Abdominal pain is common in infants and children and most of the time it is not serious. The following are some questions you can ask yourself to help decide if the child needs to see a doctor. (1)
How bad is the abdominal pain?
If the child is screaming in pain, or the pain is very severe, or if it is getting worse, the patient needs to be seen right away.
Is the child walking normally, or bent over as he walks, or even unable to walk?
If the child is walking abnormally or can’t walk, then he needs to be seen right because it might be appendicitis or irritation of the lining of the abdoman.
Is your child less than two years old?
If yes then the child should be checked right away, especially if the pain comes and goes and is very severe when it is happening (the patient could have a condition called intussusception which is diagnosed by ultrasound scan)?
Is there blood in the bowel movements?
The child needs to be checked right way to make sure something serious (like intussusception) is not going on.
Note that a tiny streak of blood on the outside of a normal bowel movement of an infant who appears healthy and is eating and acting normally is almost always not serious. It is usually due to an anal fissure.
Could the child have been poisoned by something he ate, like a plant, or a prescription medicine, or some chemical?
If yes, then the child needs to be seen right away.
Could the child have injured his abdomen (for example from a fall or a bicycle or auto accident or blow to the abdomen)?
If the answer is yes, then the child needs to be seen right away because there could be damage to the spleen or pancreas or other internal organ.
Is your child’s abdomen tender?
Press gently on his abdomen in different areas and watch his reaction. Don’t ask him if it hurts, just watch to see if it is tender either all over or in one spot. If there is tenderness, then the child needs to be checked right away.
Is the child or infant not eating?
A child or infant who refuses more than one feeding needs to be seen immediately. And if the infant or child’s appearance is worrying you for any reason, then refusing a single feeding requires immediate evaluation.
But even if the answers to all these questions are no, but you are worried that the infant or child may be very sick—trust your judgment and have child seen right away. It is not your job to prove to the doctor that your child is seriously ill. It’s the doctor’s job to prove to you that the child is not.
(1) Pediatric Telephone Advice. C1980. Barton D Schmitt MD. Little, Brown (Yes, I know it is an old reference, darn near ancient, but the newer editions’ approach are the same.)
