Tummy aches

My 2 1/2 year old tends to tell me her "tummy aches" during dinner. However, of recent, she's said it now when not eating. At what point does it stop being a reason to not eat and start being a concern? The other night, about 2 hrs after dinner she was telling me that her tummy hurt. Should I be concerned? Could it be constipation? Should I start to monitor BMs???

Stomachaches are common especially between 2 to 4 years old. In general, the closer to the pain is to the belly button the more likely the pain is to be innocent. One of the more common causes at this age is “functional abdominal pain”. Meaning pain related to one’s normal body functions. Feelings like hunger, gas, being “full” or the need to have a bowel movement are often expressed as “my tummy hurts”.

When she complains of tummy pain try not to reward her with attention. Try sending her to the bathroom and have her sit on the potty. Bathroom success may resolve her “tummy pains” and help her correctly identify the feeling.

I wonder if she is saying this to get out of eating dinner. Remember at this age your job is to present her with healthy foods and back off. You should require her to sit at dinner, but she does not have to eat. After dinner there are no snacks allowed.

Unfortunately, other problems like constipation are also common at her age. Constipation is often secondary to potty training. As children learn to hold in stool they often do it too well. I agree you should monitor her stools for constipation.

You may also want to keep a calender of episodes. I’d record when the events happen, the severity of the events and the duration of the pain. An event calender will help you know if she is getting better and is good information if you end up taking her to your doctor.

If her tummy pains interfere with her life than she needs to see her doctor. Meaning if she is missing school or dance class because “her tummy hurts” than I would recommend you take her to the doctor.

Written November, 2010 by
Dr. Gordon, Orlando Pediatrician