Intestinal Gas and Gas Pains, Child

Intestinal gas is mostly produced by normal air swallowing and digestion of food. Gas can lead to some discomfort, but it is normal, especially in infants and older children. However, it is possible that older children can have a medical condition causing too much gas. Fortunately, they can sometimes be better at describing associated symptoms. This helps to link symptoms to possible causes.

CAUSES

Problems of excessive gas in infants are different than those in older children. If your baby seems to be having problems with too much gas and related pain, possible causes include:

  • Intolerance to baby formula.

  • Intolerance to foods eaten by mothers who breastfeed.

  • Diseases of the intestine that get in the way of normal absorption of foods. These diseases are uncommon.

Problems of excessive gas in older children may be due to one of many problems. These include:

  • Food intolerances. Healthy foods such as fruits, vegetables, whole grains and legumes (beans and peas) are often the worst offenders. That is because these foods are high in fiber, and fiber can lead to excess gas.

  • Lactose intolerance. Lactose is a sugar that occurs naturally in dairy products. Some children can develop a partial or complete inability to digest lactose properly.

  • Swallowing air. Your child unknowingly swallows air when nervous, eating too fast, chewing gum or drinking through a straw. Some of that air finds its way into the lower digestive tract.

  • Gluten intolerance. Gluten is a protein found in wheat and some other grains. Some children cannot properly digest this protein. This problem can result in excess gas, diarrhea and even weight loss.

  • Antibiotic treatment can change the normal bacteria in the intestines.

  • Artificial additives. Examples of these are sweeteners found in some sugar-free foods, gums and candies. Even healthy people can develop gas and diarrhea when they eat these sweeteners.

SYMPTOMS

Symptoms of gas pain are hard to tell from the normal behavior of a baby. Some things to look for are:

  • Fussiness more than "normal."

  • Loose and/or foul smelling stools.

  • Crying/screaming without the ability to console your baby.

  • Drawing the knees up to the chest while crying.

  • Restlessness.

  • Poor sleep.

In children who are old enough to tell you what they are feeling, symptoms may include:

  • Voluntary or involuntary passing of gas, either as belching or as flatus.

  • Sharp, jabbing pains or cramps in the belly. These pains may occur anywhere in the belly and can change locations quickly. Your child may describe a "knotted" feeling in the stomach. The pain can be very intense.

  • Abdominal bloating (distension).

DIAGNOSIS

Your caregiver will likely diagnose this problem based on a medical history and an exam. Your caregiver may tap on your child's belly to check for excess gas and listen for a hollow sound. Depending on other symptoms, further tests may be recommended in order to rule out conditions that are more serious. These tests could include blood tests, urinalysis, x-rays, ultrasound, or special imaging (such as CT scanning).

TREATMENT

Baby Formula Intolerance

  • Do not switch formula at the first sign that your baby is having some gas. This is usually unnecessary. However, changing from a milk-based, iron-fortified formula is sometimes necessary.

  • 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. It is important to note that a baby may have a soy allergy. In that case, an elemental formula can be needed. Infants with milk and soy allergies will usually have more symptoms than just gas. Other symptoms include diarrhea, vomiting, hives, wheezing, bloody stools, and/or irritability.

Breastfeeding

Gas should be considered only a true issue if it is excessive or accompanied by other symptoms.

  • Consider eliminating all milk and dairy products from your diet for a week or so, or as your caregiver suggests. If this helps your baby's symptoms, then he/she may have a milk protein intolerance. Keep in mind that is not a reason to stop breastfeeding.

  • Consider avoiding a few other true "gassy" foods. These include beans, cabbage, brussel sprouts, broccoli, asparagus, and some other vegetables.

  • There may also be a foremilk/hindmilk imbalance. This can happen if breastfeeding is done on only one side at a time. Your baby may be getting too much 'sugary' foremilk. Your baby may have less gas if he/she breastfeeds until finished on each side and gets more hindmilk. Hindmilk has more fat and less sugar.

Older Children with Gas

You should not restrict your child's diet unless you have talked with your caregiver. Your caregiver may recommend that your child stop eating certain foods/drinks. Try stopping just one thing at a time to see if problems improve, or as your caregiver suggests. Below are foods/drinks that your caregiver may suggest your child avoid:

  • Fruit juices with high fructose content (apple, pear, grape, and prune juice).

  • Foods with artificial sweeteners (sugar-free drinks, candy, and gum).

  • Carbonated drinks.

  • Cow's milk if lactose intolerance is suspected. Drink soy milk or rice milk.

Eat slowly and avoid swallowing a lot of air when eating. Do not restrict the fiber in your child's diet until you talk to your caregiver, even if you think it is causing some gas. In a small number of cases, a high fiber diet can be helpful for those with irritable bowel syndrome and gas.

Medications

  • Simethicone is available in many forms, including infant's drops and gas relief.

  • Beano is available as drops or a chew tablet. It 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 lactose intolerance, it may help if he/she takes a lactase enzyme tablet to help him digest milk. This is an alternative to avoiding cow's milk and other dairy product. Newer versions of these tablets can even be taken just once a day.

SEEK MEDICAL CARE IF:

  • There is no improvement with any of the treatments listed above.

  • The symptoms seem to be getting more frequent and more intense.

  • Your child develops pain with urination or any other urinary symptoms.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child vomits bright red blood, or a coffee ground appearing material.

  • Your child has blood in the stools, or the stools turn black and tarry.

  • Your child has an oral temperature over 102° F (38.9° C), not controlled with medicine.

  • Your baby is older than 3 months with a rectal temperature of 102° F (38.9° C) or higher.

  • Your baby is 3 months old or younger with a rectal temperature of 100.4° F (38° C) or higher.

  • Your child develops easy bruising or bleeding.

  • Your child develops severe pain not helped with medicines noted above.

  • Your child develops severe bloating in the abdomen.