CLAIM:
Many parents worry that a big pot belly in children signals an underlying health problem or poor development, but, it is usually normal, a common part of early childhood as abdominal muscles and intestines develop, and often resolves on its own with time.
FACT:
A soft, protruding tummy in babies and toddlers is usually normal and commonly due to immature abdominal muscles and developing intestines, which typically strengthen with age and resolve on their own. Paediatric experts highlight that concern is warranted only if the belly is hard, painful, persistent beyond early childhood, or accompanied by warning signs such as poor growth, malnutrition, or signs of vitamin D/calcium deficiency (rickets) or a large umbilical hernia.
In a viral Instagram reel posted by Dr Madhavi Bharadwaj, the doctor addresses a common concern among parents — the “big pot belly” or “Buddha belly” in young children. Dr Bharadwaj, famously known on social media as ‘bacchon_ki_doctor’, regularly shares parenting tips and child health information through her videos.
In the reel, a baby is seen with a noticeable pot belly. Playfully pointing to the child’s tummy, Dr Bharadwaj says, “What is this cute tummy outside? He doesn’t know. I’ll tell them. I will tell them a little bit about your tummy.” She then transitions to a clear explanation that addresses the concern.
She emphasises that when multiple parents ask the same question in a day, it’s a signal to raise awareness. “A 6-month-old kid and a 12-month-old kid — both parents asked me the same thing today. 'Ma’am, why does his stomach come out? Mind you, he’s a lean, thin kid, not obese',” she explains.
Dr Bharadwaj elaborates that the area around a child’s navel is not just the stomach; it contains the intestines, surrounded by abdominal muscles that are still developing. “Until those muscles are matured and strong enough, the path isn’t completely closed. So if the child has a little gas, constipation, or heaviness after eating, the tummy can protrude, giving a Buddha-like belly. Once these things are relieved, the belly goes back in.”
She reassures parents that this is usually normal and also addresses umbilical hernia concerns. “We don’t worry about the umbilical hernia either. It can persist until the abdominal muscles fully develop, usually around 1.5 to 2 years. After that, if the tummy still protrudes, it could be linked to calcium or vitamin D deficiency, also called rickets. In such cases, consult your doctor, but in most healthy, small children, there’s no need to worry.”
The reel has struck a chord with parents, sparking widespread discussion about the normal development of children’s tummies and when to seek medical advice.
Is it normal for babies to have a protruding tummy?
In most cases, a soft, protruding belly in young children is completely normal. According to MedlinePlus, “it is generally normal for toddlers to have potbellies. By the time children reach school age, the potbelly will most often disappear, and their bodies will be more proportionate. The belly should feel soft, and NOT tender. There is nothing to worry about unless the child also has other symptoms such as belly pain, fever, hard or firm-feeling belly, short stature, swollen belly, or vomiting.”
Umbilical hernias, which can make the belly appear more prominent, also often resolve naturally. Small hernias (less than half an inch) have an 85 per cent chance of closing on their own, while larger or symptomatic hernias that persist beyond age 5 may require surgical repair.
However, in rare cases, a protruding tummy can signal underlying medical issues, such as nutritional deficiencies or structural anomalies. Persistent belly protrusion may be associated with calcium or vitamin D deficiency (rickets). A 2020 study in Delhi assessed 150 children (aged 1–59 months) hospitalised with severe acute malnutrition (SAM) and found that hypocalcemia was present in about one-fourth of them, while 42 pc showed clinical signs of rickets. The study highlighted that “abdominal distension in hypocalcemia might indicate pot-belly abdomen, which is one of the classical findings of rickets in children,” and recommended routine vitamin D and calcium supplementation in severely malnourished children to prevent complications.
Beyond nutritional issues, rare congenital conditions can also lead to abdominal distension and a visibly enlarged belly. Case reports describe previously healthy children presenting to pediatric emergency departments with abdominal pain, poor appetite, weight gain, and a significantly distended abdomen. In one such case, a 3-year-old girl had a taut, distended belly with normal vital signs. Imaging revealed a large amount of complex intra-abdominal fluid without a definite mass.
She was ultimately diagnosed with a large congenital omental cyst, requiring surgical resection. Pathology confirmed a macrocystic lymphatic malformation, an uncommon pediatric lesion accounting for only 5 pc of benign childhood tumours. While lymphatic malformations typically occur in the neck or axilla, rare cases can involve the gastrointestinal tract, sometimes presenting later in life and mimicking other abdominal conditions.
What experts say
Dr Amit Gupta, Senior Neonatologist and Paediatrician at Motherhood Hospitals, Noida, said a protruding tummy, often referred to by parents and caregivers as a “Buddha belly” or “frog-like tummy”, is very common in infants and usually harmless.
“Parents and even caregivers get extremely worried when they see a baby’s tummy sticking out. But in most cases, this is absolutely normal and nothing to panic about,” Dr Gupta explained.
He attributed this appearance to the immaturity of the abdominal muscles, particularly the rectus muscles, which are not yet fully developed in early infancy. As babies grow and start putting pressure on their abdomen, typically around five-and-a-half to six months, when they begin rolling, sitting, or crawling, these muscles gradually move closer together.
“In nearly 80 to 90 per cent of babies, this gap closes naturally by six months. In the remaining cases, it may take a little longer, but by one to one-and-a-half years of age, around 99 per cent of cases resolve on their own,” he said.
Dr Gupta added that only a small subset of babies have a true umbilical hernia, where a noticeably large opening allows part of the abdomen to bulge out. “If the opening is big and we feel that a part of the intestine is protruding, we confirm it with an ultrasound. That is what we call a proper umbilical hernia. Otherwise, in most cases, nothing needs to be done.”
He noted that nutritional deficiencies, particularly in vulnerable populations, can also contribute to a persistent protruding belly. “In children who are malnourished, especially in low socioeconomic settings, the incidence is higher. In such cases, this can be linked to rickets, caused by vitamin D or calcium deficiency.”
Describing the warning signs, Dr Gupta said rickets is often accompanied by multiple physical markers. “You may see a protruded belly along with prominent joints, flaring of the wrists, a broad forehead, bowing of the legs, and overall weakness.”
He reiterated that a protruding tummy in infants is usually normal, but parents should watch for certain red flags. “If by six to eight months the child looks malnourished, has an unusually large anterior fontanel (soft spot on the head), weak bones, or delayed development, we evaluate for vitamin D deficiency.”
Similarly, in the case of a suspected umbilical hernia, size matters. “If the defect feels larger than one to one-and-a-half centimetres, or if intestinal loops are felt inside, we recommend an ultrasound. Apart from these situations, most protruding tummies in babies are part of normal growth and development,” he said.
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.
