“Dr. Linda, my baby burps really well but she still passes a lot of gas. Is there anything I can do for her?”
The baby in this question is probably making excessive amounts of gas either as a result of her diet or as a byproduct of her intestinal flora.
Gas in your baby’s intestinal tract comes from:
- Swallowed air.
- Digestion of food in the diet.
- Metabolism of the bacteria colonizing your baby’s intestinal tract aka the ‘normal flora’.
Diet and your baby’s gas production:
- What you eat gets into your breastmilk within 12-18 hours. Certain foods in your diet may cause increased gas production in your baby’s intestinal tract:
- Cabbage, cauliflower, Brussels sprouts, red and green peppers, cucumbers, and beans.
- Dairy products.
- Whole grains.
- Citrus fruits.
As you can see, almost anything you eat can cause gassiness!
If you think your diet may be causing your baby’s excess gas production don’t despair, you should be able to track down the culprit by doing an elimination diet.
The Elimination diet:
- Keep a written diary of everything you eat and when you eat it for the next 3-5 days.
- Keep a diary of your baby’s symptoms ( gassiness, fussiness, crying, loose stools) and what time they happen or get worse.
- After 3-5 days compare the 2 diaries. Since what you eat gets into your milk 12-18 hours after you eat it: If your baby is fussy in the late evening you need to look at what you are eating in the morning (12-18 hours earlier)
For example, you have an egg with whole wheat toast for breakfast every day at around 9 am. Your baby consistently gets really gassy between 9 pm- 1 am. Most probably your baby is reacting to eggs or the whole wheat toast.
- Your next step(after consulting with your doctor) could be to stop eating either eggs or whole wheat toast or both of them for the next 5 days (It takes 3-5 days for a food to clear from your milk and your baby’s body).
- While you are off the food continue keeping a diary of your baby’s symptoms. The gassiness (and any other symptoms) should start to get a little better within 2-3 days after stopping the offending food and will continue to get better over the next few days
- If the symptoms do not change, then go back to your diary and look for patterns. Are you eating a lot of a specific type of food? Over the years many of the babies I took care of had problems with the dairy, chocolate, pizza, tacos, and caffeine their moms were eating.
- If you don’t see a pattern consult your doctor,( and make sure to take your diary to the visit!) he/she may see something you missed
- Once you’ve figured out what the offending food is you can stay off of it for a few months, eat just a little of it occasionally, or continue to eat it. Consult your healthcare provider while you’re making this decision. He/she they should be able to guide you to healthy alternatives to replace the foods you want to avoid because it is very important for you to stay healthy while you’re breastfeeding.
Bottle fed babies:
If you think your baby’s formula is causing the gassiness, here are a few facts you should know
- True Lactose intolerance which causes diarrhea and gassiness with milk products is very rare in young babies unless they were born before 34 weeks.
- An intolerance to cow’s milk protein in your baby’s formula is much more common than lactose intolerance in the newborn period. This may cause fussiness, gassiness, loose mucusy or bloody stools as well as skin rashes.
- If you suspect your baby has a cow’s milk intolerance consult your doctor before you change formulas. It can get very confusing for you to do this on your own because there are so many options: there are partially hydrolyzed cow’s milk formulas, whey/casein based formulas and extensively hydrolyzed cow’s milk formulas and Soy formulas, each has its advantages and disadvantages. Your healthcare provider will give you recommendations based on your baby’s history, your family history and on their experience with the different formulas.
- If you do decide to change your baby’s formula on your own (which I don’t recommend based on lots of experience with frustrated moms), remember, it can take 5-6days for the old formula to clear from your baby’s system. Keep your baby on the new formula for 5-6 days before you decide if it’s working or not and if you need to switch again.
Types of bacteria colonizing your baby’s intestinal tract and gas production:
During delivery, your baby’s intestinal tract is seeded with bacteria from your vaginal and rectal area. These bacteria grow and form ‘the normal flora’ ( or the microbiome)of your baby’s intestinal tract.
Babies born by Cesarean section(C/S), babies whose moms have been on antibiotics or babies who have received antibiotics themselves will have different bacteria in their intestinal tract than those who are born vaginally with no antibiotic exposure. Your baby’s healthy normal flora is made up of Lactobacillus, Bifidobacteria, and Streptococcus species all of which have been shown regulate and smooth out the digestive process, strengthen the immune system and contribute to good health as a whole.
How to encourage colonization with ‘helpful bacteria’:
- Breastfeed your baby, breastmilk naturally contains good amounts of Prebiotics which are nondigestible starches that feed the normal flora and help them grow and flourish.Having healthy normal flora leads to less gas production.
- If you delivered your baby by C/S, or have been on antibiotics you can either take a supplement containing Lactobacillus, Bifidobacteria and Streptococcus species or better yet eat foods which are rich in healthy Probiotics such as:
- Fermented dairy products especially yogurt with active cultures. Buttermilk and kefir are other options.
- Fermented vegetables especially cabbage as in Sauerkraut. Homemade pickles (pickled without vinegar) and Kimchi ( Korean pickles) are also good sources of probiotics.
- If you are bottle feeding your baby there are formulas containing Prebiotics as well as formulas with Bifidobacteria. Studies on these show them to be safe and to have some benefits but the science on just how effective they are is not as solid as with breastfeeding.
Sometimes babies are just gassy and you can’t find a reason.
Treatments for gassiness:
- Simethicone drops after meals can be used under the supervision of your doctor.
- Tummy massage.
- Herbs for gassiness:
- Tea forms of herbs are usually safe for babies. Find a reputable source for the dry herbs and put 1/2 tsp of Chamomile and 1/2 tsp of Fennel in 8 ounces of boiling water. Steep it covered for 10 minutes. let it cool and then give baby 1/2 tsp of cool tea after each feed.
As always, I hope you find this blog helpful and would love to hear from you and if you know any moms who would benefit from this blog please share it.
To your holistic health,