A build-up of gas in the intestine can lead to pain in babies and children, causing concern for parents. However, gas is often normal—especially in Newborns. Thankfully, it can be treated at home in most cases.
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.
If a formula change is deemed necessary, one of the following sensitive, gentle, or “comfort” baby formulas may help with gas:
- Enfamil Gentlease
- Enfamil ProSobee
- Enfamil Reguline
- Gerber Good Start Gentle
- Gerber Good Start Soothe
- Gerber Good Start Soy
- Parent’s Choice Gentle Formula
- Parent’s Choice Sensitivity Formula
- Parent’s Choice Soy Formula
- Parent’s Choice Tender Formula
- Similac Sensitive (formerly Similac Lactose-Free)
- Similac Soy Isomil
- Similac 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:
- Diarrhea
- Hives
- Respiratory symptoms (e.g., coughing, difficulty breathing, wheezing)
- Swelling
- Vomiting
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 Nitramine 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 paediatricians or paediatric dietitian can provide guidance on which formula is the best for your child, especially in cases of allergy or intolerance.
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.
If your breastfed infant has been diagnosed with a food allergy, it's important to work with a paediatricians, dietitian, or allergist to determine whether you need to eliminate certain foods from your diet. Some babies can tolerate breast milk even if their parent eats the foods, they are allergic to, whereas others cannot.
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.
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 fatter 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 Let-down
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.
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.
The following signs may indicate a poor latch: 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.
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.15 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.16 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.