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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 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 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 require 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.

Home care

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

  • 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.

  • Don't give medicine for abdominal pain or cramps unless instructed by your healthcare provider.

  • 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 provider about ways to thicken their feedings.

Diet

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

  • Water is important to prevent dehydration. Soup, ice pops, or oral rehydration solution may help. Small, frequent sips of fluids are best. Don't let your child guzzle it down; that may make them feel worse.

  • 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 care

  • Follow up with your child's healthcare provider 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 techniques, and trying to maintain a child's normal activities, can be helpful as directed by your 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)

  • 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 or clear liquids, 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

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 he or she is at least 4 years old.

Use the 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 him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings 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

Fever readings for a child age 3 months to 36 months (3 years):

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

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

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

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

Online Medical Reviewer: Rajadurai Samnishanth
Date Last Reviewed: 9/1/2021
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