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Mummy my tummy hurts

02 March 2018

The key symptoms of gastro problems in babies and children are abdominal pain, nausea, vomiting altered bowel patterns, weight loss and reduced appetite. Many of these symptoms will pass quickly and your child will return to their healthy, bouncy self.  Avoid diagnosing your child’s symptoms via the internet. Use common sense and try the self-help tips below. However, if you are concerned, contact your midwife, health visitor or GP straight away.

My baby vomits all her feed. I’m worried she isn’t getting enough nutrition:

Reflux is extremely common in babies. If your baby is not distressed and is putting on weight, there is nothing to worry about. Reflux starts almost from birth, but by the time a baby can sit up it lessens, and gets even better when they are weaned. The lower oesophagus sphincter muscle strengthens and normalises as the baby grows and so vomiting will lessen or disappear with age – in 65% of cases by 6 months and 85% by 18 months.

What to do: If you have become a social pariah among your friends who fear damaged carpets, then try thickening the feed in your baby’s bottle with infant Gaviscon.  Or you can buy anti-reflux formula from most chemists and supermarkets. If your baby is bottle-fed and putting on weight, then you might be overfeeding. Try reducing the volume to see if that helps. For breast-fed babies, try a thickener just before and immediately after they feed. 

Nurse your baby properly - use the correct size teat and wind after feeding. You can also try weaning a little bit earlier than the recommended six months – between four and five months with advice from your health visitor.

A slight elevation of the cot, from the head end, might help when baby is sleeping. But keep the mattress flat to protect the baby’s neck. Vomiting tends to happen soon after a feed, so it’s more a parent’s worry than a reality that your baby will be sick in its sleep. But even if they are, they can cope safely.

If, however, your baby seems distressed after a feed, is crying inconsolably, refusing a feed or arching their back, see your GP. Your baby might need anti-acid medication or may be dairy intolerant in which case dairy-free formula will be recommended. If you are breast feeding, try eliminating dairy from your diet for a few weeks to see if this makes a difference. However, ask the advice of a dietician first to ensure you are getting the right balance of nutrients to produce milk.

My baby cries a lot and draws his knees up to his tummy:

In the first few weeks from birth, otherwise healthy babies can become distressed, seem windy, and will bring their knees up to their stomachs or clench their fists. These symptoms are known as colic and it affects one in five babies.

What to do: Make sure your baby is properly winded after a feed. Breast-feeding is the best way to keep a baby’s gut healthy, but you can buy pro-biotic supplements for infants to help aid digestion.  Colic drops might also help. If you are bottle feeding, make sure you have the right flow teat to prevent your baby from swallowing air. Colicky symptoms might also be caused by a dairy intolerance (see advice above) or constipation. 

A parent’s emotional state can be linked to colicky symptoms in babies as they are aware of tension from the adult who is holding them.  Give yourself plenty of rest in the first few weeks after birth and accept offers of help from family and friends.

Colicky symptoms normally disappear between 6-14 weeks.

My child keeps complaining of a tummy ache:

Abdominal pain in school age children can be likened to tension headaches in adults. The brain is connected to nerves in the gut, so if a child is feeling anxious, it can affect their bowel function. They may experience cramping pains, constipation or diarrhoea. Recurrent symptoms like these used to be an adult complaint, but more and more children and adolescents are suffering. Change in family life or difficulty at school may be the trigger.

What to do: If the pain is in the centre of the tummy, comes and goes, but otherwise your child is healthy, then pinpoint the cause of the anxiety. Talk to your child and their teacher. Often all that is required is explanation and reassurance.

See your GP if your child is vomiting, there is a change in their bowel pattern, they have blood in their stools, tummy pain in the night, losing weight or there is a family history of Crohn’s disease. Your child may be referred to a specialist for further investigation.

My child is refusing to go for a poo:

Constipation in children is quite common, especially following a change in the diet, after they’ve been ill or during potty training.

It’s important to tackle this at an early stage. If left, the rectum can become packed, causing `overflow soiling’ - a distressing symptom for a child to experience.

What to do:

Take advice from your health visitor before starting to potty train, or put it off for a few weeks if the child becomes distressed. 

Children will voluntarily `hold on’ if they think it is going to hurt, so take the fear out of pooing by giving them something to soften their stools, such as a PEG electrolyte solution (eg Movicol). Your pharmacist can advise on the best age-appropriate medicine. Use distraction techniques while they are sitting on the toilet or potty, like a book or a cartoon on a tablet or mobile device.

Adopt a healthy approach to poo! Get the family to check theirs against the Bristol Stool Chart - a type 4 poo is normal, but if a child is regularly having a type 1-2 (constipated) or type 6-7 (diarrhoea), then see your GP.

If you have concerns you may wish to book an appointment with Dr Assad Butt, Paediatric gastroenterologist at Spire Gatwick Park Hospital.

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