My preschooler says his stomach hurts. How can I figure out what's causing it?
Pinpointing the cause of a child's stomachache can be tricky, even if your preschooler has the verbal skills to tell you where it hurts. The key isn't just focusing on where the pain is, but also looking at what other symptoms he's having (or not having).
If your child says he has a stomachache when it's time to head to preschool, some stress could be to blame. If he just had supper and dessert and he's complaining of a stomachache but has no other symptoms, it may be nothing more than having eaten too much.
But if he's feverish and vomiting or has diarrhea in addition to tummy pain, you can be sure something more serious is going on.
What causes tummy trouble in preschoolers?
The conditions below are the most common causes of stomach pain in preschoolers, although many others are possible. If your child suddenly becomes ill, has pain in his stomach that doesn't seem to go away or is getting worse, and you're at all concerned, call his doctor. It's always better to err on the side of caution.
1. Gastroenteritis or "stomach flu"
Is your child vomiting or suffering from diarrhea in addition to abdominal pain? If so, he could have gastroenteritis, also known as stomach flu. It's the most common illness in the United States after upper respiratory infections.
Doctors use the term gastroenteritis to describe any inflammation of the stomach and intestines caused by a viral or bacterial infection. Viruses are the most common culprit, including rotavirus, adenovirus, calicivirus, and astrovirus.
Gastroenteritis can also be caused by a potentially more serious bacterial infection, such as Salmonella, Shigella, Staphylococcus, Campylobacter, or E. coli. Still other cases are caused by parasites such as giardia. Your child's symptoms may be mild or severe, and they may last for just a few hours or for days, depending upon the cause.
Because a virus is usually to blame for gastroenteritis, you can't treat it with antibiotics. But that doesn't mean you should sit back and wait for the ailment to run its course. If gastroenteritis is causing your child to vomit or have diarrhea and a fever and loss of appetite, it can quickly lead to dehydration, so it's important to make sure that your preschooler is drinking plenty of fluids while he battles the illness.
Watch for signs of dehydration and give the doctor a call if you think your preschooler may be becoming dehydrated. If he shows serious signs of dehydration, take him to the emergency room.
As soon as you can, you'll want to reintroduce your preschooler's normal diet, avoiding only fatty foods.
2. Milk allergy or lactose intolerance
If your preschooler has a milk allergy, his immune system is responding to the proteins found in milk. Milk allergies occur most often in babies and children. Symptoms include vomiting, diarrhea, stomach pain, and rashes. In severe cases of milk allergy, a child may experience a life-threatening reaction called anaphylactic shock.
Lactose intolerance happens when a person's body isn't producing the enzyme needed to digest lactose, the primary sugar in milk. Symptoms include diarrhea, nausea, abdominal cramps, bloating, and gas. Lactose intolerance is uncommon in young children and usually shows up later in childhood or during the teen years.
To pinpoint the cause, a doctor will recommend that you keep all dairy (including milk, cheese, ice cream, pudding, etc.) away from your child for a few days and then slowly reintroduce it. If your preschooler's stomach troubles start up again, you've nailed the culprit.
For kids with a milk allergy, soy milk may be the answer, but it's not for everyone: Five to 10 percent of kids who are allergic to milk are also allergic to soy. In that case, you'll need to talk to your child's doctor or a nutritionist about how to make sure your preschooler gets enough calcium from other foods.
If your child is lactose intolerant, the solution is easier. He can probably continue to have dairy as long as he takes a synthetic form of lactase, which you can find in an over-the-counter supplement. You can also buy lactose-free milk products.
Learn more about how doctors diagnose and treat food allergies and sensitivities
3. Constipation and changes in diet
The most common stomach problem in young children — who are continuing to add more and more foods to their diet — is constipation. Constipation is defined as not having a bowel movement for two to three days and then passing small hard stools.
If this is the case for your child, sit tight. After a few weeks, his digestive system will adjust to the changes in his diet and he'll start having regular bowel movements again.
You can help jumpstart the process by making sure your preschooler is getting enough fluids throughout the day. And on the days when he seems particularly constipated, feed him foods that produce looser stools (like apricots, pears, prunes, and peas) and cut back on those that tend to cause firmer stools (like bananas, apples and applesauce, carrots, rice, and squash).
In addition, exercise can help get the bowels moving, so encourage your preschooler to be active.
4. Upper respiratory illness
Believe it or not, the common cold and the flu can give a child a tummy ache. That's because much of the mucus produced during an upper respiratory illness drips down the throat. When your child swallows it, it can irritate his stomach.
Some 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.
Sometimes a more serious respiratory illness can give a child a stomachache as well. If your child has a sore throat, fever, and headache along with his tummy problems, he may have strep throat. Call your doctor immediately if you suspect that your preschooler's stomachache may be related to a strep infection. This illness is caused by Streptococcus bacteria and needs antibiotic treatment.
5. Intestinal blockage
Don't take a wait-and-see approach if your preschooler is seemingly fine one minute and then writhing in pain the next, especially if these symptoms come in increasing intense and frequent waves and your child is vomiting.
These symptoms may signal intussusception, an intestinal blockage that most often happens to children 5 months to 2 years old. It's not very common, but it can be life threatening, so all your child's doctor immediately. If you can't reach her, take your child to the emergency room, as he may need surgery.
6. Appendicitis
The classic symptoms of appendicitis are abdominal pain (especially in the lower right quadrant of the abdomen), fever, and vomiting. If your preschooler has taken children's acetaminophen and it hasn't reduced his fever, his pain is worsening, and he can't keep anything down, including water, he may have appendicitis. Take him to his doctor or the emergency room.
7. Gas
You know as an adult how much having gas can hurt. It's painful for children as well. And it's a likely culprit behind persistent tummy pain that your doctor can't find a reason for.
You might try to note what your child has recently eaten when he has a bout of gas. One possibility is too much juice. Many juices — including apple juice and cherry juice — contain sorbitol, a nondigestible form of sugar.
The AAP recommends that preschoolers drink no more than 4 to 6 ounces (about 1/2 to 3/4 cup) of juice a day. Besides causing stomach upset, more than that can ruin his appetite for other nutrient-rich foods and cause tooth decay.
