medical supervision with appropriate dosing based on blood tests and individual needs. This information is educational and does not replace professional medical advice, diagnosis, or treatment. Always seek guidance from qualified healthcare providers for your child’s health concerns.