Abdominal Pain in Toddlers: Causes and Concerns

Frequent complaints of pain?

My daughter is one month shy of two years old.
Since she was one year and ten months, she has frequently complained of stomach pain, about 2-3 times a week.
She currently weighs 10 kg and has only grown 1 cm in height over the past six months.
She eats three meals a day with adults but has a poor appetite, consuming about a quarter bowl of rice per meal.
Since she was nine months old, she has been drinking one to two bottles of Yakult or yogurt (130 cc) on an empty stomach every day, as she refuses to drink toddler formula.
Consequently, her grandfather has been feeding her adult milk powder for the past two months, or mixing Yakult with the milk powder.
A month and a half ago, my daughter fell in a U-shape between the wall and the sofa, landing on her bottom.
Since then, she has been saying her bottom hurts, and upon further inquiry, it seems to be pain in the coccyx area.
There are no visible abnormalities when she walks.

I have the following questions:
1.
Could drinking Yakult on an empty stomach every day cause gastrointestinal digestive issues?
2.
Is feeding a two-year-old adult milk powder harmful to her health?
3.
Is the minimal increase in height and weight over the past six months indicative of growth delay?
4.
If there is a suspicion of injury to the child's coccyx, is it possible to perform an X-ray, and would it have any negative effects on the child?
Could you please recommend which medical specialty to consult for these issues? Thank you for your assistance.

Xiao Ci Ma, 30~39 year old female. Ask Date: 2005/03/01

Dr. Lin Wenxian reply Pediatrics

Dear Ms.
Xiao Ci,
Hello! Below are the answers to your questions:
1.
Drinking Yakult or yogurt on an empty stomach is generally not a problem.
However, it is important to avoid letting children develop a habit of consuming overly sweet beverages or foods.
Occasional consumption is fine, but if they consume too much or become accustomed to sweet flavors, it may affect their appetite for regular meals and hinder balanced nutrition absorption.
2.
Regarding foods suitable for adults, children over one year old can generally eat most of them.
Therefore, fresh milk or regular adult milk powder is acceptable for two-year-old toddlers.
3.
Typically, growth in toddlers around the age of two may slow down slightly.
The current weight (10 kg) is at the lower limit of the normal range, but growth delay should be assessed in conjunction with height and weight growth charts (which are included in the child health handbook).
If the growth pattern mostly follows the lines on the chart, there is usually no significant issue.
Additionally, genetics play a significant role.
A higher birth weight may be due to the intrauterine environment, but as the child grows, genetic factors will become more apparent, possibly resulting in a leaner physique like the mother.
Therefore, as long as height and weight remain within the normal range (according to the growth chart), and development is progressing well, continued observation is all that is needed.
4.
Occasional X-rays will not have an adverse effect on young children.
5.
For dietary and gastrointestinal issues, you can consult a pediatric gastroenterologist.
If you are concerned about growth delays, a pediatric endocrinologist would be appropriate, and for coccyx issues, a pediatric orthopedic specialist should be consulted.
Wishing you good health and all the best from Tainan Hospital!
Sincerely,
Dr.
Lin Wen-Hsien
Director, Pediatrics
Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/03/01

More Info

Understanding abdominal pain in toddlers can be quite challenging for parents, especially when the child is unable to articulate their discomfort clearly. In your case, your daughter has been experiencing abdominal pain frequently, and there are several factors to consider regarding her diet, growth, and potential injuries.

1. Daily Consumption of Yogurt or Probiotic Drinks: While yogurt and probiotic drinks like Yakult can be beneficial for gut health, excessive consumption, especially on an empty stomach, may lead to digestive issues. These drinks contain sugars and can sometimes cause gastrointestinal discomfort, particularly if consumed in large quantities. It’s essential to ensure that her overall diet is balanced and includes a variety of foods to support her digestive health. If she is consuming these drinks instead of solid foods, it might contribute to her reduced appetite and potential abdominal pain.

2. Feeding Adult Formula to Toddlers: Adult milk powder can be different in composition compared to toddler formula, which is specifically designed to meet the nutritional needs of young children. While it may not be harmful in small amounts, relying on adult milk powder could lead to nutritional imbalances. It’s crucial to provide age-appropriate nutrition that includes essential vitamins and minerals necessary for her growth and development.

3. Growth Concerns: The fact that your daughter has only gained 1 cm in height over the past six months and weighs 10 kg may raise concerns about growth and development. Growth charts can help assess whether she is growing at a healthy rate compared to her peers. If she is consistently below the growth percentile for her age, it may indicate growth delay or other underlying health issues. Consulting a pediatrician for a thorough evaluation would be advisable.

4. Potential Tailbone Injury: Given that your daughter fell and has been complaining of pain in the tailbone area, it is reasonable to suspect a possible injury. X-rays can be performed to assess for fractures or other injuries. Generally, X-rays are safe for children, but it’s essential to discuss the necessity and potential risks with the pediatrician. They will weigh the benefits of obtaining an X-ray against any potential risks.

For your concerns, I recommend consulting a pediatrician. They can evaluate your daughter’s overall health, growth patterns, and dietary habits. If necessary, they may refer you to a pediatric gastroenterologist for digestive issues or a pediatric orthopedic specialist if there are concerns about her tailbone injury.

In summary, addressing your daughter’s abdominal pain involves a comprehensive approach that includes evaluating her diet, growth, and any potential injuries. Regular check-ups with a pediatrician will help ensure she receives appropriate care and support for her development.

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