Babies’ feeding troubles could be due to various underlying problems.
IF your baby has trouble eating, chances are he could be having stomach problems. Often, these troubles will manifest into symptoms of intolerance such as excessive crying, fussiness, gassiness, spit-ups and diarrhea. Read on to find out what might be making your baby uncomfortable, and ways you can make your baby feel better.
My baby cries for hours, even after feeding. I have tried all kinds of ways to soothe her, but she is still fussy and uneasy. Is something wrong with her?
In general, babies cry to express their discomfort such as when they are hungry, tired or sleepy. However, if a baby cries excessively and/or is perpetually fussy, it could be a symptom of an underlying health problem. One of the common causes of excessive crying and fussiness is gassiness that causes flatulence.
Excessive crying leads to a baby swallowing more air. If the baby is not burped, this air can get trapped in the child’s digestive tract, which results in a bloated stomach. This causes a baby to feel uncomfortable, which could cause them to cry even more.
The state of a mother’s mental and emotional health could contribute to her baby’s crying. For example, a mother who is experiencing postpartum depression may be inconsistent in caring for her child. She may not respond to her baby’s needs, or may respond in a negative way.
Crying in newborns and babies is normal. However, if you’re concerned or if your baby isn’t eating, sleeping or behaving normally, contact your baby’s healthcare provider. He will be able to help you tell the difference between normal crying and something more serious.
2. My baby’s stomach looks bloated and he passes gas often. Could he be having a digestion problem? How can I help ease his discomfort?
Infant gas is often the reason for your baby’s bloated stomach and fussiness. Flatulence is another common symptom of infant gas. Factors that could be making your baby gassy include:
> Incorrect feeding techniques: When breastfeeding, a baby who is poorly latched-on will swallow more air than a baby who is well latched-on. Swallowed air can get trapped in your baby’s digestive tract and cause gassiness and flatulence.
If your baby is on formula, make sure you pick a bottle nipple size that is appropriate for him. A bottle nipple that is too big may make him gag, while one that is too small may cause him to swallow air or tire him out before he is full.
> Mother’s diet: If you’re breastfeeding, certain foods in your diet could cause your baby to become gassy. You may consider eliminating dairy products or allergenic foods such as cow’s milk, eggs, peanuts, tree nuts, wheat, soy and fish. Avoid these foods for up to a week to see if it makes a difference in your baby’s behaviour.
> Baby’s developing digestive system: The enzymes in your baby’s digestive system help to break down the foods that he consumes. Some babies are intolerant towards milk because their digestive systems are immature or are not fully functional. The enzymes that are required to properly digest lactose and proteins are not fully activated yet.
If lactose and protein are not properly digested in the small intestine, then they pass into the large intestine and are fermented by “bad bacteria”. This can cause infant gas.
Burping may help alleviate some of these symptoms.
3. My baby tends to spit up right after feeding. Is this normal?
Spit-ups are normal. About half of all babies experience spit-ups during their first three months as their stomach capacity is extremely small. A day old’s stomach is only the size of a small glass marble or a hazelnut, and by day 10 the size of a walnut or a golf ball. Due to its small capacity, your baby’s stomach is easily overfilled. They tend to spit up when this occurs. Gradually increase the baby’s food as he grows. Spit-ups will usually stop by the time your baby is a year old.
Spitting up usually does not interfere with normal growth. But if your child isn’t gaining weight or spits up green or yellow fluid, or blood, contact the doctor immediately.
4. My baby’s stools have been more watery than usual. Does he have diarrhoea? What usually causes this condition?
Loose and watery stools are usually signs of diarrhoea. Your little ones could pick up these viruses or bacteria through contact with contaminated food, water or surfaces and then putting their hands into their mouths.
Food allergies, sensitivity to medicines, intolerance to lactose and/or protein can also result in diarrhoea. A sudden change in a breastfeeding mother’s diet can also cause her baby’s tummy to get upset.
Maintain good hygiene. Always wash your hands with warm water and soap every time you change your baby’s diaper to keep virus or bacteria from spreading.
Keep the diaper-changing area clean and disinfected.
If your baby experiences six or more episodes of diarrhoea in 24 hours, take him to a doctor.
5. I notice that some babies experience symptoms such as excessive crying, fussiness, gassiness and spit-ups. What can parents do to reduce these symptoms and/or to prevent them from occurring?
These symptoms are relatively common in babies, especially during the first few months.
Here are tips to make your baby feel better:
> Make feeding as relaxing as possible for baby.
> Keep your baby in an upright position during feeding.
> Make sure your baby is well-supported in a comfortable position.
> A baby’s stomach capacity is small, so feed him in small amounts.
> Burp your baby during and after feeding to prevent air from building up in his digestive tract.
> Avoid bouncing and playing with your baby during and after feeding.
> Avoid disruptions such as bright lights or unusual noises during feeding.
> If your baby is crying from hunger, calm him before feeding. That might prevent him from gulping air.
> Make sure you pick a bottle nipple that is of the right size. When you turn the bottle upside down, the milk should drip and not gush out. Then the dripping should stop.
6. I breastfeed my child. Lately, his tummy has been looking bloated and he passes gas frequently. He has also been crying more than usual. What can I do to make my baby more comfortable?
Mothers should continue breastfeeding unless medically indicated. The World Health Organisation (WHO) recommends exclusive breastfeeding for babies for the first six months of life. Breast milk also contains nutrients and antibodies that regulate your baby’s digestive system. You can alleviate some of the symptoms of discomfort such as bloating and frequent passing of gas by implementing proper feeding techniques such as burping your baby. Mothers may also eliminate dairy or allergenic foods from their diet. Usually, breastfed babies experience fewer of such discomforts because breast milk tends to be more easily digested.
7. My baby is on infant formula, and has been experiencing spit-ups, gassiness and diarrhoea. She is also fussy and cries for hours. Will changing the formula solve her problems?
These conditions may not necessarily be due to the infant formula, although it could be a contributing factor. There are infant formulas with partially hydrolysed protein and low lactose that are designed to relieve symptoms of discomfort in babies. Lactose can sometimes cause mild symptoms of intolerance in babies.
However, parents should not eliminate lactose from their baby’s diet as it is a source of carbohydrates. Low-lactose, lactose-free or soy-based infant formula may help relieve some symptoms of intolerance. Added rice starch formulas are normally indicated to only reduce spitting-up and regurgitation in infants. Parents should always consult a paediatrician or healthcare provider before they start their baby on any new formula or treatment options.
While there are no hard and fast rules when it comes to nurturing your baby, ensuring that he is happy, healthy, and comfortable will start him on the path to a bright and secure future.
This article is courtesy of BrightStart4Life, an expert-driven educational programme on infant and child nutrition initiated by Nutrition Society of Malaysia, the Malaysian Paediatrics Association, and the Malaysian Medical Association, supported by the National Population & Family Development Board (LPPKN). For more information, call 03-5632 3301.
Datuk Dr NKS Tharmaseelan is the Malaysian Medical Association President.