By Dr. Karen DeVore
The first week of school has arrived. The backpacks are packed, the lunches are made, and after one last search for a missing shoe, everyone heads out the door. Then, just as you’re reaching for the car keys, your child quietly says, “My stomach hurts.”
For many parents and caregivers, this scene is as much a part of the back-to-school season as shopping for school supplies and navigating busy car lines.
The child who seemed perfectly healthy all summer suddenly doesn’t want breakfast, complains of a stomachache before school, or makes repeated trips to the bathroom. Naturally, families wonder: Are they getting sick?
Sometimes they are. But sometimes, the stomach is simply the first place the body speaks.
The brain and digestive system are in constant communication through what scientists call the gut-brain axis. When children experience change, whether it’s a new teacher, new classmates, academic expectations, a disrupted routine, or the excitement and uncertainty that naturally come with a new school year, the digestive system may respond before children have the words to describe what they’re feeling.
Sometimes, the gut speaks first. That can look like stomachaches, nausea, constipation, diarrhea, changes in appetite, or even changes in bowel habits. The question isn’t whether these symptoms are real; it’s why they’re happening.
One of the most helpful things parents and caregivers can do is look for patterns rather than focusing on a single episode.
Does the stomachache happen only before school? Does it improve later in the day? Does it appear before a test, after a difficult interaction with friends, or on Sunday evenings before the week begins?
Patterns like these may suggest the nervous system is playing a role, but they don’t rule out an underlying medical condition. Pain that wakes a child from sleep, is accompanied by fever, persistent vomiting, blood in the stool, unexplained weight loss, poor growth, or continues regardless of the situation deserves prompt medical evaluation.
Rather than asking only, “Where does it hurt?” it can also be helpful to ask: “When does it happen?” “What was happening just beforehand?” “Has anything changed recently?”
Sometimes those questions provide clues that the symptom alone cannot.
Today’s children navigate full schedules, academic expectations, extracurricular activities, changing friendships, and a constant stream of information. While these experiences are a normal part of growing up, they can place greater demands on a developing nervous system. For some children, those demands may show up in the digestive tract long before they have the words to explain what they’re experiencing.
What Can Parents and Caregivers Do?
If a child says, “My stomach hurts,” and otherwise appears well, the first response doesn’t always have to be finding the medicine cabinet. Instead, create a few minutes of calm.
Turn off the television or music. Set aside phones and other screens. Sit together quietly. Offer a reassuring hug, hold their hand, or simply be present. Children often take emotional cues from the adults around them, and a calm presence can be incredibly grounding.
Encourage slow breathing. A simple technique such as box breathing can help calm the nervous system: inhale through the nose for four seconds, hold for four, exhale gently for four, and pause for four before repeating. Younger children may enjoy imagining they’re smelling a flower on the inhale and slowly blowing out birthday candles on the exhale.
Offer a few small sips of water and allow the moment to slow down.
These simple steps aren’t meant to replace medical care. They create an opportunity to observe whether symptoms begin to settle while helping children reconnect with their bodies.
If stomachaches have happened around previous school years, don’t wait until the first difficult morning to talk about them. A relaxed conversation a few days before school starts can go a long way.
Ask open-ended questions: “What are you most excited about this year?” “Is there anything you’re a little nervous about?” “I remember your tummy bothering you before school last year. How are you feeling about going back?”
Sometimes children don’t know exactly what’s bothering them until they’re given a safe space to think about it. If this has been a recurring pattern, consider letting your child’s teacher or school staff know ahead of time. A little extra reassurance or simply having another trusted adult aware of the situation can make the transition easier.
Supporting the whole child also means supporting healthy daily habits. Consistent sleep, balanced meals with protein and fiber, regular movement, outdoor play, hydration, and opportunities for meaningful conversation all help children adapt more effectively to change.
Not every stomachache is related to the nervous system, and it’s important not to assume it is. If stomachaches become frequent, interfere with school or daily life, or are accompanied by concerning symptoms, reach out to your child’s pediatrician. They know your child’s medical history and can help determine whether additional evaluation or treatment is needed.
Perhaps the most important takeaway is this: Symptoms are information.
Rather than asking only, “How do we make this go away?” it can be equally valuable to ask, “What might this symptom be trying to tell us?”
Sometimes the answer lies in the digestive system. Sometimes it’s the nervous system adapting to change. Often, it’s a combination of several factors.
As another school year begins, remember that children don’t always have the words to explain what’s happening inside. Sometimes the gut speaks first.
When families respond with curiosity instead of assumptions, they become better equipped to recognize when a child simply needs reassurance, when they may need a little extra support, and when it’s time to partner with their pediatrician. Because every symptom has a story, and sometimes, listening is the first step toward understanding it.
