How To Help A Gassy Baby: an epic post
Seeing your baby in pain is distressing and because the symptoms of gas, colic and reflux overlap, it can be hard to figure out what is going on (or how to help).
This post provides you with some concrete ways to help (and some reassurance).
https://unsplash.com/@brytny
Why are babies gassy?
Newborn babies have immature GI systems which are naive when it comes to digestion. As they start to feed, there is an adjustment process, and gas is a normal byproduct of that process. This is totally normal (although also frustrating for parents and babies).
Its all about math:
Gas is a result of an imbalance between:
the air that goes into the system
the air that comes out of the system
If there is too much gas in the system, this is either a result of too much going in, or too little going out. Unfortunately, sometimes the answer is “both”.
The gas cycle in babies
Too much gas going in
If a baby swallows too much air, which can happen for many reasons, they may end up with excess gas in the system. This leads to a vicious cycle: when there is gas and pain, babies cry. When babies cry, they swallow air and increase the amount of gas in the system.
What to try
Minimize crying: Decrease swallowed air by decreasing crying. Check out my free guide AND this post for tips.
Optimize the latch: Babies sometimes swallow too much air during feeds. Poor latch can be due to position, tongue-tie or lip-tie, or simply not yet knowing how to latch well and working with a lactation consultant can be helpful.
Check the flow rate: For bottle-fed babies, air can be swallowed along with milk. This can happen with an overly fast-flowing nipple, which causes baby to gulp (note: rapid let-down in a chest-feeding baby can have the same effect), so switching up nipple types or flow rate can help. It can also happen with a too slow nipple if they get frustrated and fuss.
Change positions (try feeding upright): No matter how you feed, try experimenting with position to see if there is one that works best for your baby. Feeding upright, for example, can allow you and baby to better manage how much air is swallowed.
Too much gas being produced
Some babies produce more gas than others. Factors at play could include:
Maturity: Some gas formation is normal as the gut adjusts to digestion. Unfortunately, the only thing that helps here is time.
Foremilk/hindmilk imbalance: Foremilk is milk produced at the start of a feed, while hindmilk is fattier milk towards the end. The change in milk content is actually quite gradual, but because foremilk typically has comparatively less fat content, it is digested more rapidly. One result of this can be insufficient breakdown of lactose, which is then fermented in the intestine leading to gas. Breastmilk oversupply can also lead to this issue. Work with a lactation consultant if you are concerned about this.
Probiotics: Research into the infant microbiome is suggestive that gut bacteria may play a role in gas formation but we don’t yet have any really helpful information on this. There is data* that supports the use of Lactobacillus Reuteri in infants with colic (it significantly decreases duration of crying), and because the symptoms of gas and colic overlap, some parents find these helpful. Always discuss the use of any medication with your pediatrician before trying it, and keep in mind, that these types of supplements are not regulated by the FDA.
*PMID: 29279326
Not enough gas being released
Gas has two directions it can go to be eliminated: up or down. If this doesn’t happen, it collects in the system.
Burp well: Being flat on your back makes it hard to burp effectively. Not every baby needs to be burped, but for those with gas and reflux, they do seem to clinically feel better. With that said, there have been a few studies* that seem to indicate that burping does not decrease colic/crying. My thoughts on this? Colic/Gas overlap, but they’re not the same, and this is harmless intervention with potential benefit. Keep in mind, though, that if they cry a lot WHILE burping then you’re kind of defeating the purpose.
PMID: 24910161
Tummy time: Being on your back rather than upright or on your front makes releasing gas harder. Obviously your baby still needs to sleep on their back to decrease their risk for SIDS, but when alert and awake, try tummy time to promote gas release.
Bicycle the legs: Bringing the knees to the belly and pedaling the legs is a useful way to help your baby release gas if they have not yet figured out how to coordinate their abdominal muscles. I frequently get questions about the Fridababy Windi, and while it can be helpful, I recommend using only when absolutely needed: part of our goal is to help our babies develop the muscle coordination to release gas on their own, and frequent rectal stimulation to assist can interfere with that learning process.
Massage: Infant massage has been shown in more than one study to decrease duration of colic and crying. Admittedly the studies done on this are not of the highest quality, but this is a harmless intervention with the potential to help. Worth a try! There are specific techniques which are recommended for gastrointestinal issues.
Supplements: The data is weak when it comes to supplements like gripe water and simethicone. Some parents swear they make a difference, but it remains unclear whether that effect is significant or if the babies themselves are simply maturing. Always remember that supplements are not regulated.
Summary
There is nothing like the helpless feeling of seeing your baby cry and not being able to help effectively. I hope these tips help, but more than anything, please remember:
It will get better. The infant gut does mature, usually within the first few months, and there are typically no long-term problems from having had gas as an infant. If you as a parent are beginning to find yourself frustrated by your baby’s crying, it is time to seek help. This is not your baby’s fault. Never shake your baby, and reach out to your support system and physician if you feel overwhelmed.