The Gas Crisis

How cute -- your baby's cooing! Gurgling! Hiccuping! And now he's . . . he's . . . Oh my, that's not very polite!

You probably suspected that you'd encounter lots of less-than-glamorous stuff as a new parent, from messy diapers to puddles of drool. But did you ever imagine how gassy your infant would be? Babies, like the rest of us, get intestinal bubbles. Yet unlike adults and older kids, they have no inhibitions about making it known -- often loudly.

Gassiness isn't pretty, but it is normal. Sometimes, however, it can be a problem, causing discomfort or even pain. Knowing what creates gas -- and how to relieve it -- will help both you and your little one rest easier.

• The Best Remedies for Gas and Reflux
• How to Relieve Your Baby's Reflux
• How to Burp a Baby

A Lot of Hot Air

Even when she's feeling fine, an infant burps and passes gas throughout the day, says Robert Shulman, M.D., a professor of pediatrics at Texas Children's Hospital, in Houston. Some of the gas is air that she's swallowed while eating, crying, and hiccuping, but some is also produced during digestion.

Whenever we eat sugar, including the kind found naturally in many foods, our small intestine processes it only partially, send-ing the rest to our large intestine (aka the colon), Dr. Shulman explains. Millions of bacteria exist down there to help our digestive tract function, and they depend in part on this sugar to stay alive. As the bacteria break down the sugar, some gas is created. This is a normal experience for people of any age; babies may seem more gassy than the rest of us simply because they feel no social pressure to hold it in.

Battling the Bubbles

Still, some babies do occasionally have a painful buildup of gas. You'll see your child's belly become distended, and he may pull up his legs and cry or scream.

Fortunately, there are remedies. For starters, burp your child more often during feedings, and massage his tummy gently from right to left if he becomes bloated. You can also try the "gas hold." Holding your child horizontally so that he faces away from you and slightly downward, place one of your arms between his legs and across his body, your hand resting lightly beneath his chin for support. This puts gentle pressure on his intestines, encouraging pent-up air to get moving. Or lay your baby faceup on a padded surface, then gently hold his ankles and "pedal" his legs as though he were riding a bike.

If these approaches don't work, speak to your doctor. He may recommend giving your baby some commercial gas drops. Their active ingredient, simethicone, makes gas bubbles come together more readily, which allows for the easier passage of gas.

You Air What You Eat

If your baby's gassiness is chronic, you may need to reevaluate how, or even what, you are feeding her (or yourself, as well, if you're breast-feeding). Though you shouldn't do anything without your doctor's blessing, here are some tactics you might discuss and explore.

• Improve the seal that your breast-fed baby makes with your nipple. Ask for pointers from a lactation consultant or an experienced mom. Misha Tyshkov, M.D., director of pediatric gastroenterology, hepatology, and nutrition at Staten Island University Hospital, in Staten Island, New York, sometimes advises putting a very thin ring of petroleum jelly or olive oil around the areola to aid suction.
• If you're nursing, alter your diet. Certain foods, like peas and broccoli, contain difficult-to-digest sugars that are passed on to your baby.
• If you are bottle-feeding, switch to a low-flow nipple so that your child swallows less air while she's drinking.
• Change your child's formula. "Sometimes babies have trouble breaking down a formula's proteins," Dr. Shulman explains. "They become constipated, and gas can't escape." Your doctor may advise switching your child from a milk- to a soy-based formula, or to a milk- based formula in which the proteins have been broken down into easily digestible parts.
• Feed your child yogurt, or another product that contains live cultures, if he's recently had a gastrointestinal infection or taken antibiotics. (Both can temporarily upset the balance of bacteria in the intestines, which in turn may cause more gas to be produced.) Yogurt cultures can help replenish the good bacteria he has lost.When your child starts solid foods, they may make him gassy too -- some fruit purees can be high in sugar. Make his first foods ones that most babies digest well, such as squash, sweet potatoes, and bananas.

Could It Be Colic?

It's easy to blame gas if your child often develops a distended belly and acts distressed. But if his fussy behavior occurs on an almost daily basis, especially at certain hours (say, in the early evening), your child could be suffering from colic.

A colicky baby may develop a puffy belly and pull up his legs, just as if he were gassy. But he'll cry so hard, and for so long, that you may wonder if he'll ever stop. Doctors diagnose a baby as having colic if he cries for three or more hours a day on three or more days in a week, for at least three consecutive weeks.

No one knows for sure what causes colic. The good news is that most children outgrow it by 3 months. In the meantime, talk to your doctor: Many of the soothing tactics used for gas can help.

If your baby wails at feedings, he could also have reflux, in which acidic stomach fluids wash up into the esophagus. Call your doctor if a problem that seems gas-related lasts more than a couple of days or if your baby seems very distressed (i.e., cries inconsolably for hours at a time).

• How to Soothe a Colicky Baby

Originally published in the July 2002 issue of Parents magazine.