Abdominal Pain in Children

Children often complain of a “tummy ache.” This is pain in the stomach or belly. Abdominal pain is very common in children. In many cases, there’s no serious cause. But stomach pain can sometimes point to a serious problem, such as appendicitis, so it's important to know when to seek help.

Causes of abdominal pain

Abdominal pain in children can have many possible causes. Any problem with the stomach or intestines can lead to abdominal pain. Common problems include constipation, diarrhea, or gas. Infection of the appendix (appendicitis) almost always causes pain. An infection in the bladder or urinary tract, or even infection in the throat or ear, can cause a child to feel pain in the belly. And eating too much food, food that has gone bad, or food that the child has a hard time digesting can lead to abdominal pain. For some children, stress or worry about some upcoming event, such as a test, causes them to feel real pain in their bellies.

Call 911

Call 911 if your child: 

• Is vomiting blood and you can't control the vomiting.

• Is unusually drowsy, hard to wake up, weak, or listless

When to call your child's healthcare provider

Children may complain of a tummy ache for many reasons. Many cases can be soothed with rest and reassurance. But if your child shows any of the symptoms listed below, call the healthcare provider or seek medical care right away for:

• Severe belly (abdominal) pain or pain that lasts longer than 2 hours

• Fever (see Fever and children, below)

• Inability to keep even small amounts of liquid down

• Signs of dehydration. These include no urine for more than 8 hours, dry mouth and lips, and feeling very tired.

• Pain during urination

• Pain in one specific area, especially low on the right side of the belly

• Blood or pus in vomit or diarrhea, or green vomit

• Signs of bloating or swelling in the belly

• Repeatedly arching their back or drawing their knees to the chest

• Pain that makes the child unable to walk

Treating abdominal pain

If a healthcare provider’s attention is needed, they will examine the child to help find the cause of the pain. Certain causes, such as appendicitis or a blocked intestine, may need emergency treatment. Other problems may be treated with rest, fluids, or medicine. If the healthcare provider can’t find a physical reason for your child’s pain, they can help you find other factors, such as stress or worry, that might be making your child feel sick. At home, you can help the child feel better by doing the following:

• Have your child lie face down if they appear to be suffering from gas pain.

• If your child has diarrhea but is hungry, feed them a regular diet, but stay away from fruit juice or soda. These are high in sugar and can make diarrhea worse. Sports drinks, such as electrolyte solutions, also may contain lots of sugar, so be sure to read labels. Water is fine. 

• Don't severely limit your child's diet. Doing so may cause the diarrhea to last longer.

• Have your child take any prescribed medicines as directed by your healthcare provider.

• Check with your healthcare provider before giving your child any over-the-counter medicines.

Preventing abdominal pain

If your child is prone to abdominal pain, the following things may help:

• Keep track of when your child gets the pain. Make note of any foods that seem to cause stomach pain. For example, milk and dairy can be hard for some children to digest.

• Keep track of your child's bowel habits. Constipation is a common cause of abdominal pain in children.

• Limit the amount of sweets and snacks that your child eats. Feed your child plenty of fruits, vegetables, and whole grains.

• Limit the amount of food you give your child at one time.

• Make sure your child washes their hands before eating.

• Don’t let your child eat right before bedtime.

• Talk with your child about anything that may be causing them worry or anxiety.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider