title: A retrospective review of cyproheptadine for feeding intolerance in children less than three years of age: effects and side effects.
abstract: OBJECTIVE
  Premature infants and those with brain injury often suffer from feeding intolerance and vomiting in the first several years of life. Cyproheptadine is a medication with antihistaminergic, antiserotonergic and anticholinergic effects, thought to increase gastric accommodation. We aimed to retrospectively review our experience using cyproheptadine for feeding intolerance and/or vomiting in children under the age of three.
  
  
  METHODS
  This is a retrospective chart review of 39 patients less than three years of age who were prescribed cyproheptadine for feeding intolerance or vomiting and had follow-up information available.
  
  
  RESULTS
  Starting dose ranged widely (from 0.069 to 0.825 mg/kg/day). Side effects such as sleepiness and constipation were rare. The medication had a significant positive effect, defined as resolution of vomiting, improved feeding tolerance or improved comfort with feeds, in 67% of children. An additional 28% showed possible improvement, defined as some improvement in vomiting or improvement in vomiting or feeding tolerance in conjunction with other changes in addition to cyproheptadine.
  
  
  CONCLUSIONS
  In our experience, cyproheptadine appears to be safe and effective in decreasing vomiting and feeding intolerance in children less than three years of age. A trial of cyproheptadine could be considered before invasive testing in infants with feeding issues.
authors.affiliation: Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Merhar
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Scott P
authors.initials: SP
authors.lastname: Pentiuk
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Mukkada
authors.affiliation: Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Jareen
authors.initials: J
authors.lastname: Meinzen-Derr
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kaul
authors.affiliation: Division of Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Dawn R
authors.initials: DR
authors.lastname: Butler
mesh_terms: D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D003533:Cyproheptadine / Q000009:adverse effects* / Q000627:therapeutic use*; D001068:Feeding and Eating Disorders / Q000188:drug therapy*; D005260:Female; D006633:Histamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D014839:Vomiting / Q000188:drug therapy
chemical_list: D018680:Cholinergic Antagonists; D006633:Histamine Antagonists; D012702:Serotonin Antagonists; D003533:Cyproheptadine
keywords: Cyproheptadine; Follow-up; Prematurity; Tube-fed; Vomiting