Frequent stomach ache in children: Ask the Expert

My daughter often says she has a sore tummy and doesn’t want to go to school. I am not sure if she is really not well or she just doesn’t want to go to school. I work full-time and can’t take time off easily, but feel very guilty leaving her when she says she is not well. I have tried to talk to her to see if anything is wrong at school, but she says it is fine. What should I do?

No expert these days will tell you to ignore a child’s pain for fear of litigation if it turned out to be grumbling appendicitis. However, it is perfectly possible that the stomach ache is as a result of not wanting to go to school and this could be triggered by a variety of reasons (problems with friends/teacher, separation anxiety or maybe your child simply enjoys being at home).

First, I want to say that no one knows your child as well as you do and if you think it’s a proper stomach ache, then take her to the doctor and don’t worry about being seen as an over-anxious mother. On the other hand, if you think it’s got a psychological, rather than a physical basis, there are a number of things you can try. The success of these will depend on the cause of the stomach ache and the age of your daughter. The most important thing is to acknowledge the stomach ache and don’t tell her ‘not to be silly’ or that she’s ‘making it up’. There is no reason to assume that it is either psychological or physical, it could be both. Butterflies in the stomach are common and not pleasant and whilst they are not caused by any infection or medical condition that should cause alarm, they still may feel very real to your daughter.


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1. Talking
The first thing I’d always try is talking to your child. You say you’ve tried this, but children can be reluctant to burden parents with their worries, especially if they don’t think you can do anything about it. Explain that stomach aches can be caused by a number of things and that you sometimes get a funny feeling in your tummy when you are scared or unhappy about something. Tell her that this feeling is different from the type that makes you feel sick or need the toilet and try to get her to describe her feeling. The limited vocabulary of a young child can often mean that they use one word for a variety of purposes, when adults would use a variety of words. By describing how your tummy feels when you’re nervous and what you do to deal with it, you are both understanding and reassuring your daughter.
2. Keep a food diary and check for intolerances/allergies
Keeping a record of what your daughter eats and looking for patterns could help identify the cause. Look for both patterns in food she’s eating and patterns in behaviour (e.g. does she always complain about it on the day she has PE or if you’ve been working late?)
You could explain that if the tummy ache doesn’t go away, you’ll need to go to the doctor, but that before that, you need to check if the tummy ache comes on because of anything she’s eaten. Therefore, you need her to stop eating e.g. dairy foods for a week. This is something you can try to see if she has an intolerance – the doctor would probably ask you to keep a food diary anyway, so it will save time in the long run if you can rule out certain allergies.
If the stomach ache goes away when you remove certain foods from her diet, you’ll know that was the cause. You can also try saying that whilst she’s got the tummy ache, she shouldn’t have ‘treat food’, as it might make it worse. If she is using it as an attention seeking exercise, she will soon realise that she’s not getting the treats and this will give her the incentive to ignore the nerves. When taking this approach, it is really important not to make her feel like she’s done anything wrong, but you do need to be firm about removing certain foods if you are trying to investigate intolerances.
3. Speak to the teachers.
Do they know about it? Does she seem to use the toilet a lot? Has she seemed unhappy for any reason? Explain your concerns to them and they should help you identify the cause if it’s school-related.
4. Make a plan to reassure her.
Send her to school, but tell her that if it still hurts at lunchtime, she should go and tell a teacher who will call you and you’ll come and get her. If it’s separation anxiety, the chances are that once she’s at school she’ll forget all about it. This works because it reassures your daughter that you’ll be there if she needs you, which is the fear at the root of separation anxiety. Only do this if you are able to leave work to get her if necessary.

5. Make sure there’s no overall gain to being ill.
Make sure that your children feel cared for when they’re ill, but that they have more fun when they’re well. Emphasise all the fun things they can do if they’re feeling ok, but that wouldn’t be a good idea if they have a tummy ache (e.g. swimming, swings/slides etc).
6. Take a grown up approach
For older children, if you are sure it’s not a real tummy ache, you can explain that we all have to do things we don’t want to do and you don’t really feel like going to work sometimes. You can explain why you have to work, and why children have to go to school and then agree to treat yourselves every Friday (the treat can be anything simple – e.g. watching a film together, or something special to eat for tea).

There is no easy fix, and you have to trust your instincts, but many of these things are ‘just a phase’ and she is likely to grow out of it. However, if you have any concerns, speak to your daughter’s teachers, the doctor, and the school nurse and make sure you fell supported in your decisions. Generally speaking, the less fuss that is made, the quicker it will go away. Even if you decide to go to the doctor, doing it in a matter of fact way will help prevent your daughter from worrying about it.
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