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

Belly (abdominal) 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 showing the area of pain. For these reasons, abdominal pain is hard to diagnose in children.

Many illnesses also have abdominal symptoms. So it's important to keep track of 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 they are feeling something else. Other symptoms that may accompany abdominal pain include nausea and vomiting, constipation, diarrhea, fever, or trouble urinating. Children often 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 need further or different treatment. Your child may need more assessments, medicines, or tests.

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 room (ER) to find the cause of pain. But they are not always needed to diagnose or treat your child.

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

• 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.
• Offer emotional support to your child. Pain can trigger some intense, negative emotions, including anger.
• 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 if they are potty trained.
• Don't give medicine for abdominal pain or cramps unless instructed by your doctor.
• If your baby is spitting up (regurgitating), keep them upright for about 30 minutes after meals. Don't overfeed them. Talk with your child's doctor about ways to thicken their feedings.

• Don't force your child to eat solid food, especially if they are having pain, vomiting, or diarrhea.
• Water is important to prevent dehydration in children around the age of 6 months and older. Small, frequent sips of fluids are best. Don't let your child guzzle it down since that may make them feel worse. Soup, ice pops, or oral rehydration solution may also help. Ask your doctor if your child is old enough to use these products.
• Continue to offer your infant breast milk or formula unless told otherwise by your doctor.
• Don't give your child fatty, greasy, spicy, or fried foods.
• Don't give your child dairy products if they have diarrhea or vomiting. It could make it worse.
• Don't let your child eat large amounts of food at a time, even if they are hungry. Wait a few minutes between bites and then offer a little more if tolerated.

• Follow up with your child's doctor as advised.
• If tests or studies were done, you will be told about any new findings or reports that may affect your child's care.
• If the pain becomes chronic, behavioral therapies in the toddler, such as seeing a therapist, relaxation methods, and trying to maintain a child's normal activities, can be helpful as directed by your doctor.

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

Call 911 if any of these occur:

• Trouble breathing
• Difficulty arousing
• Fainting or loss of consciousness
• Rapid heart rate
• Seizure

Contact your child's doctor right away if any of these occur:

• Fever (see Fever and children, below)
• Your baby is fussy or cries and can't be soothed
• 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, clear liquids, breast milk or formula, they 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
• Your child starts acting very sick

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 doctor 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 doctor 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 okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any doctor about your child's fever, tell them which type you used.

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

When to contact a doctor about your child's fever

For a baby under 3 months old:

• First, ask your child's doctor 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 doctor

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 doctor

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 doctor