Gas and bloating can be normal in babies and children, but if it is persistent, uncomfortable, or combined with other symptoms, it may become problematic.
What is Gas?
Gas is simply air trapped anywhere in the intestinal tract, from the stomach to the colon. Gas can only be relieved at the top and the bottom of the digestive tract, through burping or flatulence. The air typically comes from two places: air that is swallowed with food/drink or normal swallowing, and gas that is produced by the digestive process itself.
What is Bloating?
When gas becomes trapped anywhere in the digestive tract, bloating may occur. A child may experience a swollen abdomen, may look “pregnant,” or may have an uncomfortable feeling of fullness. While bloating may be caused by other conditions, including excess fluid in tissues, in most cases it is caused by trapped gas in the digestive tract. Children who cannot burp or pass gas may become bloated. In addition, children with poor motility or structural abnormalities may trap gas in their digestive tracts. Some conditions, especially bacterial overgrowth, may also cause an increase in the amount of gas that is produced during the digestive process, causing bloating in the small intestine.
In large part, the treatment for gas and bloating depends on the cause of the problem. If the cause is unknown, the first step may be creating a diary outlining your child’s food, drink, or formula intake, to determine how symptoms relate to feedings. Foods/drinks that are gas-producing can be eliminated from the diet, or a different type of enteral formula may be used.
The following other treatments may also be used:
- Elimination of gas-producing foods, drinks, and formulas
- Elimination of foods, drinks, or formulas that cause intolerances, including food allergens, lactose or fructose, gluten in children with celiac disease, and other similar foods.
- Other dietary changes to find an optimal balance of fiber.
- Feeding or swallowing therapy, especially in children who have difficulty coordinating their swallows, to prevent air swallowing.
- Venting the feeding tube regularly or using a Farrell bag for continuous venting. This is especially necessary for children who have had a fundoplication surgery. See the sidebar for extensive information on venting.
- Motility medications or treatments to improve gastric emptying, constipation, and other motility problems.
- Probiotics to ensure optimal bacterial flora in the gut.
- Antibiotics and other medications for severe cases of bacterial overgrowth.
- Anti-gas medications, including simethicone drops, which break up gas bubbles, lactase enzyme supplements, or alpha-galactosidase supplements like Beano.
- Anti-reflux medications, since reflux often causes excess swallowing of air.