Most of us mothers have a bit of an obsession with our baby’s “gassiness”. We analyze every little fart and burp. We inspect their poop and how many times they squirmed around and seemed unsettled. We basically blame every little unsettled, “colicky” episode on gas or reflux. We then head out to buy some sort of concoction to help remedy our little fart machine babies.
We need to understand the causes of gas, what is normal, what is abnormal and when we need to worry. I have a few simple things to help you and your gassy, unsettled baby. Almost every new mother I see for a breastfeeding consultation comments on her gassy baby. We just can’t seem to stop worrying about this!
So what is normal?
Your baby is going to fart. Your baby is going to spit up and sometimes projectile vomit. Your baby is going to have periods of time where they are unsettled. Your baby will most likely have this unsettled time in the later afternoon/evening hours. This is what my mother calls the “witching” hour. If your baby does not do this then count your lucky stars and do a happy dance. You are in the minority! Most babies have a few weeks or months where they will spit up or vomit quite a bit. Sometimes you will look at that pile of vomit and wonder if they actually digested anything when they breastfed. In conclusion: Your baby is going to fart. Your baby is going to burp. Your baby is going to cry and sometimes they will cry for a few hours for no apparent reason.
What is NOT normal?
*A baby who cries or is unsettled ALOT, or very frequently-24/7.
*A baby who has reflux symptoms which include1:Your baby is bringing up a large amount of milk after most feeds.She seems to be in pain after breastfeeds. She is fussy and unhappy between feeds. She arches her back after most feeds. She has problems gaining weight. Ongoing breathing (respiratory) problems. Important to note that sometimes a baby will have “silent reflux” where the symptoms are not as obvious. Please seek help from an IBCLC if you suspect this is happening with your baby.
* A baby who is unsettled at every breastfeed and GULPING the milk down like they are drinking out of a fire hose. These babies usually have a “love/hate” relationship with the boob.
What is causing these abnormal symptoms and what can I do?
1. Intolerance to something you are eating that is going through your milk.
THIS IS NOT A LACTOSE INTOLERANCE. It is a cow’s milk protein allergy (CPMA). There can be many different symptoms if your baby is experiencing this issues. Cow’s milk protein allergy can cause colic-like symptoms, eczema, wheezing, vomiting, diarrhea (including bloody diarrhea), constipation, hives, and/or a stuffy, itchy nose.2 While it is estimated that 2-5% of babies have an allergic response to the milk protein, I would argue that this is a commonly under and mis-diagnosed problem with many parent’s walking out of their doctor’s offices with a colic diagnosis and medication for reflux without any discussion on the breastfeeding mother’s diet and how this could be the cause of the issues. Thankfully most babies will outgrow this by the time they are twelve months old.3
Three important aspects of figuring out if this is the cause:
-You must cut it out for at least 4 weeks to see if this is it. It takes that long to get out of your system and your baby’s system. However if your child has been diagnosed with gastroenteritis, it can take a much longer time for your baby’s gut to heal. This means that after you cut out the dairy it could take months for your baby’s digestive system to heal.4
-It must be 100% NO DAIRY. Not even in a cracker! No lactose-free milk. It’s not the lactose, for many people it’s the protein in the milk.
-Work on your gut health at the same time; take probiotics, eat foods that are fermented and cultured on a daily basis and make homemade bone broths which are good for your digestive system. All of these will go through your milk to your baby and will help both of you!
If after 3 weeks you have not noticed a changed, cut out gluten and soy. These are other foods that commonly cause issues with babies (and adults).
2. Over-supply/over-active let-down/lactose overload
Do you have fire-hose boobs like I did with all 3 of my babies?! Does your baby gulp and sputter at the breast or seem to get in lots of milk all at once? Does your baby have a “love/hate” relationship with the breast? You do not have to decrease the amount of time or how frequently you are feeding (you cannot over-feed a breastfed baby) but you can change HOW you are feeding to help with this. Click here to read my article on “pukey” babies and over-supply.
3. Tongue/lip tie.
A baby with a tongue or lip tie that is affecting breastfeeding (not every baby with a tie will have a problem latching properly) can often exhibit reflux or colic symptoms. Why is this? Babies with ties can have difficulty latching on to the breast properly. When a baby is unable to latch well, it can cause an increase in air that they are ingesting while breastfeeding which can then lead to more gas and reflux symptoms. If you have any inkling that your child may have a tie (and especially if you also have painful breastfeeding or your baby has weight gain issues) I highly suggest seeking help from an International Board Certified Lactation Consultant who can help diagnose the tie and give you information and form a plan for you. Click here to read my article on tongue ties and how it can affect breastfeeding.
4. How we care for our babies
This is something I never hear mentioned when talking about reflux…the simple remedy of holding your baby as a preventative measure. Imagine this…you have just eaten a huge, liquid meal that has filled your tummy. You are then put down on your back, you cannot really move much at all besides pulling your legs up and down. You are full, have some bubbles in your belly and you are immobile. Sounds uncomfortable doesn’t it?! Simply cuddling your baby and holding them upright will help prevent many issues with reflux/colic/unsettled symptoms. Often times a baby will burp just from being lifted up over our shoulder or passed to someone else. It gets things moving! It can be really difficult to move gas along (and out) of our bodies if we are lying down, not moving. Babies who are held often and upright will be much less likely to have these issues. You cannot hold your baby too often and it is simply not possible to spoil them.
Do not suffer alone with your baby if you feel as though your baby’s symptoms fit into the NOT normal category! Often times a mother will just be prescribed reflux medication for her baby or be recommended to switch to a hyperallergenic formula instead of actually getting to the bottom of WHY her baby has reflux. Switching your baby to formula can do more damage to their gut health in the short and long term, and reflux medications will help fix the symptoms without figuring out the cause. Seek help from an IBCLC if you need some support with this or more information. there are answers for you!
*Rarely, there will be a medical condition that will cause a baby to be unsettled or “colicky”. If you have concerns that your baby has issues above and beyond what I have discussed here please seek help from your doctor. This article is not meant to be medical advice or give a diagnosis.