Signs that your child may have more than just simple baby gas include frequent fussiness, loose or foul-smelling stools, difficulty feeding and/or sleeping, and crying for long periods of time. These could be symptoms of colic or a food intolerance. On the other hand, for babies who are otherwise happy and feeding well, gas can be normal and not a sign of an underlying medical condition. If periodic gas causes your child discomfort, find out how to avoid common triggers and treat gas pain when it occurs.
What to Consider in Formula-Fed Babies
If your infant seems to experience gas-related discomfort after drinking formula, review the following factors to see if one or more may be causing excessive gas.
Type of Formula
Parents may be tempted to try a new formula at the first sign that their baby is having gas pain. Though there are formulas that are designed and marketed to help with gas, it is not always necessary to make the switch. Willow Jarosh, MS, RDN, a registered dietitian nutritionist based in Manhattan and member of Verywell Family’s Review Board, says, “I’d recommend speaking to your baby’s pediatrician (or a dietitian who specializes in infants and can also communicate with your pediatrician) before changing formulas.” They may want to try other measures first to see if your baby’s symptoms improve. If a formula change is deemed necessary, one of the following sensitive, gentle, or “comfort” baby formulas may help with gas:
Enfamil GentleaseEnfamil ProSobeeEnfamil RegulineGerber Good Start GentleGerber Good Start SootheGerber Good Start SoyParent’s Choice Gentle FormulaParent’s Choice Sensitivity FormulaParent’s Choice Soy FormulaParent’s Choice Tender FormulaSimilac Sensitive (formerly Similac Lactose-Free)Similac Soy IsomilSimilac Total Comfort
The above formulas offer different protein sources than those found in standard infant formula. As the name implies, soy formulas are made with soy protein rather than casein and whey, the proteins found in cow’s milk. Gentle, sensitive, and comfort formulas provide specific protein and/or sugar profiles for infants who may not tolerate standard formula. For example, some products include partially-digested cow’s milk protein that may help ease gas production. Lactose-free formulas offer sugars other than the lactose that is naturally found in cow’s milk. It’s worth noting, however, that lactose is also the type of sugar in breast milk. The vast majority of breastfed infants tolerate lactose without any problem. Because children don’t usually develop symptoms of lactose intolerance until they are between 2 and 5 years old, changing your baby to a lactose-free formula is often unnecessary. However, they might temporarily need a lactose-free formula after a viral infection (such as rotavirus) that caused severe diarrhea. True cow’s milk allergy (CMA) is relatively rare, occurring in less than 5% of children. Infants and children with an allergic reaction to the protein in cow’s milk usually display non-digestive physical symptoms in addition to digestive ones. Symptoms can take up to 48 hours to begin after eating, and may include:
DiarrheaHivesRespiratory symptoms (e.g., coughing, difficulty breathing, wheezing)SwellingVomiting
While changing from a standard formula to a soy-based or gentle product is sometimes recommended, the switch does not always improve symptoms, and up to 60% of infants with CMA also react to soy protein. In these cases, a hypoallergenic formula such as Nutramigen or Alimentum is required. It’s important to remember that the protein and sugar in milk-based formulas are two separate things. Most infants who have a milk protein allergy can still tolerate lactose without a problem. A pediatrician or pediatric dietitian can provide guidance on which formula is the best for your child, especially in cases of allergy or intolerance.
Feeding Technique
Jarosh notes that in addition to the type of formula your baby drinks, the way in which you feed them can affect their digestion. This applies to both babies drinking formula or expressed breast milk from a bottle. Both the speed of milk flow and the quality of their latch are important. In addition to making sure your baby is drinking at a moderate pace, notice how they are latching onto the bottle. As Jarosh points out, “no matter the flow, if baby’s latch is not correct on the bottle then they may be swallowing too much air while eating.”
What to Consider in Breastfed Babies
Similar to parents who feed their babies formula, breastfeeding parents should only consider gas a problem if it is excessive or accompanied by other symptoms. The following are possible issues that may cause gas in your breastfed baby.
Parent’s Diet
In the past, breastfeeding parents were sometimes told that avoiding certain foods in their own diet could improve their babies’ digestive symptoms. However, newer research has shown that the foods in a breastfeeding parent’s diet don’t always affect infants’ physical symptoms. The caveat to this is babies who have CMA or other immune-mediated food allergies. Parents with a breastfed infant who has painful gas may want to try eliminating milk and milk products from their diet for a week or two. If your baby’s symptoms improve, they could have allergic colitis (a sensitivity to cow’s milk protein). While allergic colitis is not a true food allergy, the milk proteins from your diet that pass into your breast milk may still be causing a problem. Infants with this condition also typically have bloody stools. Experts caution that breastfeeding parents should not restrict their diet unnecessarily. Food avoidance can be a barrier to breastfeeding, causing some parents to discontinue breastfeeding early or not start at all from the (often unfounded) belief that they will have to cut out certain foods. The best advice is to eat a varied, nutritious diet while breastfeeding. If your breastfed infant is having painful gas, talk to a pediatrician, dietitian, or lactation consultant before removing foods from your diet.
Lactose Overload
Also known as foremilk-hindmilk imbalance, lactose overload can cause gas and other physical symptoms such as green, foamy, or watery stools in babies. Parents with an overabundant milk supply may produce too much foremilk. If you are timing your feedings rather than letting your baby nurse until they are finished on the first side before switching to the other, they may have gas and other symptoms because they are getting too much foremilk, which is higher in sugar than hindmilk. In this case, allow your baby to breastfeed until they drain the breast completely before switching sides. This practice will allow them to receive more hindmilk, which has more fat and less sugar. If you have so much milk that your baby is not able to drain one or both breasts before getting full, you may consider hand-expressing or pumping some milk before breastfeeding to remove some of the excess foremilk.
Overactive Letdown
Another issue that commonly occurs as a result of an overabundant supply is an overactive letdown reflex. This causes milk to flow faster than the baby can take it in. As a result, they may gulp and swallow air as they try to drink quickly. Once the air is in their GI tract, it can cause gas (unless it’s released when you burp after feeding). This problem is not unlike when babies drink from a bottle with a flow that’s too fast. Often, the solution is to express some breast milk before you put your baby to the breast, which should make the flow slower so they can drink without taking in so much air. You can either discard the milk or freeze it for later use. You may also find luck with a different breastfeeding position such as a laid-back position where you are reclined, your baby is lying on you upright and tummy-to-tummy, and gravity won’t exacerbate the fast letdown.
Latch and Position
If your breastfed baby is experiencing painful gas, check their latch and the position you are holding them in while breastfeeding. If your baby is not getting a good latch, they could be taking in air along with breast milk. Certain positions can make it trickier for infants (especially newborns and premature babies) to latch on well. One breastfeeding position that makes it easy for your little one to get a good latch and allows you to easily see their mouth is the cross-cradle hold.
Babies who do not make sucking sounds as they nurse Breastfeeding for more than 30 minutes with no signs of fullness Bruised, cracked, and/or sore nipples Poor weight gain Pulling off the breast repeatedly
If you suspect your infant may not be latching on well, contact a lactation consultant or pediatrician for an evaluation. In this position, you lay your baby on a pillow across your body and support them with your arm. Their head is turned toward you, even with the breast they are nursing from. A lactation consultant will also be able to recommend other positions after they evaluate you and your baby during a breastfeeding session.
What to Consider in Toddlers and Older Children
While gas can also be normal in toddlers and older children, a chronic problem with gas pain could point to an underlying medical condition. Lactose intolerance, irritable bowel syndrome (IBS), malabsorption, and celiac disease can all cause gas in addition to other digestive symptoms. Fortunately, older kids are often better at describing associated symptoms, such as bloating, diarrhea, and abdominal pain. They may also be able to recognize the association between their physical signs and specific foods, including milk, fruits, or vegetables.
Dietary Modifications
Although foods often get the blame for causing gas, you shouldn’t restrict your child’s diet unless you have talked with a pediatrician or dietitian first. If you and your healthcare team do decide to try eliminating certain foods to see if their symptoms improve, here are some common culprits to take a close look at. Although not common among kids, high-fiber diets can also lead to excessive gas. Since a high fiber diet is considered healthy, it is not recommended to restrict the fiber in your child’s diet until you talk to a pediatrician, even if you think it is causing some gas.
Artificial sweeteners (often found in sugar-free drinks, candy, and gum) Carbonated drinks Cow’s milk (in cases of lactose intolerance) Eating too fast, so they don’t swallow excess air while eating Fruit juices with a high sorbitol content (such as apple, pear, grape, and prune juices)
How to Treat Gas in Babies and Toddlers
There are a variety of treatment options for gas-related pain and discomfort, though what is safe and appropriate will be dependent on your child’s age. While determining the underlying cause and preventing gas is the best bet, there are things you can do to help your child when they experience gas pain. Home remedies and over-the-counter medications are often very effective at improving gas-related symptoms.
Babies
When your infant is fussy and displaying signs of abdominal discomfort, gently massaging their tummy can help. Lay your baby on their back and rub in a clockwise motion to help move the gas out. Another way to get things moving is to gently grasp your baby’s ankles and rotate their legs in a bicycling motion. Tummy time is a natural way to put pressure on the abdominal area, which can encourage the movement of gas. In addition to these at-home methods, simethicone is a popular over-the-counter medicine for gas. It is available for babies as Infants’ Mylicon oral drops and generic gas relief drops.
Toddlers and Older Children
Avoiding gassy foods is usually the best treatment for children with excessive gas. If gas does bother them, however, simethicone is available for kids in several forms, including Gas-X and Mylanta Gas Relief. Beano, available as drops or a chewable tablet, is a digestive enzyme that helps make many high-fiber foods, including beans, broccoli, and whole-grain bread, easier to digest. And if your child is lactose intolerant, instead of avoiding cow’s milk and other dairy products, it may help if they take a lactase enzyme tablet to help them digest the lactase in milk.
