Friday, January 25, 2008

Parents Center--Stomachache (birth to 12 mo.)

My baby seems really fussy and uncomfortable, as if his stomach hurts. How can I tell what's going on?
It can be tough to figure out whether a baby's tummy hurts, but excessive fussiness is a big clue. Pay attention to when your baby seems uncomfortable (is it shortly after a feeding?) as well as what other symptoms he has, such as a fever, vomiting, or diarrhea. Use this information to help you — and, if necessary, his doctor — figure out what's going on.

What causes tummy trouble in babies?
The conditions below are the most common causes of stomach pain for babies. There are many more, although they tend to be less common.

If your baby suddenly becomes ill and you think he may have pain in his stomach, call his doctor. It's always better to err on the side of caution.

1. Colic
Colic is the classic explanation for stomach pain and other irritable baby symptoms. What exactly is colic? It's a term used to describe uncontrollable crying in an otherwise healthy baby. If your baby is under 5 months old and cries excessively and uncontrollably for more than three hours in a row three or more days a week for at least three weeks, and there's no medical explanation for his distress, chances are he's colicky.

About 20 percent of babies experience colic. Some show colicky symptoms 24/7, while others cry at the same time of day, often in the late afternoon or evening. Colic's not a disease, and it won't cause your baby any long-term harm, but it's no fun for either of you.

If your baby has colic, you may notice that his tummy looks enlarged. He may alternately extend and pull up his legs and pass gas as he cries. Of course, as he cries he swallows more air, which makes matters worse.

Unfortunately there's no cure for colic. However, parents and doctors have plenty of suggestions to try to soothe the tears and pain. The good news is that most babies improve significantly between 3 and 4 months and are over colic by the time they're 5 months old.

2. Gastroesophageal reflux
Most babies spit up a bit — or even vomit once in a while — after feedings. If your baby does it often, it's called gastroesophageal reflux (or just reflux). Most babies who have reflux outgrow it in the first year.

But if your baby has other symptoms along with spitting up or vomiting — like signs of abdominal pain (arching his back, drawing up his legs) or coughing or gagging during feedings — he may have gastroesophageal reflux disease, or GERD.

When a baby with GERD eats, the food and digestive juices back up into his throat, irritating the lining of his esophagus. This painful sensation is akin to heartburn in adults. GERD can cause malnourishment as well as other problems, like dehydration, so it's important to take your baby to the doctor if you think he may have it. Most doctors have an easier time diagnosing GERD than other causes of stomachaches because babies with this problem act in a similar manner: Voraciously hungry, they latch on to the breast or bottle and suck for 15 or 20 seconds, then arch their back, pull away, and begin to cry. The arching and screaming begin when the reflux starts.

If your doctor suspects GERD, he'll run some tests and probably offer you one of a number of medications in addition to some feeding strategies that can help reduce pain and suffering. To find out more, see our article on GERD in babies.

3. Gastroenteritis or "stomach flu"
Is your baby vomiting or suffering from diarrhea? If so, he could have gastroenteritis, also known as stomach flu. It's the second most common illness in the United States, after upper respiratory infections.

Doctors use the term gastroenteritis to describe any inflammation of the stomach and intestines caused by a viral or bacterial infection. Viruses are the most common culprit, including rotavirus, adenovirus, calicivirus, and astrovirus.

Gastroenteritis can also be caused by a potentially more serious bacterial infection, such as Salmonella, Shigella, Staphylococcus, Campylobacter, or E. coli. Still other cases of gastroenteritis are caused by parasites such as giardia. Your baby's symptoms may be mild or severe, and they may last for just a few hours or for days, depending on the cause.

Because a virus is usually to blame for gastroenteritis, you can't treat it with antibiotics. But that doesn't mean you should sit back and wait for the ailment to run its course. If it's causing your baby to vomit or have diarrhea along with a fever and loss of appetite, it can quickly lead to dehydration.

So it's important to make sure that your baby is getting plenty of fluids (formula or breast milk) while he battles the illness. Talk with your baby's doctor. She may suggest giving your baby small sips of an over-the-counter electrolyte solution to replace fluid, minerals, and salts he may have lost, especially if he's unable to keep down formula or breast milk.

Watch for signs of dehydration and give the doctor a call if you think your baby may be becoming dehydrated. If he shows serious signs of dehydration, take him to the emergency room.

As soon as you can, you'll want to reintroduce your baby's normal diet (including solids, if he's begun to eat them), avoiding only fatty foods.

4. Milk allergy or lactose intolerance
If your baby has a milk allergy, his immune system is responding to the proteins found in milk. Milk allergies occur most often in babies and children.

Lactose intolerance — which means that the body isn't producing the enzyme needed to digest lactose, the primary sugar in milk — is rare in babies. It usually shows up later in childhood or during the teen years.

Of course, you shouldn't give your baby cow's milk until after his first birthday. But if your baby is allergic and you give him a milk-based formula — or even if you're breastfeeding and consume milk products yourself — he may have an allergic reaction.

Symptoms of both milk allergy and lactose intolerance include vomiting, diarrhea, and stomach pain. In severe cases of milk allergy, a baby may experience a life-threatening reaction called anaphylactic shock.

To pinpoint the problem, a doctor will recommend that you cut out all dairy (formula included) from your baby's diet for a few days and then slowly reintroduce dairy products. If you breastfeed, you'll likely be asked to stop eating all dairy yourself, since the irritating proteins can pass through breast milk to your baby. If changing your diet helps your baby, you may have to give up dairy products or limit your consumption until you wean him.

If you formula feed, you'll probably find yourself switching brands until you discover one that doesn't upset your child's stomach. You may have heard that soy formula is often the solution, but 5 to 10 percent of children who are allergic to cow's milk are also allergic to soy. BabyCenter can help you find a formula that's right for your baby.

Learn more about how doctors diagnose and treat food allergies and sensitivities.

5. Constipation and changes in diet
Since most babies begin eating solid food when they're between 4 and 6 months of age, this is prime time for food-related stomachaches. For example, peas may give your baby gas for the first few days that he tries them, but this is usually just a temporary adjustment.

The most common stomach problem in babies who are just starting solids is constipation. Constipation is defined as not having a bowel movement for two to three days and then passing small hard stool. If this is the case for your baby, sit tight. After a few weeks, his digestive system will adjust to the changes in his diet and he'll start having regular bowel movements again.

If your baby is eating solids, you can help by feeding him foods that produce looser stools (like apricots, pears, prunes, and peas) and cutting back on those which tend to cause firmer stools (like bananas, apples and applesauce, carrots, rice, and squash). Getting him to drink more fluids may also help.

In addition, exercise can help get the bowels moving. Try laying your baby on his back and "bicycling" his legs.

To find out more about food-related tummy pain, see our article on constipation.

6. Intestinal blockage
Don't take a wait-and-see approach if your baby is seemingly fine one minute and writhing in pain the next, drawing up his legs and crying hard. This is especially true if, unlike with colic, these symptoms are increasing in intensity and frequency and your baby is vomiting.

These symptoms may signal intussusception, an intestinal blockage that most often happens to babies who are 5 months to 2 years old. It's not very common, but it can be life threatening, so call your baby's doctor immediately. If you can't reach her, take your baby to the emergency room, as he may need surgery.



source from http://www.babycenter.com

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