What to Do for a Gassy Baby
February 10, 2020
We’ve all had gas pain. It’s that uncomfortable, crampy feeling you get when a gas bubble is trying to work its way through your digestive system. Ouch! No wonder gas pain is often blamed when baby’s fussy and squirmy. But baby gas is far from an official diagnosis, and what a lot of parents think is gas in babies might actually be something else. Here’s what you need to know to figure out if you’re dealing with a gassy baby, or if something else is at play.
What is baby gas anyway? “Generally, when baby is suffering from gas, the stomach is inflated with air, which has either occurred from the digestion process or baby has swallowed a lot of air while feeding,” says Katherine O’Connor, MD, is an associate director in the division of hospital medicine and an attending pediatric hospitalist at Children’s Hospital at Montefiore in New York City. Baby gas can lead to bloating, pain or irritation. Here, some common reasons for a gassy baby:
• Drinking too quickly. If the nipple on baby’s bottle has too fast of a flow, or if a breastfeeding mom has an overactive supply, baby will end up gulping the milk down, which can cause gas.
• Drinking too slowly. If the nipple on baby’s bottle has too slow of a flow, baby may suck in extra air while drinking formula, also leading to gas pain.
• Drinking formula with air bubbles. If you’re mixing powdered milk for baby, make sure to let it sit for a couple minutes before feeding. The more you shake the formula, the more air bubbles enter the milk, which can lead to a gassy baby.
• Crying for extended periods. Baby can also become gassy if they swallow air while crying for an extended period of time—which is why calming baby quickly is important.
• Not tolerating a formula well. Infant formulas are made differently, so what works well for one child may not work well for another. Gas could be a sign that baby isn’t tolerating their current formula well, says Meredith Grossman, MD, assistant professor of pediatrics at the Icahn School of Medicine at Mount Sinai in New York City.
• Ingesting gas-inducing foods. Baby gas can also happen naturally as food is broken down during the digestive process. It’s even more likely to occur if baby has a food intolerance to something they’ve eaten, or something mom’s eaten that makes its way into the breastmilk.
Gas and related issues can start from when baby is a few weeks old all the way up through the toddler stage. “But baby gas tends to be the worst when baby is 4 to 12 weeks old, with a peak around 8 weeks old,” O’Connor says. “They tend to have a lot of trouble with digestion. But once they hit the three-month mark, most babies are able to get through it and find other problems to distract themselves with.”
Of course, it can be hard to know if baby gas is the cause of your child’s discomfort, especially when they can’t tell you what’s going on. But there are a few common signs of a gassy baby you can look out for:
- Squirming post-feeding
- Clenched fists
- Pulling legs up toward the tummy
- Passing gas
The way to know for sure that baby gas is to blame is when baby actually burps or farts. “If you get a few burps out of baby or do something else to move things along, most babies are relieved of the symptoms and will stop crying,” O’Connor says.
Sometimes, however, these gassy baby symptoms can indicate another problem. O’Connor says, “When baby keeps crying despite passing gas, you know that there’s something else going on,” like reflux, constipation or colic, which is sometimes confused for extended gassiness in baby.
If your little one has reflux—when stomach contents back up into the esophagus and out of the mouth—they may struggle and arch their back, rather than curl in. It’s important to be able to differentiate the two, as reflux can be worsened by burping. “It usually happens about half an hour after feeding, and you won’t see the same kind of relief from burping or passing gas,” O’Connor says. “In fact, the burp can bring up reflux that will further irritate baby. You’ll see obvious spit up, arching of the body or discomfort after feeding.”
Constipation may also look very much like baby gas, with baby writhing and struggling. But you can tell baby’s constipated if the stool isn’t soft but rather comes out in hard pellets. Even if baby seems like they’re struggling to poop, it may just be what doctors call “infantile dyskinesia,” or baby practicing using their muscles to push the bowel movement out, O’Connor says. This struggle can look like baby gas and cause similar discomfort, but it’s not relieved by burping or passing gas.
Babies who cry a lot—as in several hours a day—are often said to have gas pain. But is it really gas? O’Connor says often a more accurate term for the problem is colic, which is when baby cries for more than three hours straight for at least three days a week. Some experts think colic might be related to babies’ underdeveloped digestive or nervous systems, which can cause general, extended discomfort with no easy cure. Baby gas and colic can appear to have similar symptoms: In addition to the crying, colicky babies often curl their legs toward their abdomen. Colic may or may not be related to belly pain, but some experts think colicky babies only appear gassy because they swallow so much air while crying due to existing colic pain. “If the parent has tried everything else they can do—feeding, burping, changing, rocking, all of it—and baby is still crying, then it’s likely colic,” O’Connor says.
If your child isn’t gaining weight and seems to have the telltale signs of a gassy baby, contact your doctor so they can perform a complete medical evaluation to rule out other possible issues, such as a dairy intolerance.
Watching a gassy baby struggle in pain can break any parent’s heart. Luckily, there are several baby gas relief options to help release the gas and soothe the discomfort. Read on to learn how to relieve gas in babies.
• Swaddling. Wrapping baby up tight can soothe your gassy baby by mimicking the coziness of the womb.
• Rocking or bouncing. As with swaddling, O’Connor says, the motion of rocking or bouncing simulates the environment in your uterus, helping to relax baby.
• Using a pacifier. “Almost all babies will find some baby gas relief by sucking on a pacifier,” O’Connor says, because the sucking action releases endorphins that will soothe them.
• Infant massage. Simply rubbing your child’s belly may be helpful, since massage can help calm the nerve signals in baby’s immature intestines.
• Tummy time. Some babies find gas relief from the gentle pressure that’s put on the stomach during tummy time. “Just make sure they’re supervised while doing this,” Grossman cautions.
• Encourage movement. If your gassy baby is in severe discomfort, try the “baby bike ride.” Lay baby on their back and move their legs in an up-and-down pedaling motion. This helps move gas along physically, but also helps soothe and calm nerves in the intestines.
• Change baby’s bottle. If you bottle-feed baby, “use bottles that help to prevent gas, which are usually vented or have other features that prevent the baby from swallowing a lot of air,” Grossman suggests. You can also try changing the bottle nipple. “A slower flow bottle nipple may help the baby to swallow less air,” she explains.
• Switch up baby’s formula. “For a formula-fed baby, you can try a different formula that’s made for gassy babies,” Grossman says.
If you’re breastfeeding, changes in your diet may also help ease the discomfort of a gassy baby. Some babies have an intolerance to certain foods, such as dairy, soy, gluten, eggs, nuts and citrus. Because molecules of the food you eat make their way into your breastmilk, eating foods that baby is sensitive to can cause baby gas. If you suspect something you’re eating is the reason for your gassy baby, try cutting one item out of your diet at a time for two to three weeks and see if there’s a difference in your child’s behavior.
When baby starts eating solids, see if you can spot foods that cause gas in babies. Common culprits include dark or leafy greens, beans and legumes. “When introducing solids, start with one food at a time, introducing it for a few days before trying a new one,” O’Connor says. “And start with easily digestible first foods so that you can make sure baby tolerates it well.”
Despite the fact that there are a ton of products and medicines for a gassy baby on the market that claim to help relieve gas pain, like gripe water and gas drops for babies, there is “no evidence to suggest that any of them work,” O’Connor says. “The concerning thing about using some of the herbal or over-the-counter remedies is that they’re sometimes mixed with ingredients that can cause severe reactions in babies. If you want to try an over-the-counter product, show it to your pediatrician first before you give it to baby.”
“If you’re able to comfort baby through swaddling, rocking, bouncing, feeding or burping, then you’re doing okay,” O’Connor says. “But if the crying is prolonged and you’re worried, call your doctor.” If baby gas pain persists, your pediatrician may perform a complete physical to see if there are any serious abdominal issues, such as a blocked intestine. Depending on the child’s history, allergy testing may also be in order. You should also call the doctor if baby’s fussiness is accompanied by more worrisome symptoms, for instance, a fever, bloody stool or vomiting. Most of the time, though, gas pain isn’t a serious issue and doesn’t call for any tests.
If you want to avoid baby gas pain, your best bet is to stop gas from building in the first place. Make sure you’re properly positioning baby during feedings so they’re swallowing as little air as possible. “Hold baby in your arms and elevate their head while their drinking,” O’Connor says.
When mixing formula, “make sure to let the formula settle before feeding it to baby,” Grossman says. “Mixing and shaking the formula while preparing it can lead to more air bubbles that baby might swallow, which may cause gas.” As you’re giving baby the bottle, tilt it to let as little air into the nipple as possible. You can also try using a vented bottle specifically designed to reduce how much air baby swallows as they feed. Tip: If you decide to switch bottles, don’t buy a bunch of them at once. “Try one at a time and see if the gassiness improves,” O’Connor says. Also consider switching to a nipple with a smaller hole. Large holes let milk flow through quickly, and baby may swallow a lot of air in an attempt to keep up.
When breastfeeding, it’s a bit harder to prevent baby from swallowing air. “But you can stop at regular intervals and burp baby,” O’Connor says. “And like trying different bottles, you can try different breastfeeding positions to see if one leads to less baby gas.”
Whether you offer the breast or bottle, if baby is prone to gas, then routine burping is important. Burp baby immediately after a feeding. If baby doesn’t like the traditional over-the-shoulder burping position, try laying them face-down over your lap and patting their back.
Updated February 2020
Katherine O’Connor, MD, is an associate director in the division of hospital medicine and an attending pediatric hospitalist at Children’s Hospital at Montefiore in New York City. She is also an assistant professor of pediatrics at Albert Einstein College of Medicine.
Meredith Grossman, MD, is a board-certified pediatrician and assistant professor of pediatrics at the Icahn School of Medicine at Mount Sinai in New York City.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.