Baby Digestion Issues in the First Year

tummy trouble 2451

Most babies have healthy, functional digestive systems—even those who experience an occasional bout with gas, diarrhea or tummy pain. But because common digestive issues like spitting up, reflux, diarrhea, gas, constipation and changes in bowel movements top the list of new parent concerns, they’re worth addressing. 

“New babies mostly eat, poop and sleep, so anything that makes them fussier than normal often leads to an assumption that there’s a problem with the baby’s digestion,” says Uma K. Pisharody, MD, a specialist in pediatric gastroenterology. From the first poop to the first birthday, Dr. Pisharody answers questions about first-year digestion issues.

What are the top digestive issues you see in babies? 

Most babies who come to see me are brought in for fussiness or excessive crying. The vast majority of the time, the baby is otherwise fine.

The top issues I see and treat in babies are feeding problems, difficulty gaining weight, vomiting, changes in bowel movements like diarrhea or constipation, and reflux. Conditions like digestive tract birth defects or bowel obstructions are much less common.

What’s the first step you take when a new patient comes in?

I ask the parent or caregiver a lot of questions about feeding: What’s going on in the home during feeds, when do feeds occur, and how to feeds relate to fussiness or other symptoms. I then look for red flags that tell us there could be a digestive problem.

Those red flags could be forceful vomiting (noticeably more forceful than normal spit up), particularly vomit that has a fluorescent yellow/green color or blood, any blood in the poop, or problems with the baby’s growth. 

BABY SPIT UP
When it comes to spitting up, what’s normal? How much is too much?

There is actually no “normal” or “abnormal” amount of baby spit up, as each and every baby is different and it’s best not to compare babies to each other. What I look for first and foremost is whether or not there is any forceful vomiting; second, does the spit up contain bile or blood; and third, is the baby gaining weight?

If a baby spits up dozens of times [without the above issues] and is happy and growing well, I don’t consider that a problem. On the other hand, a baby could spit up just a few times each day, but if those issues are present, there could be something going on.

BREASTFEEDING MOM’S DIET
Does a breastfeeding mom’s diet create gassiness in her baby?

Byproducts of foods that cause a mother to have gas can also occasionally cause gassiness in her infant, but this type of gas typically shouldn’t cause severe pain. The gas produced within a mother’s own digestive tract after she eats certain foods doesn’t get passed through breastmilk. I tell mothers that it’s wise not to eat too much of any one food, but to eat a varied and healthful diet while breastfeeding. Broccoli, beans, and yes, even chocolate are often OK in moderate portions.

NEWBORN POOP
Newborn poop is already so watery—how can parents tell if their baby has diarrhea? 

When I examine diarrhea in newborns, I am looking for a significant change in frequency of bowel movements more than a change in consistency. If a baby who was having six watery bowel movements each day suddenly begins having 10 to 15, that’s probably diarrhea and worth a call to your pediatrician.

With constipation we look for changes not only in frequency, but also in consistency. A baby should pass the first black, sticky stool, called meconium, within 24 hours of birth. From there, a baby’s bowel movements will vary in frequency from many per day (for example, after each feeding) to as long as one every two weeks for breastfed infants; the latter is not typical, but can be normal. We look for changes in each individual baby’s routine: If a baby is having 3 to 4 stools each day and then starts going a few days between stools, or if the stools suddenly become firm, that’s something to bring to your healthcare provider’s attention. Until solids are introduced to a baby’s diet, we want bowel movements to be fairly runny.

COLIC
What is colic and how common is it?

Colic is inconsolable crying that starts around 1 to 4 weeks of age. Around 1 in 4 babies have it. It’s thought to result from immaturity of the nervous system, rather that digestive problems or gas as many parents assume.

GAS
What are signs that a baby is experiencing gas and how can caregivers help?

One way to tell that your baby’s discomfort is from gas is that the pain seems to be relieved by burping or passing gas. I haven’t found over-the-counter gas drops to be particularly helpful, but I don’t have a problem with them, if parents want to use them or find them helpful.

For babies, gas in the digestive tract is usually caused by swallowed air. Along with regular burping after feeds, I recommend working with a lactation consultant to improve a baby’s latch during breastfeeding to reduce air swallowed during feeding.

Gentle abdominal massage can help a baby who is experiencing gas pains. For a new baby, you can place the baby tummy-down on your lap, knees tucked in towards the chest, and gently massage the abdomen with your hands. This has the added benefit of lifting the baby’s bottom up, so gas rises upward and can more easily pass. For older babies, laying them on their backs and gently bicycling the legs can help.


RED FLAGS that Need Medical Attention
Contact your baby’s pediatrician if any of these symptoms are present:

  • Feeding aversion—an infant who seems disinterested or is opposed to feeding.
  • Baby is not gaining weight or growing. 
  • Prolonged jaundice—lasting longer than two weeks. 
  • Stools that lose the normal brown or yellowish color and become white or creamy could signal a problem with baby’s liver and bile ducts.
  • Belly distension, extreme or sudden fussiness, forceful and/or bilious or bloody vomiting or bloody stools. 

When in doubt, contact your provider with questions about your baby’s digestion. If you search for answers online, Pisharody recommends visiting www.gikids.org

Malia Jacobson is a health and family journalist.

___________________

How to Transition Back to Work After Maternity Leave

How to Transition Back to Work After Maternity Leave

Just as new moms are getting into the rhythm of parenthood, reality hits for those who work away from home and it’s time to go back. Here are strategies to help plan and manage the transition back . . .

Read more

Baby Digestion Issues in the First Year

Baby Digestion Issues in the First Year

Most babies have healthy, functional digestive systems—even those who experience an occasional bout with gas, diarrhea or tummy pain. But because common digestive issues like spitting up, reflux, . . .

Read more

The Benefits of Rapid Whole Genome Sequencing

The Benefits of Rapid Whole Genome Sequencing

It is estimated that 15 percent of infants and children in intensive care units are there due to an underlying genetic condition. Just a few years ago, many of these infants would pass away or go th . . .

Read more

Easy Games that Help Baby’s Brain Development

Easy Games that Help Baby’s Brain Development

Playing with your baby yields much more than adorable smiles. According to child development experts, simple games boost baby’s brain development, fostering growth in language, math, science and o . . .

Read more

Baby Sleep Challenges and When to Consider a Sleep Coach

Baby Sleep Challenges and When to Consider a Sleep Coach

When I was pregnant with my first son, I read at least 10 books about birth. Sure, I knew the birthing process would last a mere one to two days and I’d chosen a trusted provider to guide me throu . . .

Read more

Pregnancy and Baby Nutrition Impact Growth and Development

Pregnancy and Baby Nutrition Impact Growth and Development

  The World Health Organization found that a child’s nutrition in the first 1,000 days of life—from conception through age 2—has a substantial impact on physical and behavioral developme . . .

Read more

How to Support Oral Health in Babies and Toddlers

How to Support Oral Health in Babies and Toddlers

A little-known fact for many parents—when you test the temperature of your baby’s bottle with your mouth or share food, a straw, or a utensil with your toddler, you’re also sharing bacteria th . . .

Read more

San Diego Pediatricians, OB/GYNs and Midwives Recommended by Local Parents

San Diego Pediatricians, OB/GYNs and Midwives Recommended by Local Parents

Thank you to all the local parents who responded to our request for favorite pediatricians, OB/GYNs and midwives in San Diego County. Doctors and providers are listed alphabetically by organization, . . .

Read more

San Diego Babies and Toddlers

San Diego Babies and Toddlers

We teamed up with others in the community to create a new digital guide that has essential, up-to-date information for first-time parents and must-have resources for those who are expecting the seco . . .

Read more

What New Moms Need to Know about Breastfeeding

What New Moms Need to Know about Breastfeeding

For some new moms, breastfeeding comes naturally, but for others, it brings anxiety, fear, challenges and a lot of questions: Will I make enough milk? Will my baby latch? Will it hurt? Breastfeeding . . .

Read more

Baby Feeding & Nutrition: Introducing Solids

Baby Feeding & Nutrition: Introducing Solids

When baby is ready for solids her world expands to include meaningful family mealtimes, colorful messes and even bursts of excitement over new flavors. However, the solid food transition can be stre . . .

Read more

10 Sleep Strategies for Babies + Local Mom Advice

10 Sleep Strategies for Babies + Local Mom Advice

There’s one piece of sleep advice that serves parents best: Give your child the sleep support he needs, and no more. It’s that simple. Respond to his needs compassionately, and learn when to ste . . .

Read more

We Need Your Referrals for OB/GYNs, Midwives and Pediatricians

We Need Your Referrals for OB/GYNs, Midwives and Pediatricians

Tell us about your favorite obstetricians, gynecologists, midwives and pediatricians for our Mom-Approved Referral List!This is your opportunity to refer other parents to the best OB/GYNs, midwives . . .

Read more

10 Benefits of Exercise During Pregnancy

10 Benefits of Exercise During Pregnancy

Research clearly shows that women should exercise while pregnant. The benefits include not only emotional and physical improvement for mom, but healthy heart development for the baby as well. P . . .

Read more

Baby Product Review: In the Nursery

Baby Product Review: In the Nursery

Baby Product Review. New parents can choose from a variety of products that can make every day with that bundle of joy just a little easier. Feltman Brothers Velour Holiday Loungese$62.95;  . . .

Read more

San Diego Family Magazine Logo

Be Family Informed – Sign up for our Newsletters below!