Infant Gas & Reflux
Managing Gas & Reflux
Babies can experience discomfort from excess gas as newborns, but it’s not usually until they’ve had gas discomfort for a a few weeks that they may go on to develop reflux (not every gassy baby develops reflux). The earlier gas discomfort is managed, the less likely a baby is to develop reflux.
How does a baby get gas?
Just like adults, babies get gas from how they feed and how they digest, but babies also get gas during crying. Normally and ideally, when a baby’s mouth is fully sealed and filled (at the lips, and also deeply into the oral cavity) with a mother’s nipple and areola, the space left to be filled with the air they breathe while nursing is minimal. However, when a baby’s mouth isn’t optimally sealed due to a shallow latch (where the nipple isn’t being escorted deeply into baby’s mouth), a high palate, or when the tongue and lips an aren’t strong or coordinated enough to create a tight seal, air will enter into the latch via the mouth or nose and be swallowed alongside the milk. This can happen on both the breast and bottles, so finding ways to achieve a deeper latch on either feeding method is important and lactation consultants should be able to help with both.
Note: In cases of persistent overproduction and forceful let-downs, babies may start life with strong and deep seals yet mom’s supply may “enable” them to lose this strength or develop shallow latches due to the amount of milk being received. Poor sealing and nipple pain are often seen in cases where an infant has a tongue-tie, so having your baby assessed by a provider versed in tongue-tie care is imperative.
Also, who feed too quickly due to oversupply or forceful letdowns sometimes lose the strength and oral coordination needed to maintain a full-milk supply on their latch alone. When you notice a baby is feeding too quickly, do what you can to slow them down or discuss this with a lactation consultant. Even milk production that is high at first, can be impacted by a weak latch later.
What are symptoms of reflux?
The most common symptoms of reflux are arching while feeding, sharp cries while feeding, uncomfortable gasping and choking during feeds, and a tight belly in combination with the above. These can overlap with other things, so when in doubt talk to your doctor (especially if it’s occurring in babies who are only a few days old, or who aren’t pooping). Most babies reflux during feeds, but some babies feed comfortably and begin refluxing even up to an hour after feeds.
How does gas become reflux?
After a baby had been bringing excess milk and/or gas for a few weeks, sometimes forcefully and with digestive acid, the digestive tract becomes irritated and unable to coordinate a baby’s suck/swallow and challenges may be seen when keeping milk or gas down. Many baby’s have transient reflux, such as an occasional painful burp, and some babies have very painful reflux, or even silent reflux (without spit up or without discomfort). Ironically, sometimes gas without spit up can make babies even more uncomfortable since the acid doesn’t come out.
When left untreated, or due to other underlying causes like laryngomalacia, dysphagia, or tight oral frenulum (tongue or lip tie), babies can develop Gastroesophageal Reflux Disease (GERD), which is chronic reflux that can temporarily impact a baby’s contentment and thrive. Reflux and GERD Can sometimes be used interchangeably but GERD is usually significantly more impactful and babies who have it may need to see gastrointestinal doctors (GI specialists) and may need swallow studies. If you suspect your baby has actual GERD (vs basic reflux), discuss this with your baby’s doctor soon.
What can I do before offering medicine to help my baby with reflux?
Classic remedies such as feeding a baby upright, pacing their feeds (via paced bottle feeding, or reclining while nursing if milk flow is too fast), burping every few minutes during feeds, or providing warmth to a babies belly can really be all it takes (these work best when done early in life, and early in reflux symptoms), but in some cases, remedying reflux can take a visit to a lactation consultant or your baby’s pediatrician. Sometime infant reflux medication is given, and sometimes referrals to other providers are given. Other providers like pediatric dentists and ENTs can assess for tongue/lip-tie, or doctors like GI specialists may help you determine if your baby needs more support. Often complimentary providers such as infant massage therapists and chiropractors can help alleviate a baby’s reflux symptoms.
Breastfeeding House’s Favorite
Burp Technique
There are a million burp techniques but the one that I find works best is what I call “massage burping” where a baby is held over a parent’s shoulder, legs as relaxed as possible, and baby is massaged slowly and firmly (gently) from their sacrum (lower back/butt/hip area), up through their mid backs, and to between theur shoulder blades . Usually by the time the mid back is reached a full burp has been released.
If learning about infant gas and reflux or implementing some of the basic strategies listed here and nothing works, consider making and appointment with The Breastfeeding House!
Babies can experience discomfort from excess gas as newborns, but it’s not usually until they’ve had gas discomfort for a a few weeks that they may go on to develop reflux (not every gassy baby develops reflux). The earlier gas discomfort is managed, the less likely a baby is to develop reflux.
How does a baby get gas?
Just like adults, babies get gas from how they feed and how they digest, but babies also get gas during crying. Normally and ideally, when a baby’s mouth is fully sealed and filled (at the lips, and also deeply into the oral cavity) with a mother’s nipple and areola, the space left to be filled with the air they breathe while nursing is minimal. However, when a baby’s mouth isn’t optimally sealed due to a shallow latch (where the nipple isn’t being escorted deeply into baby’s mouth), a high palate, or when the tongue and lips an aren’t strong or coordinated enough to create a tight seal, air will enter into the latch via the mouth or nose and be swallowed alongside the milk. This can happen on both the breast and bottles, so finding ways to achieve a deeper latch on either feeding method is important and lactation consultants should be able to help with both.
Note: In cases of persistent overproduction and forceful let-downs, babies may start life with strong and deep seals yet mom’s supply may “enable” them to lose this strength or develop shallow latches due to the amount of milk being received. Poor sealing and nipple pain are often seen in cases where an infant has a tongue-tie, so having your baby assessed by a provider versed in tongue-tie care is imperative.
Also, who feed too quickly due to oversupply or forceful letdowns sometimes lose the strength and oral coordination needed to maintain a full-milk supply on their latch alone. When you notice a baby is feeding too quickly, do what you can to slow them down or discuss this with a lactation consultant. Even milk production that is high at first, can be impacted by a weak latch later.
What are symptoms of reflux?
The most common symptoms of reflux are arching while feeding, sharp cries while feeding, uncomfortable gasping and choking during feeds, and a tight belly in combination with the above. These can overlap with other things, so when in doubt talk to your doctor (especially if it’s occurring in babies who are only a few days old, or who aren’t pooping). Most babies reflux during feeds, but some babies feed comfortably and begin refluxing even up to an hour after feeds.
How does gas become reflux?
After a baby had been bringing excess milk and/or gas for a few weeks, sometimes forcefully and with digestive acid, the digestive tract becomes irritated and unable to coordinate a baby’s suck/swallow and challenges may be seen when keeping milk or gas down. Many baby’s have transient reflux, such as an occasional painful burp, and some babies have very painful reflux, or even silent reflux (without spit up or without discomfort). Ironically, sometimes gas without spit up can make babies even more uncomfortable since the acid doesn’t come out.
When left untreated, or due to other underlying causes like laryngomalacia, dysphagia, or tight oral frenulum (tongue or lip tie), babies can develop Gastroesophageal Reflux Disease (GERD), which is chronic reflux that can temporarily impact a baby’s contentment and thrive. Reflux and GERD Can sometimes be used interchangeably but GERD is usually significantly more impactful and babies who have it may need to see gastrointestinal doctors (GI specialists) and may need swallow studies. If you suspect your baby has actual GERD (vs basic reflux), discuss this with your baby’s doctor soon.
What can I do before offering medicine to help my baby with reflux?
Classic remedies such as feeding a baby upright, pacing their feeds (via paced bottle feeding, or reclining while nursing if milk flow is too fast), burping every few minutes during feeds, or providing warmth to a babies belly can really be all it takes (these work best when done early in life, and early in reflux symptoms), but in some cases, remedying reflux can take a visit to a lactation consultant or your baby’s pediatrician. Sometime infant reflux medication is given, and sometimes referrals to other providers are given. Other providers like pediatric dentists and ENTs can assess for tongue/lip-tie, or doctors like GI specialists may help you determine if your baby needs more support. Often complimentary providers such as infant massage therapists and chiropractors can help alleviate a baby’s reflux symptoms.
Breastfeeding House’s Favorite
Burp Technique
There are a million burp techniques but the one that I find works best is what I call “massage burping” where a baby is held over a parent’s shoulder, legs as relaxed as possible, and baby is massaged slowly and firmly (gently) from their sacrum (lower back/butt/hip area), up through their mid backs, and to between theur shoulder blades . Usually by the time the mid back is reached a full burp has been released.
If learning about infant gas and reflux or implementing some of the basic strategies listed here and nothing works, consider making and appointment with The Breastfeeding House!
