Infant spit-up is a common occurrence that can be distressing for parents. About half of all healthy babies experience this phenomenon, often referred to as a “happy spitter,” because they are otherwise content and thriving. Gas drops are a popular product considered for this issue, as they are widely available for treating general discomfort and fussiness. This article examines the physiological differences between gas and spit-up to determine if gas drops can reduce the frequency or volume of regurgitation.
How Gas Drops Work to Relieve Discomfort
The active ingredient in most infant gas drops is simethicone, a non-systemic medication that works only within the gastrointestinal tract. Simethicone is classified as an anti-foaming agent. It works by breaking down large, trapped gas bubbles in the stomach and intestines into many smaller ones. This reduction in size allows the gas to be more easily expelled through burping or passing flatulence, relieving pressure, bloating, and abdominal discomfort. The medication is not absorbed into the baby’s bloodstream, making it safe for newborns when used as directed.
The Causes of Infant Spit-Up
Infant spit-up is primarily a plumbing issue, not a gas problem. The main physiological reason for regurgitation is the immaturity of the lower esophageal sphincter (LES), the muscle valve between the esophagus and the stomach. This muscle is responsible for sealing the stomach contents after a feeding, but in infants, its tone is weak, allowing stomach contents to flow back up the esophagus.
This mechanical failure is exacerbated by the small size of an infant’s stomach. Overfeeding, rapid feeding, or swallowing excess air can all contribute to volume and pressure in the stomach. The combination of a full stomach and a weak LES makes it easy for milk or formula to come back up. Most infants outgrow this issue as the LES muscle naturally strengthens, typically by 12 months of age.
Evaluating Gas Drops for Spit-Up Reduction
Gas drops are specifically formulated to target and break up gas bubbles within the digestive tract, an action that does not directly address the mechanical cause of spit-up. Since regurgitation is caused by the physical failure of the lower esophageal sphincter to close properly, a medication that only affects gas bubbles will not prevent stomach contents from flowing backward. Therefore, gas drops are not considered an effective treatment for reducing the frequency or volume of spit-up.
However, there is an indirect link between gas and regurgitation. When a baby swallows excessive air during a feeding, those air bubbles increase pressure inside the stomach. As the air is released through a burp, it can sometimes bring liquid contents up with it. In these specific cases, gas drops may indirectly lessen spit-up by helping to eliminate these air bubbles more quickly, thus reducing pressure in the stomach. Research studies have generally not found simethicone to be reliably effective for treating colic or reflux, suggesting any perceived benefit for spit-up is minor and not the intended use of the medication.
Non-Medication Strategies for Managing Spit-Up
Caregivers can implement several strategies to help manage and reduce the incidence of spit-up.
- Feed the baby smaller amounts more frequently to prevent the stomach from becoming overly full and putting pressure on the weak sphincter.
- If bottle-feeding, ensure the nipple flow rate is appropriate to minimize the amount of air the baby swallows.
- Burp the infant multiple times throughout the feeding, not just at the end, to release swallowed air before pressure builds up.
- After a feeding is complete, hold the baby upright for a minimum of 15 to 30 minutes to allow gravity to assist in keeping the stomach contents down.
- Avoid active play or placing pressure on the baby’s abdomen immediately after a meal, such as with a tight diaper or car seat harness.