Written by Pamela Lim,  https://joyfulparenting.sg

You’ve decided to brave the nearby cafe for the first time with your new baby in tow when your little one starts grunting and bawling loudly and you realize it's baby gas. Welcome to new parenthood! A gassy baby is common and normal due to infants' tiny and immature digestive systems. 

Swallowing air and passing gas is common in infancy. However, excessive intestinal gas can make a young baby uncomfortably miserable.  

First and foremost, respond promptly to baby’s cries.

If your baby is gassy, you’ll notice that he passes a lot of gas and seems to feel better afterward. Gas troubles often start right away or when babies are just a couple of weeks old.

Fortunately, most infants outgrow them by the time they’re 4 to 6 months old, though baby gas can last longer for some. Infants are usually gassy because they have immature digestive systems and swallow air during feedings. Some babies may have sensitivities that could be affected by a breastfeeding mom’s diet or a certain type of formula.

Signs and symptoms of baby gas that causes discomfort:

• When your baby cries and is fussy for more than an hour a day, this can be a sign of a normal amount of new-born gassiness that comes with having a tiny, underdeveloped digestive system. You should still check in with your paediatrician if it happens every day and it doesn't seem to be getting better. 
• If your baby seems unhappy most of the time, this can indicate that you have an especially gassy baby who requires a little more help. Gas that causes significant stress often indicates a problem beyond the normal gassiness.
• If your baby isn't eating or sleeping well and have issues with sleeping or eating, infant gas may be one of factors. Talk to your doctor for a proper diagnosis.
• Your baby gets red in the face when he cries and seems like he might be in pain.
• Your baby squirms as though he's uncomfortable and pulls his legs up to his chest, especially during bouts of fussiness.  

Infant gas has several possible causes:

• Swallowing air when feeding or crying, which is very common and normal among new babies
• An underdeveloped digestive system, which allows food to pass through too quickly so it doesn’t break down completely
• Hypersensitivities to certain types of formula or foods in the Mom’s diet, or possibly food allergies.

 Remedies for baby gas relief:

• Burp your baby twice. Many new-born discomfort is caused by swallowing air during bottle feedings. In addition to the burping after feedings, try giving your baby a gentle back pat mid-feed to get rid of swallowed air before it travels to baby’s bowels. One sign that your baby needs a mid-meal burp is when he turns away from the breast or bottle fussily after just a few minutes of feeding, which is more likely linked to gas than feeling full.
• Control the air.Whether his meals come from breast or bottle, try feeding your baby in a more upright position to cut back on the air he swallows. If you’re breastfeeding, be sure that your baby is properly latched with the lips covering most parts of the areola. For bottle-fed babies, test anti-gas nipples and bottles, which can change the flow of milk and reduce the amount of air your baby swallows. Be sure that the nipple is always completely full with milk, so your baby doesn’t take in expressed breast-milk or formula with air. Try to avoid shaking the bottle too much, which can add extra bubbles to the milk.
• Feed your baby before meltdowns. Crying, of course, is unpredictable especially in really young babies. But the more your baby cries, the more air he swallows and the more gas he gets. So as much as possible, learn the early hunger cues in infants so as to nip hunger from the start.
• Try the tummy hold. Lay your baby tummy-down across your knees, or hold him under his belly with your forearm, and gently massage his back. The pressure on his tummy can help relieve the pressure from gas. This touch can be a such a powerful tool to calm fussiness.
• Infant gas drops. Though they don't work for all babies, infant gas drops are generally considered safe for babies. Check the label and opt for formulations with as little preservatives as possible and be sure talk to your baby's doctor before proceeding.
• Do baby bicycles. Lay your baby on his back and gently cycle his legs in a bicycling motion toward his tummy to manually help push out trapped air. Or you can gently push baby’s knees up to his tummy and hold for 10 seconds, then release and straighten baby’s legs and repeating several times. 
• Encourage tummy time. Tummy time is great for strengthening the muscles as your baby needs to lift his head and eventually to crawl and walk. The gentle pressure on baby’s tummy can also help relieve gas. But some babies spit up if they’re put on their tummies soon after eating, so wait at least 20 to 30 minutes before doing tummy time. Always supervise your baby during tummy time and never put your baby to bed on his stomach, since tummy-sleeping can put babies at risk of sudden infant death syndrome (SIDS).
• Give your baby a rub-down. Massage can sometimes help your baby pass gas. Start with your baby’s tummy, then give a gentle rub all over the shoulders, back, legs. It might help him to relax enough to pass gas.
• Check your diet if you’re breastfeeding. If you’re breastfeeding, try cutting out foods that could potentially cause gas in your baby. Some that may cause baby gas include dairy products, caffeine, onions and cabbage.
• Try baby gripe water. Usually, a blend of sodium bicarbonate and herbs and often fennel and ginger, among others like baby gripe water may help to relieve gas and soothe fussy babies. Always check with your paediatrician first.
• Consider probiotics. Probiotics are bacteria that support your GI system. Research in people with bowel conditions like irritable bowel syndrome (IBS) has found that probiotics may help reduce gassiness, likely by supporting gut health and studies are being done to prove they work for gassy babies as well. In the meantime, while probiotics are generally considered safe, be sure to talk to your doctor before giving your infant any probiotic product.

The difference between gripe water and gas drops:

The active ingredient used in gas drops is simethicone, which, unlike gripe water, isn't absorbed into your infant's system. After its job is done, it passes right through to your baby's diaper. Simethicone simply helps gently break gas bubbles down to help your baby expel them naturally on their own. 

Can breastfeeding make baby gassy?

Some research has found that the foods in a mom's diet might make breastfed babies gassy but the evidence is still far from conclusive. Before you revamp what you're eating, see if there are other subtle ways you can help your baby swallow less air at mealtimes, including working on your latch, burping baby twice at each bottle feeding and trying different nipples or bottles if you pump.

If your breastfed baby is still gassy and you notice that every time you eat a certain type of food where he seems gassier or fussier than usual, there’s no harm in cutting that food from your diet to see if it helps.

Work with your doctor to nail down foods that might make breastfed babies gassy might include:

• Cruciferous veggies like cabbage, Brussels sprouts and cauliflower
• Dairy and eggs
• Meals that are very spicy like onion or garlic

How to tell the difference between regular infant gas and colic?

Gas can make babies fussy and it might seem like a gassy baby is colicky. But colic and gassiness are two distinct conditions. Colic in babies has many causes beyond an underdeveloped digestive system, including overstimulation and an immature nervous system.

A baby is often colicky because he has a hard time self-soothing. Your baby is more likely suffering from colic than gas if he typically starts crying around the same time of day and most often in the early evening and especially so if those crying bouts last at least three hours, three times a week and for at least three weeks.

Colicky babies are often inconsolable and have episodes of frequent, intense crying that can turn into screaming for long stretches of time, even though they're otherwise healthy.

When to see the doctor for a gassy baby?

You’ll want to visit your doctor about gas to rule out more serious medical conditions if:

• Your baby is not gaining weight.
• Your baby frequently does not want to eat or is hard to feed which could also be a sign of acid reflux in your baby or another digestive problem and both of which require treatment.
• Your baby seems constipated or has a hard time with bowel movements and the gas could be trapped behind the poop. Your doctor can help you to find and address the root problem.
• Your baby has an allergic reaction like hives, vomiting, rash, swollen face or trouble breathing after you’ve tried a new gas treatment (though allergic reactions, fortunately, are extremely rare)

If your baby is gassy but gaining weight and peeing and pooing normally for his age and everything is probably going exactly as expected, then you’ll just need to wait it out. Baby gas does pass out somehow and eventually!