Has your child ever come to you and said, “Mom/Dad, my tummy hurts”?
You may wonder, “Did they eat something that didn’t agree with them? Have they pooped today?” Figuring out what’s going on inside their belly can sometimes feel like an episode of “The Good Doctor.”
While you may have a “cast-iron stomach,” your little one might not. Most children will complain of a stomachache at one time or another—and not all will be digestive related. So, how do you know whether it’s something that will just pass or will require medical attention?
Although there are serious disorders that can cause abdominal pain, usually your child’s stomach pain is something less worrisome. We dive into four common reasons for your child’s tummy ache and ways you can put their stomach and mind at ease.
“By far, constipation is the most common cause of abdominal pain in children,” said Lynn Lawrence, MD, an emergency physician at Banner Children's at Desert in Mesa, AZ..
Childhood constipation accounts for 3% of pediatric visits and 30% of pediatric gastroenterologist visits.
Children’s tummies are quite finicky. Things like changes in diet and routine, dehydration, potty training and illnesses can affect your child’s bowel movements and contribute to constipation.
“For younger kids, be aware of their stooling pattern. If they haven't had a bowel movement for a day or two, that could be the cause of their pain,” Dr. Lawrence said. “If your child has pain, let them rest, see if maybe they need to go to the bathroom and check for a fever.”
Tips to reduce constipation
- Ensure your child is drinking plenty of water – especially during hot, summer months where it’s easy for them to get dehydrated. “Most kids don’t drink enough water and dehydration in combination with a poor diet are the two biggest factors in constipation,” Dr. Lawrence said. Check out this helpful chart from the American Academy of Pediatrics on suggested daily water intake.
- Make high-fiber meals, rich with whole grains, fruits and vegetables.
- Limit sugary foods and drinks, which can aggravate constipation and contribute to long-term health problems, such as type 2 diabetes and childhood obesity.
- Call their doctor if you notice rectal bleeding, pain with an accompanied fever or longstanding issues with constipation as this could point to other medical conditions.
It’s not uncommon for children to complain about tummy aches (or butterflies) around the start of school or before a big test or game. In fact, we are now acutely aware of our brain-gut connection and how stress and anxiety can send our nervous system into a fight-or-flight response—affecting our entire body and not just our stomach.
“This is more common in children than many people often realize,” Dr. Lawrence said. “When children have recurrent stomachaches and we cannot find a medical explanation, the next thing we look at is stress. Are there changes at home or trouble at school that may be causing stress to manifest itself as a stomachache?”
During stressful or intense emotional times, children may not have the appropriate coping skills. Here are some things you can do to help them.
Tips to reduce your child’s stress
- Ask questions to figure out where the stress is coming from by talking with your child. Some kids are better than others at sharing their feelings, so you might be unaware there were any issues unless you do some prompting.
- Practice deep belly breathing exercises and adapt to what works best for your child. This calming exercise is good for both children and parents to help you feel relaxed and grounded.
- Make sure they are getting enough sleep at night. Preschoolers need between 10 and 13 hours of sleep, school-aged children 9 to 12 hours and teens 8 to 10 hours.
- In some cases, it may help to have your child seen by their doctor or get a referral to a behavioral health specialist who can help address the underlying cause of their pain.
- For other helpful tips to reduce your child’s stress, check out, “Four Ways to Help Kids Stress Less” and “How to Help Your Child Cope With Stress.”
3. Infections … and not just the stomach bug
While mild stomach bugs (called gastroenteritis or stomach flu) can cause vomiting, diarrhea and other tummy issues, your child’s stomachache could be related to other viruses or bacteria. Viral infections tend to resolve quickly, while bacterial infections, like urinary tract infections, strep throat or ear infections, may need an antibiotic to improve.
Tips for minimizing stomach pain from infections
- Keep them hydrated. Diarrhea, especially with vomiting, can lead to dehydration. If they’ve been throwing up, make sure they take small sips of water or popsicles.
- Give them bland foods that will ease their tummy, such as crackers, bananas, rice and toast.
- Let them rest. Now is the time to let them play on their iPad or tablet, read a good book or simply sleep.
- Call their doctor if you notice blood in their throw up or stool, if they have worsening or persistent pain, if they are unable to keep fluids down or if they experience pain during urination.
4. Lactose Intolerance
If you’re child loves ice cream and milk in the morning but finds hours later they are doubled over with gas, cramps and other stomach issues, they may have a dairy allergy known as lactose intolerance. This dairy allergy is caused by problems digesting lactose, the main sugar in milk and milk products. These symptoms can start in late childhood or adolescence and can become more noticeable into adulthood.
“Milk allergies are not as common a cause for a stomachache, but some kids do suffer from lactose intolerance and have pain,” Dr. Lawrence said.
Tips for minimizing stomach pain from dairy
- One way to check to see if your child has trouble digesting dairy is to remove all milk products from their diet for two weeks to see if symptoms improve.
- Have your child’s doctor test them for lactose intolerance with a hydrogen breath test. In some cases, lactose intolerance is temporary, but often it is a long-term condition that requires many children and adults to alter their diet to avoid symptoms.
When Should You Seek Immediate Medical Care?
“If your child seems like they are still playful and hydrated, then it’s OK to monitor at home,” Dr. Lawrence said. “ If pain is worsening or there is persistent pain, concern for dehydration (due to excessive vomiting and diarrhea or the inability to keep fluids down), lethargy or they are unable to walk due to pain, they need to be evaluated.”
In most causes of stomach pains, your child won’t require medical care, but do call your doctor right away if any of the following occur:
- Pain on the lower right side is severe and constant, which may indicate appendicitis.
- Your child has a fever and/or vomiting.
- You see blood in their stool or vomit.
- Your child is younger than 12 months old.
- Your child can’t keep fluids down or shows signs of dehydration.
- Your child is lethargic and difficult to wake up.
You know your child the best. In the end, if your gut is telling you something isn’t’ right, don’t be afraid to call their doctor. Call it “gut feelings” or “mother’s intuition, but there are some signs your intuition is on point and a reason to not ignore it.
To find a Banner Health specialist near you, visit bannerhealth.com.