By Roy Benaroch, MD
A very simple and very good question popped up on the WebMD parenting community discussion board last week. Zlmkay1 asked: “My 6 year old daughter is constantly complaining that her tummy hurts 3-5 times a day… What do I do?”
Belly aches are very, very common and the vast majority of them are not caused by any serious medical problem. Still, they hurt! Parents who learn the best way to handle belly aches (and headaches, and many other aches of childhood) can help their children feel better while looking out for the occasional “red flag” that might mean a problem needs to be further evaluated.
The first step parents should take with belly aches is to ask: “Does this need immediate medical attention?” I will tell you that parents are actually very good at knowing who needs to go straight to the emergency room. Pain that’s intense, prevents a child from moving, or is associated with a lot of vomiting (especially if it’s green like bile) should get immediate medical attention. If your child with a belly ache has a genuinely tender belly—that is, it hurts a lot when you touch or gently squeeze the abdomen—you need to be heading to the ER.
But of course the vast majority of belly aches aren’t nearly so dire. If your child’s not “sick-sick,” here’s what you should do:
1) Look at your child to see how he or she is. You’ll learn more about how dire things are from looking than from listening.
2) Listen to what your child says is wrong. You’ll learn more about what’s causing the pain by listening to the clues your child might give. And being listened to is, itself, therapeutic—your child should be able to tell from your body language that you care.
3) Do something tangible to help your child feel better. A heating pad, a suggestion to go try the bathroom, a belly massage, a few sips of ice water—almost anything can help if you suggest it. Say: “I think this will help,” and afterwards say: “I’m glad you’re starting to feel better.”
Sometimes it can be very helpful to keep a log or diary of belly pain: when it occurs, what the child was doing, what’s been eaten, what makes it better, what makes it worse. Those kinds of clues can help parents (and pediatricians) best figure out what’s going on. Children will often provide the answers if we listen carefully.
These steps will help with ordinary belly aches in children, no matter what the cause. In my next post, we’ll cover some more specific examples of common belly aches in children.