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DEAR MAYO CLINIC: Our 3-month-old is on formula and gets really fussy sometimes after she eats. It seems like she’s in pain. When we give her the over-the-counter gas drops, it usually seems to make her feel better. Are there any risks from giving her the gas drops every day? Is there anything else we should be doing for her?
ANSWER: You and your baby are not alone. Fussiness is common and can be a normal part of infant behavior. In general, there’s no harm in giving your baby gas drops if they seem to help. It’s likely her frequent fussiness will fade over time without additional treatment.
Over-the-counter gas drops usually contain simethicone, a medicine designed to relieve painful symptoms associated with having too much gas in the stomach and intestines. Simethicone is generally a safe medication for babies. It could cause loose stools, but that is uncommon. The typical dose for simethicone is 20 milligrams, up to four times a day. It is safe to use every day. If gas drops make your baby feel better, you can continue using them.
When you choose gas drops, however, check the ingredient information, and avoid drops that contain sodium benzoate or benzoic acid. These substances can be harmful to babies in large quantities. Fortunately, they are not included in most gas drops intended for infants.
As in your case, gas drops may be useful for infant fussiness. To date, though, research studies have not found simethicone to be very effective at relieving infant colic. Though your question doesn’t mention colic, it’s possible that some of your baby’s fussiness might be related to that condition, rather than feeding.
Infant colic is defined as a baby crying for more than three hours a day, more than three days a week, for a period of three weeks or longer in an otherwise healthy infant. This crying occurs for no apparent reason, despite the baby being well-fed and in a clean diaper. The amount of daily crying usually increases after birth, reaching a peak around six weeks, before gradually starting to improve. Although colic can be quite distressing for babies and their parents, it usually doesn’t require medical care.
In some cases of colic or other frequent fussiness, parents worry that their baby might not be on the right formula. Usually, healthy babies do well on standard infant formulas. Some formulas are marketed to ease fussiness and spit up. There is little evidence that they are helpful or necessary in most cases. The nutrition in these formulas is similar to standard formulas, and both are safe for babies. Of course, breast-fed babies can be fussy, too, and moms sometimes wonder if making personal dietary changes might be helpful. However, evidence is limited regarding avoidance of any particular foods.
There has been some new research indicating that probiotics could be helpful for infant colic. Unfortunately, other studies have shown mixed results, so more research is needed. Probiotics are not routinely recommended for fussiness, but some parents try them anyway. I would recommend talking to your baby’s health care provider if this is something you would like to consider.
Sometimes, babies may swallow extra air during feedings, leading to discomfort afterward. To help avoid this, feed the baby in a more upright position, and pause regularly for burping. Experimenting with various nipples or bottles may be helpful, as every baby is different. Moving the baby’s legs in a bicycling motion sometimes can help, too. Giving your baby a warm bath or lightly rubbing her stomach when she seems uncomfortable also can be soothing.
In many cases, colic and other forms of fussiness slowly disappear with time and can be managed with self-care. You should visit your baby’s health care provider if you have concerns about her growth or weight gain. An evaluation is also a good idea if your baby seems to be constipated. Although they typically are not medical emergencies, if you notice blood in your baby’s stool, if she is vomiting, or if she has prolonged or excessive crying that is different than usual, seek prompt medical care. — Dr. Kara Fine, Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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