Gas and Gas Pain

Common Childhood Symptoms

Although gas can lead to gas pain, it is important to remember that gas is normal, especially in newborns and infants.

Signs and symptoms that your child may have more than just simple 'baby gas' include that he is often fussy, has loose or foul smelling stools, has difficulty feeding, isn't sleeping well, or cries for long periods of time when he has gas. Babies who are happy, feeding well, and their gas doesn't seem to bother them likely don't have any kind of medical condition and may have normal 'baby gas.'

Baby Formula Intolerance

Parents of babies who drink baby formula often make a formula switch at the first sign that their baby is having some gas. This is usually unnecessary, but is likely prompted by all of cans of formula that has been 'designed' for babies with gas. These include:

• Enfamil Gentlease LIPIL
• Enfamil LactoFree LIPIL
• Enfamil ProSobee LIPIL
• Similac Sensitive (formally Similac Lactose Free)
• Similac Isomil Advance Soy Formula
• Nestle Good Start Supreme Soy DHA & ARA
• Parent's Choice Gentle Infant Formula

Changing from a milk-based, iron-fortified formula is sometimes necessary, but much less often than most parents realize. For example, congenital lactase deficiency, in which babies can't digest the milk sugar lactose when they are born, is thought to be extremely rare. And since older children don't usually develop symptoms of a lactose intolerance until they are four or five years old, changing your baby to a lactose-free formula is often unnecessary. However, your baby might temporarily need a lactose-free formula, such as if he recently had at viral infection that caused severe diarrhea, such as rotavirus. Unlike lactose intolerances, newborns and infants can have true milk protein allergies. In this case, changing to a soy formula can be a good idea. And when these babies also have a soy allergy, an elemental formula can be needed, such as Nutramigen or Alimentum. Keep in mind that infants with milk and soy allergies will usually have more symptoms than just gas, including diarrhea, vomiting, hives, wheezing, bloody stools, and/or irritability.

Breastfeeding

As with a formula-fed infant, breastfeeding moms should usually only consider gas a true issue if it is excessive or accompanied by other symptoms.

Before restricting your diet too much when your breastfed baby has gas, consider eliminating all milk and dairy products from your diet for a week or so. If this helps your baby's symptoms, then he may have a milk protein intolerance, and the milk proteins from your diet that are passing into your breastmilk could be causing a problem. However, that isn't a reason to stop breastfeeding.

Breastfeeding mothers should avoid a few other true 'gassy' foods. Instead, you can just temporarily avoid those things that really seem to cause your child to have a lot of gas.

If you have a foremilk/hindmilk imbalance, in which you time your breastfeedings and don't let your baby nurse until he is finished on one side, then he may have gas because he is getting too much 'sugary' foremilk. Your baby may have less gas if he breastfeeds until he is finished on each side and gets more hindmilk, which has more fat and less sugar.

Older Children with Gas

Although it can also be normal, older children with gas can have a medical condition causing their gas, including a lactose intolerance, irritable bowel syndrome, malabsorption, or celiac disease. Fortunately, they can sometimes be better at describing associated symptoms, such as bloating, diarrhea, and abdominal pain, etc. And older children can sometimes recognize when their symptoms are being caused by specific foods, including milk, fruits, or vegetables.

Dietary Modifications

In general, although foods get the blame for causing kids to have gas, you shouldn't restrict your child's diet unless you have talked with your pediatrician.

It can sometimes help gas and gas pains if your child:

• Avoids those foods that you are sure are causing your child to have gas.
• Avoids fruit juices with a high sorbitol content, including apple, pear, grape, and prune juice.
• Avoids foods that include artificial sweeteners, including sugar-free drinks, candy, and gum.
• Avoids carbonated drinks.
• Drinks soy milk or rice milk instead of cow's milk if he has a lactose intolerance.
• Eats slowly and so doesn't swallow a lot of air when he eats.

A high fiber diet, which is not common among kids, can lead to excessive gas. Since a high fiber diet is considered healthy, don't restrict the fiber in your child's diet until you talk to your pediatrician, even if you think it is causing some gas. Surprisingly, a high fiber diet can be helpful for those with irritable bowel syndrome and gas.

Treatments for Gas Pains

Avoiding 'gassy foods' is usually the best treatment for kids with excessive gas.

Simethicone is a popular treatment for gas that is often tried by parents with fair success. It is available in many forms, including Mylicon Infant's Drops, Gas-X, and Mylanta Gas Relief, etc.

Beano, available as drops or a chew tablet, is a dietary supplement that is supposed to relieve gas associated with eating many high fiber foods, including beans, broccoli, and whole grain breads, etc.

If your child has a lactose intolerance, instead of avoiding cow's milk and other dairy product, it may help if he takes a lactase enzyme tablet to help him digest milk. Newer versions of these tablets, such as Digestive Advantage Lactose Intolerance Therapy, can even be taken just once a day.

_Sources:

Irritable bowel syndrome, functional dyspepsia, and functional abdominal pain syndrome. Hyams JS - Adolesc Med Clin - 01-FEB-2004; 15(1): 1-15.

American Academy of Pediatrics Policy Statement. Committee on Nutrition. Hypoallergenic Infant Formulas. Pediatrics 2000 106: 346-349.

American Academy of Pediatrics Clinical Reports. Melvin B. Heyman for the Committee on Nutrition. Lactose Intolerance in Infants, Children, and Adolescents. Pediatrics 2006 118: 1279-1286.