By Dr Joanna McMillan
Sore tummies are common in kids and it can be really hard to identify what exactly is causing the problem. Food is often the first thought and indeed many sore tummies are the result of a digestion issue. Wind, caused by trapped gas, constipation, food intolerances or allergies, eating or drinking too much can all result in abdominal pain, as can medical causes such as gastro or appendicitis.
Your first step therefore is to assess whether your child needs medical help. If you are at all unsure, the pain is severe, the pain doesn’t go away, or becomes a chronic problem, see your GP. And if there is blood in your child’s poo or vomit take them to accident and emergency at your local hospital.
Putting these more serious medical causes aside, what can you do to identify digestive issues and prevent repeat sore tummies?
Here are my top tips:
Check out their poo
Constipation is common in kids and can easily go unnoticed, especially once your kids are toilet trained and going on their own. The pain will come and go, may be accompanied by cramping, bloating, nausea and/or a loss of appetite.
Ask your child how often they go and about the state of their poo. Passing a few hard dry pellets might mean they tell you ‘yes I’ve had a poo’ but this means they are constipated. Check out the Bristol Stool Chart online and ask your child which one their poo most looks like… honestly that’s the easiest way to get your answer!
The cause can be dietary, but it may also be practical. Lots of kids don’t want to do a poo at school and so hold it in. That makes for dryer poos that are hard to pass and constipation results. This can become an ongoing cycle as it may be painful for the child to have a bowel motion and so they avoid it even more.
At the other end of the scale diarrhoea can also cause tummy pain. This of course may be the result of an infection or food poisoning but can also be due to food intolerances of allergies. If the diarrhoea is accompanied by fever and/or vomiting it’s likely to be the former, whereas if the problem doesn’t go away or is a frequent problem, consider a problem food or foods. Ask your GP for a referral to a specialised clinic for proper testing and diagnosis.
Fibre up their diet
If your child is frequently eating highly processed foods from a packet or from a fast-food chain, rarely eats their vegies, doesn’t like brown bread and prefers a fruit roll over a piece of actual fruit, that sore tummy is very likely related to a lack of fibre.
Fibre is key in preventing constipation of course, but it is also essential for the development and maintenance of a healthy, diverse gut microbiome. That will not only help with bowel movements, but also impacts on their immunity and has even been linked to fewer allergies and intolerances.
Ensure the whole family are eating a diet rich in vegies, fruit, wholegrains, legumes, nuts and seeds (allergies allowing) delivering a diversity of fibre types.
Mull over their milk
Milk is a key food for kids, especially younger kids, yet it can be the source of digestive problems. Consider the quantity of milk your child
is consuming as well as the type and how they are drinking it.
Milk is the only source of nutrition in the first 6 months or so, but it continues to be a major contributor of nutrients for toddlers and pre-school children. After weaning’ the problem can be quantity. If kids are drinking lots of milk that can displace those fibre-rich foods they need for a healthy gut. If this is the case give them their milk separate to meals and not before to ensure they are hungry at mealtime for solid foods.
Secondly, there are nutritional differences between milks. Cow’s milk is by far the most common of animal milks, but in fact the earliest domesticated animal milk came from goats. Interestingly goats’ milk and the cheese and yoghurt made from it, were the main dairy foods in traditional Mediterranean diets, touted as being one of the healthiest in the world. There are also several reasons why goats’ milk may also be easier to digest:
- Compared to cows’ milk, goats’ milk has smaller fat globules that make it easier for digestive enzymes to break them down.
- Goats’ milk also has a greater percentage of short and medium chain fats. These are more readily used as fuel by the body.
- It has more of the short chain carbohydrates, called oligosaccharides, also found in human breast milk, that act as prebiotics to fuel the gut microbiome.
- And goats’ milk is naturally A2. This relates to the type of beta-casein proteins found in the milk. The A1 type, found in most cows’ milk (unless specifically labelled as having only A2 proteins) has been associated with digestive issues in some people. In kids with less developed and mature guts, this may be more of a problem. Ensuring only A2 proteins may help with some digestive problems.
Note that if your child has an allergy to cows’ milk, goats’ milk may be equally problematic. It does also contain lactose and may not be suitable for those with lactose intolerance. For other digestive issues however, it can offer a good alternative. It has all the protein and calcium of cow’s milk and seems to be easier to digest. It might be worth a go.
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