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Stomachache Comfort for a Tender Tummy



STOMACHACHE

Comfort for a Tender Tummy

It's 6:00 A.M. and the weak voice from the bunk bed is apologetic. 'Mommy, my tummy hurts.'

And suddenly you're thinking--'All the things I have to do today'--as you try to figure out how a small person's tummyache will affect your commute, your career, your life. But foremost among your concerns is the almost shamefaced thought: 'Does his tummy really hurt?'

If your child is under age 12, the answer is almost certainly yes, says pediatrician Catherine Dundon, M.D., of Goodlettsville, Tennessee, who is the mother of two children aged 6 and 9. 'Children under 12 do not have the ability to malinger,' she says. If your child says it hurts, you can assume it hurts.

Many times, stomachache in children is the result of indigestion, constipation or nervous upset, says Dr. Dundon. If the symptoms are severe, you'll want to give the doctor a call soon. If not, there are many things you can do to treat tummyache yourself. Here's what doctors recommend.

Apply warmth. Most children find heat a big comfort when their tummies hurt, says Bruce Taubman, M.D., a pediatrician in Cherry Hill, New Jersey, clinical associate professor of pediatrics at the University of Pennsylvania School of Medicine in Philadelphia and author of Your Child's Symptoms. An infant may find comfort if you place a hot-water bottle on your knees and then let the child lie tummy-down on the bottle. Older children can use a heating pad, but it should be turned on low, and an adult needs to be present. (A child should not lie on top of a heating pad, but on his back with the pad on his stomach, according to Dr. Taubman.)

MEDICAL ALERT

When to See the Doctor

'Most parents fear appendicitis whenever a child complains of stomach pain,' says Bruce Taubman, M.D., a pediatrician in Cherry Hill, New Jersey, clinical associate professor of pediatrics at the University of Pennsylvania School of Medicine in Philadelphia and author of Your Child's Symptoms. 'But a child with appendicitis will not be walking around saying, 'I have a tummyache.' He will be in severe pain.'

'A child who can't get up or who is writhing in pain, needs to be seen by a doctor immediately,' says Don Shifrin, M.D., a pediatrician in Bellevue, Washington, and president of the Washington State chapter of the American Academy of Pediatrics. 'So does a child who--in addition to pain--has fever with nausea or vomiting not associated with meals. A child who develops pain, significant discomfort or vomiting after falling or being hit in the stomach area should also be checked.' You should call your doctor for an immediate appointment if these symptoms begin, or take the child to an emergency room as soon as possible if your physician is unavailable.

Reduce the stomach's workload. 'It's also a good idea to rest the gut,' says Dr. Taubman. Hold off on food for 24 hours. 'Give your child lots of clear liquids such as flat soda, water, Gatorade and chicken broth,' he says. But keep everything else in the cupboard.

Relieve pain with medication. 'Acetaminophen [Children's Tylenol] will take the edge off your child's pain,' says Dr. Taubman. Check the package directions for the correct dosage for your child's age and weight. If your child is under age two, consult a physician.

Never mask the problem with codeine. One thing you shouldn't do for a tummyache is give your child a codeine-based medication left over from a previous illness, cautions Don Shifrin, M.D., a pediatrician in Bellevue, Washington, and president of the Washington chapter of the American Academy of Pediatrics. It may temporarily relieve the pain, but it can also mask the progression of something serious such as appendicitis or a blockage or infection.

Touch Therapy for a Tender Tummy

When a child has a mild tummyache rather than severe pain, massage is a good way to relieve it, says Ann Linguiti Pron, a certified registered nurse practitioner in private practice in Willow Grove, Pennsylvania. Especially if it's caused by excess gas, constipation or colic.

Even if the child is an infant, Pron suggests, you should tell her you're going to massage her tummy to make her feel better. Then start to gently massage in a clockwise, circular direction that mimics the movement of food and gas through the digestive system, says Pron. If you do it right, she says, you may not only relieve your child's pain, you may also encourage what's causing that pain to move toward the exit.

Here are some ways to help relieve that ache.

* Have your child lie down on his back and rub a quarter-size dab of vegetable or massage oil between your palms to warm it up. Using your oiled hand, massage the abdomen clockwise in a circular motion starting just below the rib cage, circling around to the groin and up across the belly, says Pron. Circle the abdomen for several minutes, then change your stroke.

* With your child still on his back, place one hand horizontally just under the rib cage and slide it straight down to the groin as though you were sweeping grains of sand off the abdomen. Alternate hands, in a rhythmic way, to massage the abdomen with steady sweeping strokes. Repeat several times, then massage the tummy again with a gentle, circling hand motion.

* If your child hasn't eaten within the last hour, you can also try lifting his legs as you do the sweeping motion, says Pron. Hold his feet with one hand and lift them to almost a 90 degree angle as you continue to sweep with the other hand. It's easy to raise the feet of an infant or younger child. If the child is older, you can ask him to lie down and bend his legs with his feet on the ground.

* For an infant to get additional relief from gas or colic, help the child bend his knees instead of raising his legs all the way in the air, suggests Pron. Lift one leg and gently bend the knee toward the belly, then quickly release it. Do the same with the other leg. Then bend and release both legs together. Repeat the exercise, then return to massaging your child's tummy.

Make time for bowel movements. 'As our lives speed up, one of the things we're not giving our children is the time they need on the toilet,' says Dr. Dundon. In fact, the way we're rushing our children around both at home and at school can cause major constipation, she says.

'I see at least one kid a week in my office who's been holding back so long and so often that his bowel is dilated and he's lost a lot of the ability to move waste through,' says Dr. Dundon. As a result, stool becomes impacted in the bowel, and liquid from higher up in the gut leaks past the impaction and out onto the child's clothes. 'A child with an impaction may frequently have belly pain after eating,' she says.

The way to prevent both the problem and the pain is to give your child five to ten minutes of uninterrupted time on the toilet every morning, suggests Dr. Dundon. 'Most houses are a total zoo in the morning, but make this a regular part of the routine--just like brushing teeth,' she says. Have your child sit on the toilet and read a book or listen to a story. Don't let anyone else come in and don't pressure him. Just give him the opportunity, and let nature take its course.

Cuddle to scuttle stress. 'If your child's not vomiting or constipated, belly pain could be caused by stress,' says Dr. Dundon. 'Pain from stress is something we adults tend to get in our heads; kids get it in their bellies.' Some causes of stress might be a family move or a death in the family.

How can you help? ' What the child with stress-related stomachache needs is loving,' says Ann Linguiti Pron, a certified registered nurse practitioner in private practice in Willow Grove, Pennsylvania. Hugs, kisses and cuddles are often enough to untighten an uptight tummy and relieve the pain, she says.

Ask about school. 'If a child continues to complain of a tummyache throughout the week, however, there may be a problem at school that he has not been able to verbalize,' says Pron. 'He needs to talk--to you and maybe to a teacher or guidance counselor as well.'

So put whatever you're doing to one side, and sit down and talk to your child. The problem may be as simple as a bully at the bus stop, a teacher who loses his temper or a seat assignment that forces your child to sit next to someone of the ( horrors! ) opposite sex.

Any of these situations can make your child want to avoid school, says Dr. Dundon. 'But even if 'school phobia' is the culprit, when a child says his belly hurts, it does. And he doesn't need you to tell him it doesn't. That just hurts him a second time.'

Instead, says Dr. Dundon, when your child complains of tummyaches before school, offer hugs and gentle praise when he manages to get himself moving. Then, once he's off to school, pick up the phone and call his teacher. If the teacher knows that he's getting before-school tummyaches, she may be able to reduce the stress load at school by not calling on him in class, by moving Billy the Bully to the other side of the room or by offering more praise and support than she might normally give in a busy classroom.



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