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My 3 month old has cried out at between 4:00 and 6:00 a.m. for hours in gas pain almost every night for the past 6 weeks or so. There have been 2 or 3 nights in this time where she did not have an issue. She usually nurses right before bedtime around 6:45 p.m., between 12 and 2 a.m. (depending on how she sleeps), and then again sometime during the gassy episodes at around 5 a.m. The nights when she has not had pain have usually happened because she had an unusually good first stretch of sleep and did not nurse until after 3:30 a.m. I know it is gas pain because she is scrunching her legs up and crying very shrilly. Unfortunately feeding her at 5 does not usually help to release gas or a bowel movement. It does sometimes put her in a deep enough sleep that she doesn't notice the pain. To help soothe her I usually give her a pacifier to suck on and put a gently warmed rice sock on her tummy. I'm loathe to try more invasive things because she's usually half asleep crying. However my spouse and I are getting exhausted from the 4 a.m. morning and I can't imagine baby is getting good quality sleep either!

I've talked to either a nurse or doctor at my pediatrician's several times describing the fact that the episodes can last up to 2 hours, basically until Baby's usual wake-up and feeding (when she often does release gas and a bowel movement because she's finally wide awake - during the day she rarely has gassy episodes and usually about 3 dirty diapers, all loose to very loose). All I ever get is "that's normal for her age." One nurse did advise the rice sock, and it does seem to help her feel better.

I've seen online all the suggestions for Mom to avoid dairy or "gassy" foods, but I'm loathe to complicate life with an infant further without real medical cause and I don't know of any doctor who routinely advises a breastfeeding mother to avoid certain foods unless an allergy really is suspected. My baby doesn't spit up much that we can see but does seem to occasionally spit up and then swallow it back down. She's pretty cheerful, though, so I don't suspect reflux. It's just this night time episode when she's been lying still for hours after a feeding, hits light sleep, and then notices the pain.

I've heard that 4 months is the magic time when the usual gas pain will go away. I've been planning on gritting my teeth about this whole issue until my baby's 4 month check-up and bringing it up yet again if it's still happening. What should I say when I do, or should I try calling in yet again with other information? Could the pediatrician be missing something?

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I'd like to add a link that backs up the accepted answer to this question on actual studies supporting an elimination diet for breastfeeding mothers. So helpful to see the evidence out there. –  justkt Aug 20 '13 at 14:00
    
Why do I get the same then and men bottle fed? I had this x10 turned out he was intolerant to my milk. Though not fully gone I was only having 1 hr sleep now he cried at times like yours. I wondered if he was teething my self –  Kelly yesterday

4 Answers 4

up vote 6 down vote accepted

It's actually quite common for foods that a breastfeeding mother is eating to cause gas or colicy behavior in a child. A friend had to avoid eating chocolate because her child would cry on hours and hours after she'd eat a chocolate. Lo behold, that child still doesn't like chocolate - not allergic to it - but it just doesn't sit well. I've known people whose infants have had issues with the mother eating orange juice as well.

Occasionally a baby will be fussy at the breast or gassy after you eat a particular food. If you notice a pattern, avoid that food for a few days. To test whether that food really was the cause, reintroduce it once and see if there's an effect. Mothers report that babies most often object to chocolate; spices (cinnamon, garlic, curry, chili pepper); citrus fruits and their juices, like oranges, lemons, limes, and grapefruit; strawberries; kiwifruit; pineapple; the gassy veggies (onion, cabbage, garlic, cauliflower, broccoli, cucumbers, and peppers); and fruits with a laxative effect, such as cherries and prunes. Read More

If there is something you eat in the evening or at dinner everyday, and you are breastfeeding, consider eliminating that - or at least finding out what it is. I am not sure why you are dismissing this is a "lack of medical cause." This happens, it is a fact. The cause of it is clear too. It is not an old wives tale. And no, it is not common to medicate the child to get rid of this gas pain. It is an adjustment period for the child to very new foods. There are even studies on this topic.

Relative risks (RRs) and 95% confidence intervals (CIs) for colic symptoms by food items the mothers consumed ranged from 0.7 (CI=0.3 to 1.5) for beef to 2.0 (01=1.1 to 3.5) for cow's milk. Maternal intake of cabbage (RR=1.3, CI=1.1 to 1.5), cauliflower (RR=1.2, CI=1.0 to 1.4), broccoli (RR=1.3, CI=1.0 to 2.2), cow's milk (RR=2.0, CI=1.1 to 3.5), onion (RR=1.7, CI=1.1 to 2.5), and chocolate (RR=1.5, CI=1.0 to 2.2) were significantly related to colic symptoms. Maternal intake of more than one cruciferous vegetable was associated with an RR of 1.6 (CI=1.1 to 2.4) for infants experiencing one or more colic symptoms.

If you don't want to change your eating habits, your options revolve around switching to formula (look for ones that go down gently; formulas give gas too) or just waiting it out. The baby's body may get used to it. Clarification: Don't begin by avoiding "known gaseous foods." You'll unnecessarily be depriving yourself and your child of nutritional variety. It is better to figure out what it is that you ate that particular day that might be causing gas. Do you eat orange juice with dinner everyday? Try it in a smaller quantity or skip it for a few days. Skip garlic one day - did it make a difference? No? Okay, put it back in your diet and try skipping cauliflower next. Think of it as a game ;)

I haven't heard of four months being the magic time when gas pain goes away. Usually gas pain happens when the kid's stomach is adjusting to something new - breast milk, solids, etc. So it'll "come back" when you start your child on solids.

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Interesting that there are studies on the topic. Most of what I've consulted says that it's not found in research, so I have taken it as an old wive's tale that most of those foods (except dairy, which I read was confirmed) were problematic. I'm a strong proponent of looking for evidence before making choices for my baby. As for the 4 month number, that comes from my pediatrician. It's also noted in the study you referenced and has to do with an immature digestive system. –  justkt May 31 '12 at 16:08
    
As a note, I don't mean my comment to be combative. It's just that no source I consulted on food and babies has mentioned any cause based on food in the mother other than milk protein allergy as being backed by research before. I am glad to change my eating habits to help my baby, but I don't want to complicate my family's life needlessly. –  justkt May 31 '12 at 16:16
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Also, from my understanding, there is no "one list" of food that a mother should avoid. Orange juice for some babies is perfectly fine, but not fine for a select few. Same goes with anything else. It's absurd for anyone to eliminate hundreds of nutritious foods because it MIGHT be gaseous. Its better to just figure out what that one food is that is bothering your child...and try to limit that. (Eat in smaller doses, perhaps.) –  Swati May 31 '12 at 19:25
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Try skipping nuts today and see what happens :) Then start the process of "which nut is driving the little one nuts!?!?" :) –  Swati Jun 1 '12 at 12:56
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@Swati - I'm trying skipping my big glass of milk at dinner, since that's an evening constant. Either she's growing out of the pain on schedule, or skipping the very dairy dairy is helping. Since "the last thing you try always works" regardless of whether it helps, I don't know if that's the issue or not until I test the milk again...but it may be it. –  justkt Jun 4 '12 at 13:09

Having now reached 16 weeks with my little one I can say that my pediatrician actually ended up being correct - time was the answer. The gas pain began tapering off around 14 weeks and at 16 weeks has been gone for well over a week.

Unfortunately it has left in its wake sleep issues that will now have to be addressed. Were I to do this all over again I might try modifying my diet during the earlier phases of my child's life to prevent the gas pain and subsequent sleep problems if possible. Hence the accepted answer will be a future strategy. However I wanted to update the question with an answer that defends my pediatrician's office and provides this information for anyone else with the question in the future.

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I think Swati has made excellent valid points. I suspect it's probably primarily gas as well. If you don't want to approach the change in diet as an option, there are some OTC gas remedies that might help some. You can try Mylicon gas drops (sometimes just called gas drops) or you might have some limited success with gripe water. I wouldn't discount acid reflux either just because your child seems "happy". My daughter had silent reflux and rarely if ever spit up, but you could hear her spit up and then she'd swallow. Some physicians suggest his form of reflux is worse than if they actually do spit up because by swallowing they are subjecting their esophagus to the stomach acid twice. Likewise, my niece was a happy baby and wasn't diagnosed with AR until she was almost a year old--which explained her trouble sleeping and recurring ear infections. It may be a combination of gas pains and acid reflux that is causing the crying. If she has a mild case of reflux, then having a gas bubble is putting more pressure on her little digestive tract and might be intensifying the AR pain.

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My pediatrician suggested Mylicon (well, any Simethicone drops) and I tried them briefly, but they never seemed to help - and the pediatrician said that research backs up the fact that Simethicone doesn't make any more difference than a placebo. As I said, I'm fine with changing my diet if there's evidence for it. Swati provided some evidence, but until her excellent answer I'd never seen or heard any. –  justkt May 31 '12 at 17:07
    
I should add that my pedi was not too optimistic that they would do anything, but told me they wouldn't hurt either. –  justkt May 31 '12 at 17:19

While time may be the long term answer, and changing your diet may be the medium term answer, if you're awake at 4 am with a screaming baby who is pulling up their legs and showing every sign of gas pain, you probably want a short term answer.

We did really well with gas/colic massaging. Basically you're moving everything along for them. It can be very soothing even if gas (or not-gas) doesn't end up leaving their body, and provide immediate relief when it does. The internet abounds with articles and videos on colic massage - they basically all involve swiping moves with medium pressure from about belly button down to the pubic bone, and some involve circles as well. There is a fair amount of lifting their legs and pumping them back and forth in these internet hits that I don't recall being a thing in the days when I dealt with colic, but it probably wouldn't hurt. Here's a representative article and video and some good tips - you can probably find plenty more.

We specifically used what's called the I Love You motion - I being a straight line on the baby's left side (on your right if you're facing them) moving downward, L the same but starting with a segment 90 degrees to that, and U adding another 90 degree segment before that. I found a good description online with a diagram. (If you've seen a diagram of the large intestine, you'll get it.) This can really produce output so be prepared.

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Although I'm not currently mired in this issue, I wanted to mention that we did use the I Love You massage per a friend's recommendation at the time. She never seemed to release gas when I was doing it for some reason, so maybe I did it wrong? For future reference I'll come back to this diagram. Bicycling also did nothing for us. I 100% agree with wanting a short-term answer. I've told my husband that next time I will not hesitate one bit to do an elimination diet. –  justkt Aug 20 '13 at 13:56

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