“Mommeeee… my tummy hurts!” my three-year old complained as he came out of his room for the second time that night.
“Show me where it hurts,” I said to him.
He pointed to an area around his belly button (where most children will point when asked this question). My son was normally a great sleeper, so I was a little concerned that maybe he really was coming down with something.
I looked at him and went through my checklist. Dressed in his dinosaur fuzzy footy pajamas, he had walked over to my room to report his distress (no signs of pain with walking). He wasn’t bent over or crying (not severe pain). He had come up with this reason after a previous unrelated reason for leaving his bed (not repeated or consistent pain). He had eaten dinner well earlier today and went to the bathroom normally (no loss of appetite and no vomiting, diarrhea or constipation). I put his hand on his forehead and he did not feel feverish (yes, we will always tell you to take your child’s temperature with a thermometer – but I’ll admit to using the mommy forehead test).
“What do you need to make it better?” I asked. I almost always ask my kids this question when they have a complaint. They usually have a fix in mind and the “boo-boo” disappears magically. My favorite was when my daughter told me that “chocolate candy” would fix her stomach pain. (I didn’t give in on that one!)
“I need boo-boo penguin,” he answered promptly. He was referring to our penguin-shaped ice pack that seems to cure almost all ailments.
So, I said okay. And within five second of boo-boo penguin’s magic, he was ready to sleep.
I wouldn’t recommend giving in to demands on repeated nights, but since this was a first request, I let it slide. Sometimes it isn’t worth the battle! (ummm - perhaps “do as I say, don’t do as I do” applies here also)
How do you know when a stomachache is the sign of real illness or when it’s just a behavioral ploy for attention or to get out of doing something (like eating vegetables or going to school)?
It can be difficult to tell sometimes. However, there are certain signs that are red flags for illness. Some of these require immediate medical attention. Others can be treated first at home and then your child should be brought to your pediatrician if there isn’t any improvement.
When you call your doctor, think about the following so that you can have these answers ready.
Timing - How long has the pain been going on? How often does your child have the pain? How long does it last? When does it happen? Most simple pains only last a few minutes and happen only once or twice. If the pain lasts for several days or several hours, call your child’s doctor. Some pains only occur during school mornings. Others happen only at bedtime. These can all be clues as to the underlying cause (or motive as the case may be!)
Severity – Is your child running around and playing? Or is she rolled up in a little ball crying about her pain? This will help you to determine the seriousness of the pain. Asking young children if their stomach hurts does not always help since they will usually give the answer that they think you want (not how they actually feel).
Location – Where does your child point to when you ask where it hurts? Tell them to point with one finger to where it hurts the most – otherwise, they’ll usually rub their entire belly button area and say “It hurts all over!” Pain located in the lower right side of the belly is possible appendicitis and is an emergency.
Triggers – Does it occur after eating certain foods or drinking certain liquids? Lactose-intolerance is fairly common and can be helped by eliminating lactose from the diet (your child can drink soy milk or Lactaid milk to get the needed calcium). Also, food allergies can cause stomach pain or vomiting or diarrhea. Celiac disease (or gluten intolerance) is a common food allergy that can cause ongoing stomach pain. Bloating and gassiness can be associated with food-related allergies or intolerance.
Vomiting or Diarrhea – Stomach bugs can cause short-term belly pain along with vomiting or diarrhea. However, if the vomiting/diarrhea is severe, lasts more than 24-48 hrs, contains blood, or your child is unable to keep fluids down, call your doctor.
Constipation – If your child’s pain is much better after having a bowel movement, then the pain may be related to constipation. Increase water, fiber and vegetables in your child’s diet to see if your child’s pain improves with softer stools. See my previous blog post on constipation for more information.
Urinary problems or groin pain – these can be signs of other medical problems like a urinary tract infection or testicular torsion. Call your doctor immediately.
Rash – stomachache and rash can be signs of other types of illnesses, such as a Strep infection, call your doctor for guidance. If your child has hives, then it may be an allergic reaction, seek help immediately.
Fever – fever usually means infection. If the fever is low grade (102 or less), has been less than 3 days, and the stomach pain is minimal, you can likely treat your child’s symptoms at home. However, if the pain is severe, your child is in distress, the fever is high, or any of the warning symptoms described above are present, then you should call your child’s doctor.
Weight changes or poor growth – if your child is not growing well or is losing weight, these can be signs of more serious diseases and your child needs to be seen.
What to do if you suspect the complaint is behavioral?
If your child is running around happily and is not ill-appearing, then the complaint of a tummyache may be a way of getting attention or a ploy to get out of an activity. If you think this is the case, the best thing you can do is to ignore it. The more you acknowledge it, then the more he will repeat the behavior (i.e. getting boo-boo penguin in the middle of the night – oops!)
Instead, provide a distraction and move on to the next activity. If there are no further complaints, then you know it’s just a clever way to get some attention. Or if he insists on a cure, then give a placebo, like a medicine syringe full of colored water or juice and see if the pain improves. If so, you know that there is nothing serious causing the pain.
Shower your child with love and attention when he is not complaining of tummy aches and gradually the behavior will stop. It may take a few weeks, but if you stick to it, then the imaginary tummy aches will be cured. (and then they’ll move on to “Mommeeee… my leg hurts!!!”) (more on that later!)
Happy Holidays, and thanks for reading!
