Gassy Baby

Dear Lisa,

Whenever I feed my 3 week old son the bottle he becomes fussy and he has a lot of gas. He cries a lot and eventually settles down after I burp him a few times, which seems like forever. I wish there was something I could do to help him because he is so uncomfortable. Is there anything I can give him for the gas that is safe for babies?

“Gassy baby in N.J.”

Dear “Gassy baby”,

An infant with "flatus" or gas usually cries and pulls his knees to his chest during and after feeding. The symptoms usually subside once the baby belches. Gas symptoms cause an infant to have much discomfort and crying which ultimately affects the lifestyle and sleep pattern of the whole family. All babies entrap air during sucking which results in gas bubbles in the baby’s stomach. A build up of these gas bubbles causes the infant to have abdominal discomfort until the gas dissipates. You can help a baby expel the gas by burping him after every one to two ounces of formula ingested. Effective burping includes patting the bottom of the infant's back or his diapered behind while maintaining the infant in an upright position. The idea is to pat under the level of the baby’s stomach so that the air bubbles will rise and escape out of the mouth.

Babies tend to entrap air while sucking on the bottle, especially those babies with a vigorous suck. In order to prevent the baby from sucking in too much air it is important to make sure the nipple is totally covered with formula during the entire feeding. To do this, the bottle needs to be tilted close to a 90 degree angle or positioned straight up. If the bottle is held at a 45 degree angle for example, only half of the nipple will be covered with formula and the other half of the nipple will be filled with air. If this angle is too hard to maintain, or if your baby still entraps a lot of air, you can purchase a Dr. Brown’s bottle which limits the amount of air that a baby takes in.

Parents who use dry powdered infant formula should mix the water and powder by gently rolling the bottle back and forth as opposed to vigorously shaking it. If you shake the bottle too much a layer of foam will appear on top of the formula, which essentially is a layer of air similar to the head on a beer. If the baby drinks this bubbly layer, he will suck in too much air which will very likely lead to problems with gas. Some parents switch to ready to feed preparations so as to prevent this from happening. Another option is to add an extra ounce of formula to the bottle so that the baby never drinks the foamy layer.

Most Doctors and Nurse Practitioners recommend Infants' Mylicon Drops for babies who suffer from gas symptoms. Infants' Mylicon Drops can be found over the counter at your local pharmacy. The recommended dosage is 0.3 ml given four times daily after meals and at bedtime. The dropper provided clearly marks the 0.3 ml dosage to be less than a full dropperful. You should not exceed 12 doses in a 24 hour period. The purpose of the Mylicon Drops is not to keep the baby from burping. Instead the medication works by changing the surface tension of the gas bubbles enabling them to stick together and escape more readily through belching.

If your baby has continued symptoms that seem to cause him pain, back arching, excessive hiccoughing, coughing or choking with feeding, blood in the stool or fever, it would be important to bring him to your health care provider for an evaluation. These symptoms may be a sign of a different problem, other than gas.

Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Pediatric Advice for Healthy Babies