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Parents the world over know the signs and symptoms of tummy ache only too well. But what exactly causes tummy trouble in young children and how is it best handled?

It’s just before bath time and my three-month-old opens his mouth wide. Tongue quivering, he lets out an almighty scream. Nothing seems to soothe him, we rock him, we feed him and we play music. Nothing helps. It is, we conclude after cross-referencing our 75 or so baby books, a simple case of tummy ache. In other words, he has colic.

Looking for answers

“Give him some probiotics,” the sister at our friendly clinic tells us. Probiotics are micro-organisms that assist in maintaining the natural balance of healthy organisms, in other words the ‘good’ bacteria, in the digestive tract. For older children, it amounts to eating extra yoghurt when taking a course of antibiotics to maintain that balance in the gut. For babies, it involves, in this case, a powder that looks like sherbet that I choose to dip his dummy into and pop into his mouth. Twenty-four hours later the crying seems worse. I shelve the probiotics, too afraid to try again.

Still seeking solutions

A year on and I wonder if the crying was indeed louder. Or, was I subconsciously trying to avoid having anything other than the holy flow of breast milk passing through his system. I can’t be sure, so I head off in search of proof. Dr Greene’s trusty website tells me of research done by the Regina Margherita Children’s Hospital in Italy. They recruited 90 breastfed babes who had been crying for more than three hours more than three days a week. Half the babies were given five drops of good-gut bacteria for 28 days. The other half were given simethicone – a popular colic treatment that works as an anti-foaming agent in the gut. All the moms then quit cow milk and – abracadabra – 95% of the probiotic babies responded, compared to only 7% of the simethicone babies. At the end of the 28 days, the average daily crying had decreased by 2 hours and 26 minutes in the probiotic group and by only 52 minutes in the simethicone group. I like Dr Greene even more as he chooses not to pimp the probiotics, but instead states that, while this is all very exciting, further research is needed.

Is stress a cause of tummy ache?

Unlike measles or mumps, the tummy is a place of great mystery when it comes to diagnosing and treating the ‘soreness’.  Cape Town-based doctor and homoeopath Dr Murray Rushmere says: “School-going children with recurring tummy ache that is not associated with diarrhoea and vomiting are usually suffering from some sort of stress.

“Stress-related tummy ache in children is usually short-lived,” says Dr Rushmere, but they can recur over years. “I regard them as the childhood equivalent of irritable bowel syndrome, although the management is different.”

So, in most children, where there is no clear physical cause for the tummy ache, the chances are good that it could be linked to something stressful.

Diet, digestion and constipation

If you’ve ruled out stress as a possible factor, think about your child’s diet. Little tummies are not yet desensitised to the rubbish we inadvertently put in them and the aching may well be a pain of protest. Eradicate junk food from your child’s diet and you may see an improvement in recurring tummy aches. Keep rich food to a minimum and don’t allow your child to eat excessive amounts, which tiny tummies then battle to digest.

Constipation can be a difficult problem to manage, says Dr Rushmere. This is best diagnosed with an abdominal X-ray. Another reason for the constipation and tummy aches could be the stress related to potty training.  Take three-year-old Robert for example. He would hold it in till his whole body ached – letting it go into the toilet was too much for him to cope with. After many visits to the toilet with various obliging adults, he finally considered that his parents might be right. Everyone was doing it and so Robert finally let go and his tummy ached no more.


Lucy Burney, a British-based author and nutritionist, believes that a tummy ache can be a symptom of deficiency. “If the pain is accompanied by constipation, suspect a lack of magnesium,” she writes. Spinach, pumpkin seeds, cashews, Brazil nuts, almonds and pine nuts, black beans, whole grains and artichokes all have high magnesium content. Other signs of a magnesium deficiency, according to Burney, may include “restlessness, tiredness, and poor sleeping habits, grinding teeth, pins and needles and muscle cramps.”


Just when you thought you’ve unravelled the secrets of the stomach, along comes another possibility to consider – allergies. According to Durban-based nutritional therapist Karen Horton, if stomach pains occur 2–72 hours after eating, a food allergy cannot be ruled out. Horton lists “general IgG [Immunoglobulin G] food allergies, especially lactose or wheat/gluten intolerances, as some of the common causes of stomach pain in children.”

Testing kits are available to assist in the detection of allergies, and Horton recommends that in addition to this there should be an in-depth assessment with an experienced health provider. This is essential if other members of the family have similar symptoms.

Could it be something more serious?

What if it isn’t a simple tummy ache? Dr Rushmere cites a few of the more serious possibilities that could be the cause of acute stomach pain. These all require immediate medical attention:

  • Gastroenteritis (when seen with diarrhoea and vomiting)
  • Appendicitis (this would be accompanied by severe abdominal pain, complete loss of appetite and possibly a fever and vomiting)
  • Intussusception (a rare acute cause of stomach ache where the bowel telescopes in on itself, resulting in total obstruction and bloody stool)
  • Stomach ulcers
  • An abdominal pain associated with jaundice (yellow skin), which is a result of a liver disorder, either congenital or acquired (hepatitis).
  • An unusual, but increasingly common complaint behind acute stomach pains is kidney stones.

More often than not, a mummy-my-tummy-is-sore cry is not going to need any medical intervention; instead it might just need a hug, some love and a bit of a rub.

10 ways to treat a simple tummy ache

1. Give them an over-the-counter medicine.

2. Ask about bowel movements and encourage them to use the toilet as soon as they are able.

3. Have them lie on one side with their legs tucked up.

4. Get them to drink a glass of water. This may help to dilute any acidity imbalance.

5. Administer some tea. A couple of slices of ginger immersed in hot water works wonders.

6. Give them a piece of unbuttered bread.

7. Put them in a warm bath. Follow this with a warm hot-water bottle placed over the tummy.

8. Encourage them to chew on a sprig or two of parsley. Alternatively, sprinkle parsley in with salads.

9. Distract them. Read a favourite story together or watch a good movie.

10. Spend time together. You may well find out what the emotional issue is behind the pain.

Donna Cobban