Why your baby is doing so much grunting, what may help and when it’s worth looking more closely at feeding.
It can take a surprising amount of effort for a newborn to pass a little gas. There’s the grunting, the red face, the knees pulled up toward the tummy, and you sitting beside them wondering whether this is something you’re supposed to be helping with.
For some babies and families, however, it isn’t always that straightforward. When your baby keeps crying, seems uncomfortable after every feed or only settles while being held upright, being told that newborn gas is “normal” can be less than helpful. . You want to know whether they’re hurting, whether feeding has something to do with it and what you can reasonably try before buying another bottle of drops.
Gas is common in young babies, who swallow air during feeding and crying and also produce gas as they digest milk. It can be tricky to sort out, though, whether gas can explain what is happening with your own baby’s behaviour. It’s important to remember that correlation doesn’t always equal cause; because your baby passed gas while they were crying doesn’t necessarily mean that they started crying because they were gassy. Figuring out what is happening with your own baby may require a good look at how feeding is going, whether your baby is growing well and how they seem between feeds.
Why does my baby grunt and strain so much?
Young babies are still learning to coordinate their muscles: pooping requires them to push with their abdomen while relaxing the muscles that let stool pass. Those two things need to happen together, and some babies haven’t quite worked out the timing yet. There can be a fair amount of grunting and turning red before they poop, which understandably can make parents think their baby must be constipated.
Soft stool after all that effort is different from hard, dry stool that’s difficult to pass. The grunting sounds don’t really give us a lot of information – what can be much more helpful is getting information about feeding difficulties, a swollen tummy, and whether your baby seems unwell. seems unwell.
It helps to notice what follows the grunting – including whether your baby settles, feeds comfortably and seems like themselves again, or whether the discomfort continues after they’ve pooped. This is all helpful information to bring to your baby’s doctor when you’re unsure.
Could feeding be making my baby uncomfortable?
It’s worth noting if your baby repeatedly clicks at the breast, comes on and off, spills milk from the corners of their mouth or gulps and coughs through a bottle. None of those things are diagnostic in and of themselves, , but they absolutely do give us a good starting place for determining whether it’s more than just gas.
A lactation consultant can watch a whole feed, including your baby’s latch, how much milk they’re getting and how they manage the flow. Having an expert watch what is actually happening while you feed can help you understand why one position seems easier than another or why your baby becomes unsettled partway through.
Your own comfort belongs in that conversation as well. Feeding your baby involves two people – you and your baby. You may make an appointment because you’re concerned about your baby, but your comfort matters too. If feeding is painful or uncomfortable for you, it’s important that your own wellness is a part of the conversation.With bottle feeding, holding your baby fairly upright and keeping the bottle close to horizontal, tilted just enough for milk to fill the bottle’s nipple, gives them more opportunity to manage the flow and pause between drinks.Gulping or coughing may mean the flow needs reviewing. Bottles should never be propped, and your baby doesn’t need to finish the last bit just because it’s there.
Before changing the bottle, formula and feeding position all in the same afternoon, it can help to have someone watch a feed. Otherwise, even if things improve, you’re left wondering which change helped and whether you need to keep doing all of them.
How long should I keep trying to get a burp?
You can offer a burp at a natural pause or after a feed, supporting your baby’s head and neck while gently rubbing or patting their back. If they seem comfortable and nothing has happened after a few minutes, you don’t necessarily need to keep going until you get a result.
Some babies also have fairly strong opinions about having their dinner interrupted. Following their natural pauses can be easier on both of you than stopping repeatedly because you’re worried about gas later.
Burping may release air that was swallowed during feeding, but it won’t prevent the gas that forms further along during digestion. Even a very satisfying burp doesn’t mean your baby will have a completely gas-free evening.
What can I try when my baby seems uncomfortable?
Gentle bicycle movements with the legs may help some babies when they’re awake and reasonably calm. With your baby lying on their back, keep the movement easy and unforced, and stop if they resist or become more upset. Supervised tummy time while awake is another option, although immediately after a full feed is not likely to be the moment they appreciate it most.
A cuddle, gentle rocking or a warm bath may help them settle too. After a busy stretch of activity, moving to a calmer room can be worth trying before adding more movement or stimulation.
You don’t need to work through every suggestion in order. If your baby is getting increasingly upset, doing more isn’t necessarily helping. Trying one thing at a time makes it easier to notice what they seem to find comfortable.
Sleep advice stays the same, even when gas is involved. Your baby should sleep on their back on a firm, flat sleep surface without pillows or positioners. Tummy time is for awake, supervised play, and a position they enjoy while being held isn’t automatically a safe sleeping position.
Do gas drops or gripe water help?
The baby aisle offers plenty of things that sound as though they should make things easier for you and your baby. Unfortunately, the research isn’t always as convincing as the packaging.
Most gas drops contain simethicone, and studies of infant colic haven’t shown it to work better than a placebo for that pattern of prolonged crying. Colic is wildly different from occasional gas, but the evidencedoes mean we shouldn’t expect drops to reliably settle a baby who’s crying for hours. Your baby’s doctor or pharmacist can help you decide whether a medicine is appropriate.
Gripe water products vary in their ingredients, and there isn’t good evidence that they treat colic. A “natural” label doesn’t tell you whether something is suitable for a newborn either. Honey should never be given to a baby under one, including in a remedy that contains it.
Probiotics need a more specific conversation. Research involving one strain for colic doesn’t tell us that every probiotic will help every gassy baby, so it’s worth discussing the particular product and the reason for using it with your baby’s doctor.
Do I need to change what I’m eating?
When you’re breastfeeding and your baby seems uncomfortable, it can start to feel as though every meal you eat may offer a possible explanation for your baby’s discomfort. Someone blames dairy, someone else mentions broccoli, and suddenly you’re analying yesterday’s lunch while trying to settle the baby.
Gas in your own digestive system doesn’t pass into breast milk, and a gassy baby doesn’t automatically mean you need to remove foods. Cutting things out without a clear reason can leave you with a very restricted diet at a time when feeding yourself is already enough of a challenge.
A suspected allergy needs a medical assessment, particularly with blood in the stool, feeding difficulties or concerns about growth. If a dietary change is recommended, you should know what you’re removing, how long you’re trying it and how you’ll find out whether it helped.
If your baby is formula-fed, it’s best to talk changes through with their doctor instead of constantly switching formulas. The water and powder amounts on the packaging should always stay exactly as directed, since changing that ratio can be unsafe and won’t help with gas.
Is it colic??
Colic is usually defined by the “rule of threes” – crying for more than 3 hours daily, at least 3 days a week, for more than 3 weeks. It usually peaks around 6 weeks and resolves itself by around 3 months of age. Unfortunately the exact cause is unknown, though it may include an immature digestive system, trapped gas or food sensitivities. Your baby should be checked when you’re concerned, especially if feeding, growth or behaviour has changed.
Knowing that something may improve over the next few weeks can be both reassuring and also intensely frustrating. Hearing “it gets better” isn’t particularly helpful when you’ve been attempting to console your crying baby for the past several hours. Having help becomes incredibly important in the newborn phase, and moreso when you’ve got a baby that cries more than others. If you’ve got someone around that you trust that can share some of the load, by all means let them.
When you’re reaching the point where you can’t cope, put your baby on their back in a safe crib or bassinet and step away for a few minutes. However frustrated you feel, never shake a baby, and get help immediately if you’re afraid that you or someone else might hurt them.
Our guide to soothing a colicky baby looks more closely at prolonged crying and the support parents may need through it.
When does my baby need medical care?
A baby under three months with a rectal temperature of 38°C or higher needs urgent medical assessment. The Canadian Paediatric Society also advises medical assessment for fever in babies under six months.
Green vomit, trouble breathing, unusual floppiness, difficulty waking or a swollen, painful-looking abdomen need urgent care. Blood in the stool needs prompt medical attention as well. Poor feeding, fewer wet diapers than usual, repeated forceful vomiting or concerns about weight gain should be checked by a doctor, and none of these should be put down to gas or left until a routine feeding appointment.
A few questions that come up
Can breastfed babies have gas too?
They certainly can, since gas happens with breastfeeding and formula feeding alike, so it’s more useful to look at how the feed is going before deciding the feeding method needs to change.
Should I wake my baby to get a burp?
If your baby is sleeping comfortably, there’s no real reason to wake them to burp them. Any individual feeding advice you’ve been given still applies, and they should always be put down in a safe sleep position.
Does passing wind mean my baby is in pain?
Babies are gassy – in and of itself, a gassy baby doesn’t necessarily mean they are in pain. Ongoing distress, difficult feeds or a change in how they’re behaving overall tells us more than the amount of gas.
You don’t have to try everything
There can be a lot of noise and effort involved in ordinary newborn digestion, and it’s understandable to want to help when your baby looks uncomfortable. Feeding, growth and how they seem between feeds give you more useful information than the grunting alone. Gentle settling measures may help, but if feeds are difficult or the discomfort keeps going, having someone look more closely is a better next step than working your way through every remedy in the baby aisle.
How we can help at Oona
If feeding has become the part of the day you’re struggling with, our lactation consultants in Toronto and Newmarket can watch what’s happening and help you try changes that make sense for you and your baby. That may involve the latch, positioning, milk flow or bottle feeding, with attention to your comfort too.
While the jury is still out, research-wise, on whether hands-on body work can assist with gas or colic, we can say that empirically, some of our smallest patients do seem to find some relief with chiropractic, osteopathy and massage therapy. A separate movement concern, such as difficulty turning the head or a strong preference for one side, can be looked at without assuming it explains all the crying.
You can book lactation support without a referral. If you’re unsure which appointment would be useful, our free 20-minute Care Navigator call gives you a chance to talk through what’s been happening before choosing where to begin.
Sources and further reading
- American Academy of Pediatrics: infant constipation
- NHS: bottle feeding advice
- American Academy of Pediatrics: gas relief for babies
- Canadian Paediatric Society: colic and crying
- Canadian Paediatric Society: safe sleep
- Cochrane: pain-relieving agents for infantile colic
- NHS: colic and foods to avoid giving babies
- Canadian Paediatric Society: probiotics
- NHS: your breastfeeding diet
- Canadian Paediatric Society: fever and temperature taking
- NHS: signs that your baby is seriously ill
- Cochrane: manipulative therapies for infantile colic
