Gassy And Colicky Babies Are Normal in Young Babies

Question: Our six-week-old baby is very gassy and colicky. My pregnancy was uneventful; he was delivered by elective C-section because he was over 10 pounds at birth. He latched onto my breasts right away, but my milk was slow to come, so he did get some formula. Most of the time, I am able to nurse him. However, he was slow to gain weight. In the last few weeks, he has been very gassy, especially at night. He would pull up his knees, kick them out, and squeal. In the daytime, he is not too bad. Some of my friends suggested that he may have lip tie. When I read on the internet, it does say lip tie can cause some of these symptoms, and surgery may be necessary. I am exhausted and scared. What should we do?

Answer:

I am glad that you had a healthy pregnancy, and now a healthy baby.  Being gassy and colicky is very common in young babies.  I don’t think he needs surgery.

Babies grow and develop in the mother’s womb, which is a sterile environment and free of germs.  If the mother goes through natural birth, the baby can swallow mother’s normal germs when passing through the birth canal.  These would become the first germs growing in the baby’s intestines.

If the mother has elective C-section, the baby is not exposed to the mother’s germs in the vagina.  Other healthy germs, especially those on mother’s breasts, would enter the baby’s stomach and intestines during breastfeeding.  These germs multiply and become the “gut microbiome” of the baby, helping to digest milk and food throughout his lifetime.

Mother’s milk, as well as cow’s milk formula, have lactose as the sugar, together with proteins, other nutrients, and antibodies that protect the baby.  Young babies don’t have adequate enzyme in the intestines to digest and absorb all the lactose.  The germs in the intestines would convert the excess lactose into gas and acid.  A lot of gas inside the baby’s intestines will cause irritation, pain, and loose stools, similar to the time that you have “stomach flu.”

Babies react to the pain by drawing up their legs, tightening their belly, and screaming.  They are truly in pain.  For some unknown reason, these episodes tend to happen more frequently in evenings and through the night, when sleep-deprived parents desperately need their rest.

The gas that cause these cramps and pain is not due to air that babies swallow when feeding due to lip tie or tongue tie.  The gas is produced in the intestines from lactose in the milk.

I have seen many hundreds of young babies with colicky pain over decades of work as a consultant paediatrician.  After listening intently to their concerns, asking questions to make sure that there is no other serious medical problems, and carefully examining these babies, I would spend the rest of the consultation explaining to these distraught parents the most likely cause of their baby’s issues: this is something natural, and will improve over weeks to months.

I recall one mother who was a nurse at our hospital.  She had waited years for her first baby, and I saw him around two months of age.  The mother was exhausted because her baby was screaming every day; she was willing to give away her baby because it was too hard for her.  I reassured her that her baby would get better over time.  As expected, the colicky pain gradually decreased, and he should be a healthy young man in his 20s by now.

This is the most difficult time for both of you.  Your baby needs to be nursed and diapers changed almost constantly.  You are sleep-deprived and exhausted.  It is hard to see that tomorrow will be better.  Tomorrow won’t be better, but it will gradually get better over next few weeks and months.

Another advice that I give to parents: when he sleeps, you sleep.  Don’t try to tidy up the house.  Take care of yourself and your baby; this is your only priority, nothing else matters.