“Mummy My Tummy Hurts” Understanding Tummy Pain in Children: A Paediatric Dietitian’s Guide
Blog is based on Podcast Episode 57: Tummy Pain in Kids click here to listen now with apple
click here to listen on spotify
As a paediatric dietitian, I’ve spent over two decades helping families untangle the root causes of tummy troubles in babies and children. Often these problems have gone on for months and years… and the disruption to the health and well being of the whole family is visible.
Whether it’s caused by allergy, food intolerances, anxiety, illness or other medical issues, tummy pain deserves proper attention. Parents and their little ones need a plan that is based on their specific underlying issues, which is often the hardest part of the puzzle.
As a specialist in this field, I’m here to explain, some of the common causes for tummy pain in babies and children, so that you can better understand why your child may have tummy pain.
1. Infection and Illness: The Common Culprits Behind Gut Pain
First up, let's start with the common cold or virus. If your child comes down with a cold or virus, it’s not uncommon for them to complain about tummy pain. This kind of discomfort is often short-lived and associated with fever, lethargy, or other signs of general unwellness. But sometimes, the pain lingers—even after the virus has passed.
That’s where we start to suspect what we call post-infectious IBS, where a child’s gut remains hypersensitive even after they’ve recovered. This can be particularly distressing for a picky eater, who may begin avoiding foods out of fear of discomfort, which in turn limits their nutrient intake.
If gut symptoms persist, it may be time to consider paediatric dietitian support tailored to gastrointestinal issues. [[click here to learn about an online nutrition consultation with myself]]
Parasites like threadworms or infections such as Helicobacter pylori can also trigger persistent tummy pain. If your child has changes in bowel habits or an itchy bottom, it's worth chatting to your GP or paediatric dietitian. Testing may be necessary to get to the root of the issue.
2. Emotional Stress and Anxiety: The Hidden Link to Gut Health
One of the most overlooked causes of tummy pain in kids is anxiety. The connection between the gut and the brain—what we call the gut-brain axis—is incredibly powerful. Emotional stress can absolutely manifest physically, especially in children.
More and more research confirms the link between mental wellbeing and gut function. As highlighted in Stanford Children’s Health’s article on improving your child's gut health, nurturing the gut microbiome through a varied, whole-food diet doesn’t just help digestion—it also supports mood and behaviour.
Children experiencing stress, transitions (like starting school), or social challenges may find their discomfort shows up as tummy pain. Add a picky eating habit on top, and it becomes a nutritional concern. They may begin restricting their intake, further compromising gut function and increasing food aversions.
Toileting anxiety is another contributor, particularly if your child avoids using the toilet at school or daycare. These holding on behaviours can increase the risk of constipation, setting off a cycle of discomfort and reduced appetite.
3. Food Allergy and Intolerance: When Nutrition Becomes the Trigger
This is where I see some of the biggest transformations in my work.
Many families have been told their baby or child with tummy pain will “grow out of it,” only to spend years managing gut symptoms, sleepless nights and food refusal. They get very little guidance and often I think it’s because people don’t know how to help them - and this goes for doctors too (through no fault of their own - they have to be “A jack of all trades”). It can be a very confusing area, unless you are truly specialised in it.
The good news? With the right support, we can often identify specific food triggers— either food allergies (reacting to the food protein) or food intolerance (commonly reacting to carbohydrates such as lactose or fructose).
It’s imperative that we fully understand exactly what is going on, so that we can then create a dietary plan that reduces symptoms, improves gut health and increases their overall nutrient intake. This is even more important when you throw fussy eating into the mix!
It’s common for little ones to begin avoiding certain foods when it causes them pain. Over time, they may fall short on key nutrients essential for growth, immunity, and even learning. As a Paediatric Dietitian, my role is to help you navigate these challenges with structure, science, and empathy.
A food and symptoms diary is an essential tool to identify connections between meals and reactions. It helps create a clear picture of what’s driving your child’s discomfort.
And yes, sometimes probiotics can help with children. be part of the picture. If you’re curious about their role, you’ll find my detailed breakdown in this guide to probiotics for kids, which explains how these supplements—and prebiotic foods—can support a child’s immune and gut health naturally.
4. Underlying Medical Conditions: The Rarer Diagnoses
While most gut symptoms in children are due to food reactions, common infections or stress, occasionally they may signal something more serious. Undiagnosed coeliac disease or inflammatory bowel disease (IBD) should be considered in children with persistent symptoms and no obvious cause.
Coeliac disease can lead to ongoing tummy pain and discomfort, especially after eating wheat or gluten-containing foods. IBD, while rare, can be incredibly impactful and needs medical diagnosis and treatment.
Once these serious causes are ruled out, many children are given a diagnosis of irritable bowel syndrome (IBS), particularly if their symptoms are ongoing but unexplained. This is more common than you might think—affecting up to 16% of children—and can often be improved significantly through dietary intervention.
Helping the Picky Eater Thrive
If your child is a picky eater or a fussy eater, dealing with tummy pain complicates mealtime even further. They may begin associating food with pain, leading to aversions, fear, and nutritional gaps. That’s where a tailored approach is critical.
In my clinic, I design food plans that take into account:
Individual sensitivities and intolerances
Mealtime stress or anxiety
Nutritional gaps due to limited variety
Strategies to introduce new foods gradually
Quick, easy food swaps to suit your busy routine
A healthy diet for fussy eaters doesn’t have to be restrictive or difficult. With the right support, your child can begin to enjoy food again—without tummy troubles getting in the way. [[click here to learn about an online nutrition consultation with myself]]
Final Thoughts: Trust Your Gut, and Theirs
Tummy pain isn’t something your baby or child has to “just live with.” If they’re experiencing ongoing symptoms—especially if they’re a picky eater or showing signs of food fear—please don’t wait it out. You don’t have to navigate this alone.
Please reach out to me, I’m happy to chat about the best path forward for your little one’s gut health. [[click here to contact me]]