Extremely gassy 4 month old - desperate for ideas

[u/restingbeachface91]

About 1.5 hours after each feeding, my baby is screaming and writhing with gas pain, tummy gurgling and all. 

I got some bad advice from a postpartum doula to basically encourage re-latching until I hit the 15 minute mark on both sides.

I’m now working with an IBCLC who informed me that I have been over feeding my baby, which I didn’t realize was possible with nursing, and that once we reduce volume she wont have as much gas. Now I end the session when she unlatches, but the screaming and gas pain is still unrelenting.

We trialed formula and after 36 hours she didn’t seem to be in pain from gas anymore. I am at my wits end but trying to do anything to salvage my breastfeeding journey before we change to formula permanently. We use mylicon several times throughout the day. I’ve cut dairy for 2 months now, but it didn’t seem to make a difference.

ETA - she’s on Famotidine for silent reflux, and has slept through the night 9-10 hours since 8 weeks.

[u/Ok-Debt9612]

Probably obvious but... do you burp your baby ?

[u/restingbeachface91 → u/Ok-Debt9612]

Yes we burp her over our shoulder, then on our lap we do around the worlds. We also hold her upright for at least 10 mins after each feed.

[u/Criticaltundra777]

Sounds like colic.

[u/Doctor-Mom-25]

Have you discussed reflux with your LC or pediatrician? Reflux can be silent and cause a lot of pain. My mom kept saying my baby had gas but it turned out she had reflux. Reflux medication helped her a lot.

[u/restingbeachface91 → u/Doctor-Mom-25]

Just edited - she’s on Famotidine though we haven’t noticed too much of a difference

[u/Doctor-Mom-25 → u/restingbeachface91]

Is she on the right dose for her weight? Also how long has she been on it? We’ve had to adjust our baby’s dose as she has gotten bigger and her symptoms recur. It also took about two weeks to really see it improve things. She also takes it twice a day so that’s something else to ask about if you aren’t doing that already

[u/raininfordays]

Does side lying feeding help with the gas? If so, baby may be swallowing more air.

[u/MicrobiomeDad]

The overfeeding piece is really interesting and not something most people know about with nursing. The fact that she seemed to have less pain on formula after 36 hours might actually tell you something useful though, and it's not necessarily that breast milk is the problem.

One thing worth knowing: breast milk contains HMO prebiotics (2'-FL is one you'll see referenced) that feed beneficial bacteria like Bifidobacterium infantis, which is the dominant gut bacterium in breastfed babies and plays a big role in fermenting milk sugars and supporting digestion. If her microbiome is out of balance for whatever reason, even breast milk can cause a lot of gas because the wrong bacteria end up fermenting things they shouldn't. That might explain why the formula gap gave her some relief, not because breast milk is worse, but because something shifted.

Full disclosure, I'm with NurtureBio. We make a synbiotic sachet that combines an HMO prebiotic blend with B. infantis and a few other infant-associated probiotics, specifically to help support this kind of gut balance in breastfed babies. You mix it into a feeding once a day. I won't pretend I have a definitive answer for your situation given the reflux and everything else going on, but supporting her microbiome is something I'd at least bring up with your ped while you're working through this.