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YOU with a range of different baby care problems.
Symptoms
often linked with infant gas include…
• Burping/belching
• Flatulence (passing gas)
• Abdominal bloating or distension
• Abdominal pain or cramps
• Vomiting or spitting up (posseting)
• Diarrhea
• Constipation
• Crying
• Sleep disturbances
1. Burping/belching
A burp or belch comes from expelled air that has been swallowed (rarely
from gas produced in the stomach). It’s normal for babies to burp
because swallowing some air while drinking or eating is unavoidable.
Excessive burping and belching is due to swallowing excessive amounts
of air.
2. Flatulence (passing gas)
Passing gas can be the result of swallowed air and/or gas produced
in your baby’s intestines (bowel) from:
• Normal digestion
• An incomplete break-down of food or milk
• A gastrointestinal infection
• A side effect of some medications (prescribed or over-the-counter)
or herbal therapies.
In the vast majority of babies, where parents complain of excessive
flatus, there are NO recognizable disorders of the intestinal tract.
Often what may seem like large amounts of gas is in reality very normal.
Most parents don’t realize that a baby can pass gas up to 20 times
a day. Without other symptoms, this is considered normal.
3. Abdominal bloating or distension
Excessive gas can cause distension of the abdomen or a bloated feeling.
But more commonly, abdominal distention in a baby occurs as a result
of a full stomach from normal feeding or possibly overfeeding*
Overfeeding can occur when a baby feeds from the breast or bottle too
quickly. Another reason for overfeeding relates to the fact that babies
are in an oral stage of development. Because of this they often want
to suck or feed for reasons other than hunger. (See our article on hungry
baby for more about this).
* A baby who is overfeeding gains very large amounts of weight and
is more likely to spit up soon after feeding.
4. Abdominal pain or cramps
Abdominal pain can range from mild to severe and can last anywhere
from a few minutes to days, depending upon the cause. Pain can be continuous
or it can present in waves or spasms.
It’s not easy to tell whether a baby has pain. Parents often
become concerned that their baby may have pain when they observe normal
infant behavior. For example, young babies regularly fuss, grunt, groan,
pull faces and strain as they pass gas or a bowel movement. This is
normal infant behavior and not a sign the baby has pain.
It is common belief that when a baby draws up his legs while crying
that this is a sign of abdominal pain, but this is not always the case.
Young babies naturally pull up their legs whenever they become upset
and cry - for any reason.
What may appear like pain may in reality be a sign a baby is stressed.
Babies often become extremely distressed and can scream inconsolably
for long periods of time, for reasons other than pain. (See our articles
on crying baby and infant colic for examples).
5. Vomiting, spitting up (posseting)
There is a subtle difference between vomiting and spitting up. Spitting
up occurs spontaneously and unlike vomiting is effortless.
Spitting up is associated with reflux (gastro-esophageal reflux). Gas
can also be connected with reflux in the following ways…
1) Milk comes up with a burp. (Officially this is not reflux).
2) Heartburn, sometimes associated with reflux, may cause the child
to salivate and/or cry. As the child swallows the saliva, or cries,
air is also swallowed.
3) Feeding too quickly and/or overfeeding can lead to an increase in
the amount of air swallowed and also an increase in the amount and frequency
of spitting up.
When a baby vomits, this is more commonly due to a gastrointestinal
infection; a food or milk allergy; or intolerance or a side effect from
medications. Diarrhea is also frequently linked to these conditions.
However, diarrhea is not a symptom of reflux.
6. Diarrhea
Disorders such as food or milk allergies or intolerances can cause
symptoms which may include wheezing, rash, chronic runny nose, eczema,
vomiting, excessive gas, diarrhea, bloody stools and failure to grow.
Excessive gas and diarrhea can also be present when a child has a gastro-intestinal
infection or as a side effect of some medications and herbal treatments.
7. Constipation
Infant gas can be a symptom of constipation.
8. Crying
Infant gas is often thought of as being the same as infant colic. However,
they are NOT the same. Although a baby experiencing episodes of colic
may also have gas (possibly due to swallowing air while crying) a baby
with gas does not necessarily have colic. Studies have shown that gas
alone does not cause the level of distress and/or discomfort experienced
by a colicky baby.
9. Sleep disturbances
Understandably, a baby with a stomach ache will have problems sleeping,
either falling asleep or staying asleep. However, there are many more
common reasons for a baby to have disturbed sleep other than discomfort.
What
causes gas in infants?
1. Swallowed air
Swallowed air is the most common cause of gas in the stomach and is
the major reason for burping or belching. Swallowing some air is unavoidable.
Big and small alike, we all swallow air. Infants swallow air…
• During breast or bottle feeding - Eating or drinking quickly
greatly increases the amount of air swallowed.
• While eating solid foods.
• During episodes of intense crying.
• When swallowing saliva.
• While vigorously sucking on a pacifier.
In a breast feed infant, swallowing large amounts of air may be linked
to a poor latch-on and/or a fast and plentiful supply of breast milk.
In a bottle fed infant, swallowing large amounts of air may be due to
an unsuitable feeding nipple which is too small, too short or too fast
for the baby.
Myth: A common belief is that babies will swallow air if they
are taken outside on windy days or travel in the car with the window
down. Both of these are untrue.
2. Normal digestion
Acid produced in the stomach is neutralized by pancreatic secretions
as it passes into the intestines (bowel) and the resulting interaction
creates gas as a by-product. Some of this gas is absorbed into the blood
stream and exhaled out of the lungs. The rest of the gas will continue
though the bowel and is passed as flatus.
3. Incomplete breakdown of milk or food
A small number of babies may experience excessive gas (along with many
of the other symptoms associated with gas) due to an inability to adequately
digest one or more of the proteins and/or carbohydrates (sugar and starches)
found in milk (including infant formula), juices and/or some foods.
This is due to insufficient production of particular digestive enzymes,
believed to be related to an immaturity of an infant’s digestive
tract.
Both breast and formula fed babies may continue to display gastric
symptoms, such as loose bowel movements and excessive gas, following
a gastro-intestinal infection, due to secondary lactose intolerance.
Often mistaken for lactose intolerance is lactose overload. Lactose
overload commonly occurs in healthy, thriving breast fed babies under
the age of 3 months. Although the symptoms are identical to lactose
intolerance, the management for these two conditions is quite different.
A small number of formula fed babies may experience gastric symptoms
due to milk protein allergy or intolerance. Although rare, similar symptoms
can also develop in a tiny number of breast fed babies, as a result
of an allergy or intolerance to proteins, from cow’s milk or other
foods, which are transferred though breast milk from the mother’s
diet.
Gastric symptoms may also occur when a child starts on solid foods or
juices. Symptoms may develop due to carbohydrate malabsorption, where
some foods are malabsorbed due to incomplete digestion. These foods
include sugars such as raffinose in beans; lactose in milk and dairy
products (mentioned separately above); fructose in onions, artichokes,
pears and wheat; sorbitol in fruits such as apples, pears, peaches,
and prunes; and starches found in potatoes, corn, noodles, oats and
wheat.
The amount and type of fiber contained in a food can impact on the
amount of gas produced. Not all fiber causes gas. Some fiber is soluble
and others insoluble, describing whether is can be absorbed or not.
Fibers found in oat bran, beans, peas and fruits may cause gas, whereas
fiber found in many other foods may not. It can depend on what is eaten
and how much is eaten. A high fiber diet will generally produce more
gas than a diet containing less fiber.
Vegetables - carrot, eggplant, broccoli, cabbage, brussels sprouts,
onions, artichokes, and asparagus; and legumes - beans, peas, chickpeas,
soybeans and nuts, can increase the amount of gas produced.
IMPORTANT:
• It is known that babies lack sufficient digestive enzymes
to adequately digest solid foods before the age of 4 months. Recent
recommendations for starting solids, for both breast and bottle fed
babies, is now 6 months.
• Many of these foods provide an excellent source of vitamins
and essential nutrients and it is not recommended to exclude them from
a child’s diet - simply to find a balance.
3. Gastro-intestinal infections
Gastric symptoms can be due to a gastro-intestinal infection (also
known as gastroenteritis, a tummy upset, bowel infection, stomach flu
or infectious diarrhea) are common in infancy. A gastro-intestinal infection
can be caused by a virus, bacteria, yeast/fungus or parasites (protozoa,
roundworms, tapeworms or flukes).
IMPORTANT:
See a doctor if you suspect your baby has a gastro-intestinal infection.
DO NOT give any medications, including intestinal worm medications (anthelmintics)
to infants or children unless specifically advised to do so by your
child’s doctor.
4. Medications and over-the-counter drugs
Many medications given to children to treat…
• colic
• reflux
• constipation
• pain
• fever
• infections
…have side effects which can include gastro-intestinal upsets,
abdominal cramping, diarrhea or constipation. If your child is currently
on medications or an over-the counter drugs, discuss the possibility
of these side effects with your doctor.
Herbal therapies are also not without similar side effects - talk to
a herbalists personally before using any herbal remedies with infants
or children.
Reducing
the amount of air your baby swallows
1. While breast feeding
• Make sure your baby latches-on correctly. If you are unsure
or are experiencing difficulties with latching your baby to the breast,
seek the hands-on support of a qualified lactation consultant.
• If your baby gulps due to a fast supply (which often occurs
during the early weeks of breast feeding) slow down feeding by nursing
lying down.
• Where supply is plentiful and your baby is gaining large amounts
of weight, offer only one breast at each feeding (alternating breasts
at each feed).
• If your milk supply is plentiful and let-down is strong and
provides a rush of breast milk, which your baby experiences difficulty
in coping with, pump off approx an ounce of milk BEFORE latching your
baby to the breast. (Freeze pumped breast milk for future use).
2. While bottle feeding
• Check how long bottle feeding should take for different age
groups and slow feeding down to the recommended time, by using a slower
nipple and/or tightening the nipple ring.
• If feeding continues to be too fast, encourage your baby to
take a couple of brief breaks during feeding.
• Experiment with different shaped feeding nipples. See feeding
equipment for more information on choosing a nipple.
• See - How to bottle feed your baby for additional bottle feeding
tips.
3. When your baby is eating solid food
• For babies younger than 9 months of age, offer milk (breast
or formula) 15 – 20 minutes before offering solids.
• For babies older than 9 months. If your baby appears ravenous
at meal times, make sure he still drinks enough milk (breast or formula)
for his age. Also offer a small healthy snacks approximately mid way
between main meals.
4. While using a pacifier
Unfortunately, both vigorous sucking on a pacifier and crying can result
in swallowed air. To remove your baby’s pacifier may result in
further crying, so you will need to weight up the benefits.
5. While crying
Babies cry! Crying is essential for a baby’s survival. Crying
doesn’t necessarily mean your baby has pain. Babies cry to communicate
their needs. (Unfortunately sometimes they don’t know exactly
what it is they need). It’s not possible to avoid all crying.
• Try to establish a flexible feeding and sleeping routine for
your baby, where both you and he can learn to predict what the next
step will be.
Before
making changes to your baby’s diet
1. Breast fed infants
You may have already received advice to eliminate certain foods from
your diet. This rarely makes a difference – because, contrary
to popular belief, what a mother eats is rarely the cause of her baby’s
distress or discomfort.
RECOMMENDATIONS:
• See our article on lactose overload for tips to reduce gastric
symptoms related to feeding patterns.
• Exclude the many other more common reasons for both gastric
discomfort as well as irritable and wakeful behavior (they are often
NOT due to the same cause) BEFORE going down the path of dietary restrictions.
• If you suspect a food or milk allergy or intolerance seek professional
advice from a doctor or dietician who specializes in this field.
2. Formula fed infants
Changing formula rarely helps, particularly when there are no significant
gastric symptoms other than gas. Prolonged use of an inappropriate infant
formula can negatively affect your baby’s growth and/or development.
RECOMMENDATION:
• If you suspect a food or milk protein allergy or intolerance
see your doctor for advice on the most suitable formula.
3. When your baby is on solids
• If your baby is less than 6 months old, stop solids completely
or restrict solids to low risk foods.
• If you are offering fruit juice to your baby on a regular basis,
try ceasing this for a period of time. Offer water at these times instead.
• Offer only cereal specifically designed for babies. Some cereals
are too high in fiber (and low in iron) for a young baby’s digestive
system to cope with.
• High fiber foods should be introduced slowly to allow your baby’s
bowel sufficient time to adjust.
Why
medications don’t work!
There is a huge array of medications (prescribed, over-the-counter
and herbal remedies) on the market which are used to treat infant gas
and/or colic. The majority these products aim to reduce the amount of
gas in the baby’s stomach by helping to facilitating a big burp.
Of more concern is that some of these medications contain alcohol or
drugs that provide a sedative effect. In theory, these medications claim
to relax the bowel to allow gas to pass, but in practice their effectiveness
in the treatment of gas in infants remains unproven. What is often perceived
as an improvement from their use is due to the fact that they make the
child sleepy.
Whatever these products aim to achieve, they are limited by the simple
fact, that they do nothing to correct the cause of excess gas and/or
a baby’s distress (which as mentioned previously, is not always
due to the same cause). Medications do little to resolve the problem
of a distressed, crying baby other than to provide exhausted parents
with some relief by sedating the child.
Almost all medications (prescribed, over-the-counter and herbal remedies)
have side effects. The side effects often outweigh any benefits of using
medications to treat infant gas or infant colic.
Relieving
gas symptoms naturally
The following methods aim to provide temporary relief from tummy troubles
related to gas. However, unless the underlying cause of excessive gas
is discovered and corrected, it’s likely you will be faced with
the same problem again and again. If in fact, gas is not the real reason
for your baby’s distress, these methods may not provide much help
at all.
1. Burping your baby
• Burp your baby, both during and following breast or bottle
feeding. But don’t spend too long tying to burp him. If he becomes
upset return to feeding (some babies want to finish to whole feed without
interruption).
• 2-3 minutes burping time is all that’s necessary. If he
hasn’t burped by then, either return to feeding or if feeding
is already completed and he continues to cry, try other soothing methods.
(Also consider tiredness as a likely reason for his unsettledness).
2. Water
Studies have suggested that a small about of sugar water (1 oz) is
just as effective as many of the colic medications currently on the
market. Offering small amount of water can often help to calm your baby’s
unsettled tummy, when he’s not really hungry.
3. A Warm bath
This may help your baby to relax. Also the warmth (body temperature
only) may help the gases in his bowel to expand and be expelled.
4. A warm compress on baby’s tummy
Warm a cloth diaper or a towel in the microwave, place it over your
knees and lie your baby face down across the towel. (Make sure it is
not too hot!)
5. Tummy massage
A tummy massage may help to relieve abdominal gas. Put some oil on
your hands and gently massage your baby’s abdomen in a clockwise
direction using long stroking actions. Alternate this with lifting his
knees and the ‘bicycle’ motion.
RECOMMENDATIONS:
• Choose either a bath OR a massage, not both as this can be
over-stimulating. For babies younger than 5 months of age, massage and
bath time need to be separated by a nap or night time sleep.
• Do not massage your baby’s abdomen if he has hiccups or
has just been fed.
6. Soothing methods
You will find some additional tips on soothing methods helpful.
When
to see a doctor
• Any sudden change in your baby’s behavior.
• If your baby experiences prolonged periods of distress.
• If your baby passes frequent, watery bowel motions*.
• Before starting on medications or over-the-counter drugs –
ask him/her to explain about potential side effects.
• Before changing infant formula.
• If your baby develops any other unusual symptoms.
* It can be very normal for a breast fed baby to pass frequent watery
bowel motions.
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CLICK HERE FOR HOW WE CAN HELP YOU with a range of different
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See also:
Infant colic
Crying baby
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