Abdominal Pain with Unknown Cause, Female (Infant/Toddler)

Abdominal (stomach) pain is common in children. But children often don't complain of pain because they don't yet have the words to describe what's wrong. They just know they feel bad or don't want to eat. Children also have trouble pinpointing the area of pain. For these reasons, abdominal pain is hard to diagnose in children.  

In addition, many illnesses have abdominal symptoms. So, it's important to monitor the child's pain, especially if symptoms have not gone away. Most of the time, the causes of abdominal pain in children are not serious and will go away.

In the first few days, abdominal pain may come and go or be continuous. It can be hard to decide whether your child has pain, or if she is feeling something else. Other symptoms that may accompany abdominal pain include nausea and vomiting, constipation, diarrhea, fever, or trouble urinating. Often, children don't recognize nausea they may just feel bad and constantly touch their stomach.

A child's abdominal pain may continue for several days, even if treated correctly. Depending on how things go, sometimes the cause can become clearer, and may require further or different treatment. Additional evaluations, medicines, or tests may also be needed.

Sometimes viruses or bacteria can cause an infection that causes stomach pain. But not all stomach infections should be treated with antibiotics. Taking antibiotics for reasons other than a bacterial infection can cause problems.

Lab tests and X-rays may be done in the emergency department to determine the cause of pain. But, they are not always needed to diagnose or treat your child.

Home care

Your healthcare provider may prescribe medicines for pain or symptoms of an infection. Follow the instructions for giving these medications to your child.

General care

  • Comfort your child as needed.

  • Try to find positions that ease your child’s discomfort. A small pillow placed on the abdomen may help provide pain relief.

  • Distraction may also help. Some children may be soothed by listening to music or having someone read to them.

  • Lying down with a warm washcloth on the stomach may help improve symptoms.

  • Have your child sit on the toilet regularly.

  • Do not give medicine for abdominal pain or cramps unless instructed by your healthcare provider.

  • If your baby is spitting up (regurgitating), keep her upright for about 30 minutes after meals. Don't overfeed her. Talk with your healthcare provider about ways to thicken her feedings.

Diet

  • Don't force your child to eat, especially if she is having pain, vomiting, or diarrhea.

  • Water is important to prevent dehydration. Soup, popsicles, or oral rehydration solution may help. Small, frequent sips of fluids are best. Don't let the child guzzle it down and it may make her feel worse.

  • Don't give your child fatty, greasy, spicy, or fried foods.

  • Don't give your child dairy products if she has diarrhea or vomiting. It could make it worse.

  • Don't let your child eat large amounts of food at a time, even if she is hungry. Wait a few minutes between bites and then offer a little more if tolerated.

Follow-up care

  • Follow up with your child's healthcare provider as advised.

  • If labs or cultures were done, you will be notified if she is positive or if your child's treatment needs to be changed.

  • If X-rays were done, they will be seen by a radiologist and you will be notified if your child's treatment needs to be changed.

  • If the pain becomes chronic, behavioral therapies in the toddler, such as seeing a therapist, relaxation techniques, and trying to maintain a child's normal activities, can be helpful as directed by your healthcare provider.

Special notes to parents

Keep a record of your child's symptoms such as vomiting, diarrhea, or fever. This may help the healthcare provider make a diagnosis.

Call 911

Call 911 if any of these occur:

  • Trouble breathing

  • Difficulty arousing

  • Fainting or loss of consciousness

  • Rapid heart rate

  • Seizure

When to seek medical advice

Call your child's healthcare provider right away if any of these occur:

  • Fever (see Children and fever, below)

  • Continuing symptoms such as severe abdominal pain, bleeding, painful or bloody urination, nausea and vomiting, constipation, or diarrhea

  • Abdominal swelling

  • Vaginal discharge or bleeding

  • If your child can't keep down water or clear liquids, she may become dehydrated, and will need immediate medical attention

  • Severe pain lasting more than 1 hour

  • Constant pain lasting more than 2 hours

  • Crampy, intermittent pain lasting more than 24 hours

  • Pain in the lower right side of the abdomen

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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