Why is my baby gassy?
Gas is a collection of air moving through the gastrointestinal system–it is a normal and healthy finding. With infants, however, a large build up of gas can cause discomfort as it travels through an immature digestive tract. It is common to hear parents describe their baby as “gassy”, primarily in the first 3 months of life. A baby described as “gassy” can appear irritable, may not sleep well, often pulls their legs into their chest, and seems soothed by burping or passing gas. The cause for the irritability that is commonly tagged as “gassiness” can be from many sources, several of which are listed below.
Possible causes of gassiness: Immature digestive tract Swallowing too much air Infrequent pooping
Irritating food in Mother’s diet
What can be done for gassiness?
If the suspected cause of gassiness is an immature digestive tract, then time, movement, and growth will improve the problem. Time will allow gas to naturally pass through the digestive tract. Movement of the baby’s abdomen and lower body can help expedite gas movement. Specific examples of helpful movements are infant belly massage, bicycle stretches with baby’s legs, or allowing baby to lie on their abdomen across a parent’s lap. Lastly, a baby’s intestinal tract will grow as the baby grows, and subsequently, gas pain will often be less noticeable1.
If the suspected cause of gassiness is swallowing too much air, then utilizing interventions to decrease excessive swallowing of air can solve the problem. If the baby is breastfeeding, excessive swallowing of air can be due to a forceful let-down of milk. Positioning the baby in an upright feeding position or expressing the first spray of milk can decrease the baby’s intake of air. With a fast milk flow, babies can often act fussy, mimicking signs of reflux, colic, or allergy. Commonly, reflux will involve pain and vomiting, colic will involve consistent crying, and allergy will have rash or digestive symptoms like nausea or vomiting. If the baby is bottle feeding, then using a slower flow nipple and holding a bottle during feedings at a 45 degree upright angle will help decrease any resulting gas pain. If crying has led to a large intake of air and gas pain, pain can be resolved with common soothing measures.
If the suspected cause of gassiness is due to infrequent stooling, then increasing the baby’s intake of milk may help. Sometimes consulting with the baby’s pediatrician to review next interventions may be necessary if infrequent stooling continues. Depending on the baby’s typical stooling pattern and the age of the baby, stooling one time per day or one time per week could both be considered infrequent stooling patterns.
It is probably least likely that the cause of gassiness is an irritating food in Mother’s diet. According to a study by Kvenshagen, Halvorsen & Jacobsen, only 5% of nursing babies have a reaction to a food in their parent’s diet, and if they do, it is generally cow’s milk 2. Generally, if the cause of gas pain for an infant is a mother’s diet, there would be other associated symptoms of green, frothy stools, congestion, nausea, vomiting, or skin rash1. If it is determined that the baby is having a reaction to a food, this food could be eliminated from the mother’s diet for a 2 week trial to assess if the allergen was the source of pain.
Anecdotally, some babies have shown irritable gastric symptoms of gas and loose stools when they have consumed large quantities of foremilk, containing a higher water and sugar and lower in fat concentration. Foremilk is typically released at the start of a feeding, especially when the breast is full and holding a large capacity of milk. Although breastmilk is never distinctly fore or hindmilk, the recommendation has been to encourage babies to nurse thoroughly from each breast in hopes to consume more hindmilk, containing a higher fat content, and subsequently soothing their digestive symptoms. However, this theory has not been proven.
Thankfully, most gas pain is transient and treatable.
Contributed by Danielle Chu, RN, BSN, IBCLC