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Tummy aches are a frequent problem for children younger than 5. Constipation is the most common cause, but other culprits include gas, reflux, GERD, colic, stomach flu, upper respiratory infections, motion sickness, food allergies, lactose intolerance, intestinal blockage (obstruction), food allergies, other infections, and appendicitis.
Why does my baby or toddler have abdominal pain?
Common and uncommon causes of abdominal pain, ranging from gas to appendicitis, are covered in detail below. It may take some detective work with the doctor to figure out what's causing your child's tummy trouble, especially if symptoms come and go. For clues, pay attention to when your child seems uncomfortable (like shortly after a feeding) as well as what other symptoms she has, such as a fever, vomiting, or diarrhea.
When should I call the doctor?
Call the doctor if your child has a stomach ache and:
- Has pain that occurs several times a day for more than three consecutive days
- Has abdominal pain that is getting worse
- Has other symptoms, such as vomiting, diarrhea, or fever
- Is losing weight because of her stomach ache
You know your child best. If your child has a stomach ache and you're concerned that something more serious is going on, call the doctor.
Seek immediate medical attention if your child's belly pain is severe – if you can't distract her from the pain or she is obviously extremely uncomfortable.
Symptoms: If your baby or child has bowel movements less frequently than usual, especially if he hasn't had one in three or more days and is uncomfortable when he does have one, he's probably constipated. Hard, dry stools that are difficult for him to pass are another sign. If your child is old enough to tell you where it hurts, he may point to his lower belly.
Causes: A switch in diet (for example, starting solids), lack of fiber, an illness, or dehydration are common causes of constipation.
What to do: Provide plenty of fluids throughout the day. Exercise can help get the bowels moving, too. If your child is eating solids, offer fiber-rich foods that produce looser stools, such as oatmeal, apricots, pears, prunes, and peas. Until the problem has passed, cut back on foods that tend to cause firmer stools, like bananas, apples and applesauce, carrots, squash, cheese, and rice.
If your baby or toddler still has trouble pooping, talk to his doctor about treatment options. Do not give your child a laxative or other over-the-counter medicines unless his doctor recommends it, because they can cause harmful side effects if not given properly.
Learn more: Constipation in babies and constipation in toddlers
Gas pain: babies
Symptoms: Your baby may be fussy for no obvious reason, or she may pull up her legs and stretch out, arching her back.
Causes: Gas forms when babies swallow air, for example, due to bubbles in formula, a poor latch if breastfeeding, or gasping between cries. A gassy tummy is common when babies start solids and are trying different foods for the first time. Gas could be a sign of gut immaturity, especially in the first three months: The colonies of bacteria in a baby's digestive tract (the "gut microbiome") are still developing.
What to do: Ways to ease the discomfort include burping your baby frequently, keeping her upright for feedings, and giving her a gentle belly rub. You might try placing your baby's tummy down across your knees and rubbing her back.
Learn more: Gas pain in babies
Gas pain: Toddlers and young children
Symptoms: Your child may experience bloating, pain, or burning in his belly, along with frequent burping or flatulence. He may also feel a bit of nausea.
Causes: Eating gas-producing foods (such as cauliflower or broccoli), too much fiber, or too many fatty foods can result in gas. Other common causes include eating fast and gulping air, not drinking enough water, and drinking too much juice. An accumulation of stool in the colon is another culprit, especially with toddlers, who may not be able to poop completely during a bowel movement. This is related to muscle development, not diet.
What to do: Eliminate or reduce the amount of foods that trigger your child's gas. Encourage your child to drink plenty of water and avoid juice. Many juices, including apple juice and cherry juice, contain sorbitol, a nondigestible form of sugar that causes gas. Establish a bathroom routine that involves having your child sit on the potty several minutes a few times a day, such as after meals.
Learn more: Gas pain in toddlers and young children
Reflux and GERD
Symptoms: Most babies spit up a bit – or even vomit – sometimes after feedings. This is a condition called gastroesophageal reflux (or just "reflux"), and it's normal in babies and children. Reflux can cause an upset stomach and a burning sensation in the throat and chest.
When babies have reflux that's severe enough to cause complications, such as poor growth, trouble breathing, or feeding problems, it's called gastroesophageal reflux disease (GERD).
Causes: Reflux happens when the valve between your child's esophagus and stomach isn't working properly, and food and gastric acid gurgle up from the stomach into the throat.
What to do: Talk with the doctor if you think your baby has reflux. Ways to ease symptoms include feeding smaller amounts, burping frequently, and holding her upright during and after feedings. Most babies outgrow reflux in the first year.
Learn more: Reflux and GERD
Symptoms: Your baby is considered colicky if she's younger than 5 months old and cries excessively and uncontrollably for more than three hours in a row, three or more days a week, for at least three weeks, and there's no medical explanation for her distress.
Causes: Experts aren't sure what causes colic, but it seems to involve painful contractions of the intestines. The discomfort may be more intense in the late afternoon and early evening. Your baby may cry inconsolably, pass a lot of gas, and pull up her legs.
What to do: Unfortunately, there's no cure for colic, but you can try to soothe the tears and pain. Symptoms usually improve significantly between 3 and 4 months, and most babies are over colic by the time they're 5 months old.
Learn more: Colic
Symptoms: Vomiting and diarrhea are the most common signs of gastroenteritis, also known as the stomach flu.
Causes: Stomach flu is caused by a variety of viruses and bacteria. Your child may have eaten something that was contaminated. The stomach flu is very common and highly contagious, so likely your child touched something with the germs and then put his hand to his mouth.
What to do: Call the doctor if you suspect your child has gastroenteritis. Offer lots of fluids to prevent dehydration and a normal diet as tolerated.
Learn more: Stomach flu
Upper respiratory infections
Symptoms: Your child may develop a tummy ache when she has a runny or stuffy nose.
Causes: Much of the mucus produced during an upper respiratory illness drips down your child's throat and can irritate her stomach.
What to do: Some babies and children vomit to clear the mucus out of their system. It's not pretty, but it usually does the trick and the pain goes away. You can also try home remedies to help clear the mucus and make your child more comfortable.
Learn more: The common cold and the flu
Symptoms: Your child gets nauseous or even vomits during car trips.
Causes: Experts believe that motion sickness happens when there's a disconnect between what your child sees and what he senses with the motion-sensitive parts of his body, such as his inner ears and some nerves.
What to do: Take plenty of breaks during long rides, so your baby or child can get some fresh air. Give him a little something to eat before rides, and offer plenty of fluids to keep him hydrated. Don't give your baby or child any medication for motion sickness without talking to his doctor first.
Learn more: Motion sickness
Symptoms: In addition to stomach pain, a food allergy can cause a range of symptoms from mild to severe including vomiting, diarrhea, wheezing, coughing, stuffy or runny nose, swollen tongue, or hives or an itchy rash.
Causes: If your child is allergic to a food, her immune system overreacts to a food or substance in food (such as the protein in milk) and treats it like a germ, causing allergy symptoms. The most common allergens are eggs, milk, peanuts, tree nuts, fish, shellfish, wheat, and soy. Allergic reactions can happen within minutes or a few hours of eating food.
What to do: Talk with the doctor if you notice your baby having symptoms after eating a certain food. She may refer you to a pediatric allergist for testing.
Learn more: Food allergies in babies and food allergies in children
Call 911 or go immediately to the emergency room if your child has a life-threatening allergic reaction. Symptoms include turning blue, breathing trouble, extreme weakness or paleness, hives all over the body, bloody diarrhea, or swelling of the face, neck, or head.
Symptoms: Diarrhea, nausea, stomach cramps, bloating, and gas can result from lactose intolerance.
Causes: Lactose intolerance happens when the body doesn't produce lactase, the enzyme necessary to digest the sugar in cow's milk and other dairy products.
Lactose intolerance usually emerges later in childhood or during the teen years. However, children of any age who have had a gastrointestinal illness can experience temporary lactose intolerance that may last for a few weeks while the intestines recover.
What to do: Children who are lactose intolerant can take a synthetic form of lactase (an over-the-counter supplement) before eating foods containing lactose, and they can consume lactose-free milk products. If your child has temporary lactose intolerance due to an illness, avoid cow's milk and other dairy products until he recovers.
Learn more: Lactose intolerance
Intestinal blockage (obstruction)
Symptoms: Your baby or child seems fine one minute and is writhing in pain the next – he may be forcefully vomiting, drawing up his legs, and crying hard.
Causes: An intussusception happens when one part of the bowel slides into the next part. Pyloric stenosis, characterized by projectile vomiting, is caused by the thickening of the muscle leading from the stomach into the intestines, resulting in blocking food from passing through.
What to do: Call the doctor. If you can't reach the doctor immediately, take your child to the emergency room.
Learn more: Intussusception and pyloric stenosis intestinal blockages
Symptoms: Consuming or being exposed to a poisonous substance can cause a stomach ache, as well as vomiting or diarrhea.
Causes: Children can be poisoned by swallowing something toxic – such as a drug, plant, or chemical – or through chronic exposure to a toxic substance, such as lead.
What to do: Call the American Association of Poison Control Centers' national emergency hotline at (800) 222-1222 immediately. If you suspect lead poisoning, ask the doctor about having your child tested.
Learn more: Poisoning symptoms, treatment, and prevention
Symptoms: Certain infections can cause tummy troubles, including nausea and vomiting.
Causes: A urinary tract infection, strep throat, pneumonia, and even an ear infection can upset your child's tummy.
What to do: Talk to the doctor. Treatment depends on the type of infection.
Learn more: Urinary tract infections, strep throat, pneumonia, and ear infections
Symptoms: In addition to fever and vomiting, abdominal pain progresses from the belly button to the lower right abdomen, which an older child may be able to describe. The abdomen may be distended and sensitive to touch. Your baby may bend over on his right side if the inflamed appendix irritates the muscles that lead to the leg.
Causes: The appendix – an organ that sits at the beginning of the large intestine – becomes inflamed and infected when bacteria get trapped in it, typically by hard stool or a large lymph node compressing it.
What to do: Call your baby's doctor to determine if you should take your child to the emergency room.
Learn more: Appendicitis