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PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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Back to School Belly Achin’

I’ve got a good friend whose son Vince, a 4th grader, has a regular problem with “stomachaches.”  These are kind of unusual stomachaches, because they appear to be seasonal, almost exclusively occur during daytime hours, and are temporarily incapacitating.  They don’t include fever or vomiting, and his bowel movements are normal.  Last spring Vince was afflicted nearly every day for several hours, and came home from school quite a lot.  He saw his regular pediatrician who did multiple tests, and when everything came up normal as Summer arrived they agreed to watch him closely.  He had a wonderful summer, filled with friends and vacation and no stomachaches.  Last week he started his first day of school, and do you know what my friend Patricia told me this morning?  You guessed it; Vince had another stomachache today.

School phobia can manifest itself in many ways,

but one of the most common ways is for kids to claim illness, often in the form of abdominal pain.  It’s the oldest trick in the book — act sick so you don’t have to go to school.   This can be a really difficult situation when it becomes a recurring issue, so it’s got to be handled delicately yet definitively.  First, a visit to your child’s pediatrician is in order.  It’s crucial to make sure that there really is NO disease process going on.  Just as I help many parents with children acting sick who aren’t, there are those few who really do have a medical problem, and they must be identified.  Once it has been determined that there really is no medical problem, then you can get to work tackling your child’s fears.

But don’t do it alone.

Involve your child’s teachers as soon as possible so that you can partner with them as you fix the problem.  The school guidance counselor may have helpful ideas such as suggestions about relaxation techniques and other behavior therapies to help your child overcome this anxiety.  It’s important to set boundaries firmly that your child is indeed going to attend school — there can’t be any wiggle room on that, but then try to brainstorm on ways to ease into this reality—whether it means that you volunteer at school a few mornings a week so that your child sees you there regularly or that he/she gets a reward (not a material thing, but rather a treat like picking what’s for dinner) for making it through the day, the week, or whatever.  Encourage your child to talk about his/her fears with you. They can even write them down as a way to “get them out.”

 

Make a plan.writing in notebook picture

What my pal Patricia did with Vince last spring was work up at the school as a cafeteria monitor 3 days a week, and often she would bring him a lunch treat if things were going well.  I invited him to call me every single day after school to discuss how his stomach had been that day.  We celebrated the good days and didn’t give much energy to the bad ones, and what we found was after about 10 days Vinny was no longer that interested in calling me.  He was too busy trying to get his homework done after school so he could get outside to play with his classmates from the neighborhood.  His stomachaches disappeared too.

 

I’m going to offer the same thing to Vince again.   My guess is a couple of days of the same old routine for him will help him get through this transition time.  I’ll let you know how it goes, but mostly I’m proud of Patricia for not letting this get out of hand, as it can indeed be a very serious problem for some kids.  Don’t let your child be one of them.
Keep reading: Your finger is NOT a door stopper!

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