F98.21 Rumination disorder of infancy

Name of the Condition

• Rumination Disorder of Infancy (ICD-10 Code: F98.21)

Summary

This condition involves repeated regurgitation of food in infants, typically occurring within the first year of life. The regurgitated food may be re-chewed, re-swallowed, or spit out. It is not due to a medical condition or other feeding disorders and can lead to weight loss or malnutrition if persistent.

Causes

Causes are often multifactorial, including psychological factors (e.g., stress or anxiety), environmental influences (e.g., inconsistent feeding routines), or learned behaviors. Underlying medical conditions must be ruled out before diagnosing this disorder.

Risk Factors

• History of neglect or inconsistent caregiving
• Premature birth or low birth weight
• Coexisting developmental or behavioral disorders
• Lack of structured feeding routines
• Parental anxiety or stress during feeding times

Symptoms

• Repeated regurgitation of food (typically within 30 minutes of feeding)
• Re-chewing or re-swallowing of regurgitated food
• Weight loss or failure to gain weight appropriately
• No evidence of gastrointestinal or other medical conditions
• Symptoms not attributable to other feeding disorders

Diagnosis

Diagnosis requires a thorough evaluation by a pediatrician or specialist. This includes a detailed medical history, physical examination, observation of feeding behaviors, and assessment of growth patterns. Additional tests may be performed to rule out medical causes, and psychological input may be considered if needed.

Treatment Options

Treatment often involves behavioral interventions, such as modifying feeding routines or providing positive reinforcement. Nutritional support may be necessary to address weight concerns. In some cases, parental education and counseling are recommended to address environmental or psychological factors.

Prognosis and Follow-Up

Prognosis is generally good with appropriate intervention, especially if addressed early. Follow-up monitoring of growth and feeding behaviors is important to ensure improvement and prevent recurrence. Long-term outcomes depend on the consistency of treatment and any coexisting conditions.

Complications

• Malnutrition or failure to thrive
• Delayed growth or development
• Social or emotional difficulties related to feeding
• Increased risk of other feeding disorders if untreated

Lifestyle & Prevention

• Establish consistent, calm feeding routines
• Minimize distractions during meals
• Provide a supportive environment to reduce stress
• Monitor for signs of regurgitation and address promptly
• Seek early intervention if symptoms persist

When to Seek Professional Help

Consult a healthcare provider if regurgitation is frequent, leads to weight loss, or interferes with the infant’s growth. Professional help is also recommended if there are concerns about underlying medical conditions or if symptoms worsen despite home care.

Tips for Medical Coders

When coding F98.21, ensure documentation supports the diagnosis by confirming repeated regurgitation in an infant, exclusion of medical causes, and alignment with the clinical criteria. Note the age of onset (infancy) and any associated factors, such as feeding environment or behavioral observations, to support accurate coding.