Issue link: http://viewer.e-digitaledition.com/i/872903
When is a child's stomachache just a stomachache, and when is it something more? C H I L D R E N G R U M B L I N G IF A CHILD develops a runny nose and is coughing or sneezing, it is safe to assume that a cold or allergies are the cause, even if the child is too young to express discomfort. But the source of tummy trouble is not always easy to define. There are many possible causes for upset stomach, including gas, viruses and bacteria, food allergies, contaminated food, illnesses or disease, and fear or anxiety. Although most childhood stomachaches— particularly in children age five to 12—are not serious, it is important to know what to keep in mind and be concerned about when faced with gastrointestinal issues. CONSIDER AGE "Indications of gastrointestinal distress in a two- to four-month- old child may include seeing behavioral changes like stronger crying, being difficult to console, or pulling up the legs and arching the back," says Yvonne McFarlane-Ferreira, M.D., chief of pediatric gastroenterology at NewYork-Presbyterian Brooklyn Methodist Hospital. "With these particular symptoms, it is best to take your child to a pediatrician for diagnosis, just to be on the safe side. The symptoms might indicate something benign like colic, but it's possible that a serious condition could be the cause." Feeding challenges and classic signs of stomach issues, such as vomiting or diarrhea, also need medical attention because these symptoms can quickly lead to dehydration in an infant. "If there is any suspicion that your baby is not receiving enough nourishment or has excessive diarrhea, the safest thing to do is see a doctor," Dr. McFarlane-Ferreira says. As infants grow into toddlers and young children who can point to or talk about the source of their discomfort, parents may have an easier time deciding whether medical attention is needed. CONSIDER TIMING Knowing about events that occurred before the child's upset stomach began can provide insight about the cause. For instance, if the child recently attended day care, school, or any event or venue where germs could be easily shared and the stomachache is also accompanied by a fever, an infection, such as a virus, might be the culprit. On the other hand, pain or nausea that develops a few hours after eating may indicate a food-related illness like food poisoning, especially when there is also a change in stool. Stomach pain after having specific foods like cow's milk or pizza may suggest an intolerance to lactose (a sugar in dairy products). If there is a pattern of stomachaches following meals, write down any foods the child has eaten and discuss them with his doctor. It is also true that some children develop off-and-on again stomach pain due to celiac disease, a condition in which bodies react to gluten, a protein found in grains like wheat, barley and rye. Gastrointestinal distress brought on by these causes usually clears up on its own and can be prevented by avoiding the trigger foods, but consult a pediatrician if the child experiences any of the following: Vomiting for more than 12 hours Diarrhea for more than 48 hours Constipation (fewer than three bowel movements a week or hard stool that is difficult to pass) accompanied by fever, vomiting or blood in the stool or constipation without secondary symptoms for two weeks or longer Stomachache with a temperature higher than 100.4 degrees Diminished appetite for more than two days Persistent abdominal pain for 24 hours or longer Intermittent abdominal pain lasting a week or more CONSIDER ANXIETY LEVELS Changes in social situations or events that prompt an emotional reaction sometimes make children nervous and tense, which can affect the stomach. If a child complains of a stomachache that disappears as soon as a decision is made to let him stay home from school or another scheduled function, there is a good chance that the pain may be stress related. Talk to the child about what is happening to cause the anxiety and ways to alleviate it. T U M M I E S RU M B L I N G , FA L L 2 017/ / W W W.N Y P.O RG / BRO OKLY N 20 K I D Z O N E