Most of the popular remedies for newborn gas, including gas drops, gripe water, and ritualistic burping, have surprisingly little scientific backing. The interventions that do show promise tend to be targeted and specific: certain probiotics for breastfed infants, lactase drops when transient lactose intolerance is suspected, and feeding-technique adjustments that reduce air swallowing. Understanding what the evidence actually says can save you from spending money on products that perform no better than a placebo and help you focus on the handful of approaches that might genuinely make a difference.
Why Newborns Are So Gassy in the First Place
A newborn’s digestive system is essentially a work in progress. The gut at birth is structurally complete but functionally immature: the muscular contractions that move food along are uncoordinated, enzyme production is still ramping up, and the microbial communities that help with digestion are only beginning to establish themselves. That immaturity affects motility, fermentation of undigested sugars, and the gut’s ability to process gas efficiently.
The colonization of the gut with bacteria plays a large role in how much gas a newborn produces and how well they tolerate it. Disruptions to normal colonization patterns can alter immune and neural development in the gastrointestinal tract and, particularly in preterm infants, have been linked to more severe digestive complications.1PubMed Central. Development of the Gastrointestinal Tract in Newborns as a Challenge for an Appropriate Nutrition: A Narrative Review In practical terms, this means that two newborns on the same feeding regimen can have very different experiences with gas, depending on their individual gut maturity and microbial makeup.
Infants born by cesarean section appear to face a higher risk of early gastrointestinal disturbances such as colic, reflux, and constipation, consistently associated with reduced microbial diversity and delayed colonization by key beneficial bacteria like Bifidobacteria and Bacteroides.2PubMed Central. Gastrointestinal consequences of cesarean section birth: A systematic review of short- and long-term effects in infancy and beyond If your baby was born via C-section and seems unusually gassy or fussy, this is one plausible contributing factor, though it resolves on its own as the microbiome matures over the first months of life.
Does Burping Actually Help?
Burping after feeds is one of those parenting rituals so deeply embedded in the culture that questioning it feels almost heretical. But the only randomized controlled trial on the topic found that burping did not significantly reduce colic events in healthy term infants followed up to three months. What it did do was significantly increase regurgitation episodes.3PubMed. A randomized controlled trial of burping for the prevention of colic and regurgitation in healthy infants A 2025 review of the evidence on aerophagia and eructation in newborns confirmed this, noting that current data show no benefit of burping in preventing colic and a possible increase in spit-up.4PubMed Central. Science of the burp: understanding aerophagia and eructation in newborns
This does not mean you should never burp your baby. If a baby seems uncomfortable mid-feed and pausing to hold them upright for a minute or two makes feeding easier, that is a perfectly reasonable response. The point is that prolonged, vigorous patting on the back as a gas-prevention strategy has no evidence behind it, and you should not feel guilty for skipping it if your baby seems content. The research base here is thin (one trial of 71 mother-infant pairs), so the honest answer is that nobody has studied this enough to say much definitively either way.
Gas Drops (Simethicone) Do Not Work
Simethicone, the active ingredient in most over-the-counter infant gas drops, works by breaking up large gas bubbles into smaller ones in the gut. It sounds reasonable in theory. In practice, the evidence is quite clear: it does not outperform a placebo.
A multicenter randomized controlled trial found that whether an infant was receiving simethicone or a placebo, the likelihood of improvement, worsening, or no change was the same. Even when researchers isolated infants whose parents specifically reported “gas-related symptoms,” simethicone still showed no advantage over placebo.5PubMed. Simethicone in the treatment of infant colic: a randomized, placebo-controlled, multicenter trial A systematic review of systematic reviews echoed this, concluding that simethicone had moderate to low evidence showing no benefit.6BMJ Open. Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines An earlier systematic review in the BMJ similarly found that simethicone showed no benefit, a result that held even when only higher-quality trials were analyzed.7BMJ. Effectiveness of treatments for infantile colic: systematic review
Simethicone is at least safe, which is more than can be said for some alternatives. But when both the treatment and the sugar water placebo produce the same perceived improvements in symptoms, you are paying for the comfort of doing something, not for a pharmacological effect. The placebo effect in infant colic trials is consistently strong, likely because colic tends to improve on its own over time, and parents naturally interpret any improvement as a response to whatever they happened to try most recently.
Gripe Water Is Worse Than Useless
Gripe water occupies a strange position: it is enormously popular, widely recommended by well-meaning relatives, and has essentially no evidence supporting it. A cross-sectional study of infants aged one to six months found that gripe water administration did not appear to prevent infantile colic and was associated with vomiting and constipation.8PubMed Central. Gripe Water Administration in Infants 1-6 months of Age-A Cross-sectional Study Formulations vary widely between brands and countries, some historically containing alcohol or sodium bicarbonate, neither of which belongs anywhere near a newborn’s digestive system. There is no standardized formulation, no regulatory requirement to prove efficacy, and the ingredient lists on many products read more like herbal marketing than medicine. Skip it.
Probiotics Show Promise, With Caveats
Of all the interventions studied for infant fussiness and gas-related distress, the probiotic strain Lactobacillus reuteri DSM 17938 has the most interesting evidence. A double-blind, placebo-controlled trial found that breastfed infants with colic who received this strain had significantly less total crying and fussing time over 21 days compared with infants receiving a placebo. By the end of the treatment period, roughly three times as many infants in the probiotic group had achieved at least a 50% reduction in crying time compared with placebo.9PubMed. Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938
The picture gets murkier when you dig deeper, though. A study examining how L. reuteri colonization affected gut inflammation and crying found no difference in crying time between infants who were successfully colonized by the probiotic and those who were not. There was also no difference in calprotectin levels, a marker of gut inflammation.10Scientific Reports. Impact of Lactobacillus reuteri colonization on gut microbiota, inflammation, and crying time in infant colic This raises the question of whether the benefit seen in the positive trial was genuinely caused by the probiotic or reflects other factors, including the same placebo dynamics that make simethicone look effective to parents.
Most of the positive evidence for L. reuteri has come from exclusively breastfed infants, and the evidence for formula-fed infants is weaker and less consistent. If you are breastfeeding and want to try a probiotic, this particular strain has the best case behind it, but keep your expectations modest. You are unlikely to see a dramatic overnight change, and the honest scientific answer is that we still do not fully understand why some babies seem to respond and others do not.
Lactase Drops for Suspected Lactose Intolerance
Lactase drops represent one of the more targeted interventions for infant gas. The idea is straightforward: some newborns produce insufficient lactase, the enzyme that breaks down lactose in breast milk or formula, and the undigested lactose ferments in the gut, producing gas and discomfort. Adding lactase to feeds before giving them to the baby can reduce the lactose load.
A randomized double-blind trial found that infants receiving oral lactase had significantly shorter daily crying and fussing times after four weeks compared with those on placebo, with the lactase group averaging roughly 90 minutes of crying per day versus about 179 minutes in the placebo group.11PubMed Central. Oral lactase for infantile colic: a randomized double-blind placebo-controlled trial Two earlier studies found similar results: one showed lactase reduced crying by about an hour per day,12Journal of Human Nutrition and Dietetics. A trial of lactase in the management of infant colic and another found that pre-incubating feeds with lactase resulted in both lower breath hydrogen levels (a marker of lactose malabsorption) and at least 45% lower total crying time in roughly a quarter to a third of infants studied.13PubMed. Improvement of symptoms in infant colic following reduction of lactose load with lactase
The critical insight here is that lactase drops do not help every gassy baby. They help the subset whose discomfort is driven by transient lactose intolerance. The research consistently suggests that infant colic has multiple causes, and lactose intolerance is one of them in a meaningful minority of cases. If your baby’s gas and fussiness seem consistently tied to feeds and you have ruled out other causes with your pediatrician, lactase drops are worth a trial. They are safe, available without a prescription in most countries, and the response, if your baby is in that subset, tends to be noticeable within a couple of weeks.
How Bottle Choice and Feeding Technique Matter
For bottle-fed infants, how they feed can matter as much as what they are fed. Research comparing feeding teats with and without an anti-colic venting system found that standard (non-vented) teats caused disruptions in sucking when the bottle vacuum was released by air entering from the baby’s mouth. This forced the baby to suck at a higher frequency to rebuild oral vacuum, which in turn increased the risk of swallowing air. Vented teats produced a more coordinated drinking pattern, which the researchers suggested may have a positive effect on gastric distress.14PubMed Central. Sucking behaviour using feeding teats with and without an anticolic system: a randomized controlled clinical trial
Beyond bottle design, a few simple adjustments can reduce the amount of air a baby swallows during feeds:
- Paced feeding: Holding the bottle at a more horizontal angle and allowing the baby to control the flow rate, rather than tilting it vertically so milk pours in by gravity, gives the infant more natural pauses and reduces gulping.
- Proper latch: Whether breast or bottle, a shallow latch that allows air to sneak past the seal is a major source of swallowed air. For bottle-fed babies, the nipple should be fully in the mouth with lips flanged outward.
- Upright positioning: Feeding with the baby’s head slightly higher than the stomach allows air bubbles to rise and be released more easily.
These are low-cost, zero-risk adjustments that address one of the most straightforward mechanical causes of gas. They will not help if the problem is gut immaturity or lactose intolerance, but they are a reasonable first step before reaching for any product.
The Myth That Maternal Diet Causes Infant Gas
If you are breastfeeding and your baby is gassy, someone in your life has almost certainly told you to stop eating broccoli, onions, garlic, or beans. Surveys confirm that this belief is widespread: in one study of over 1,200 breastfeeding women, 77% were avoiding specific foods or beverages, with the most commonly cited reasons being the baby being unsettled, having gas, colic, or excessive crying.15PubMed. Dietary Changes Among Breastfeeding Mothers Qualitative research has found that most mothers believe infant cry-fuss behavior is directly linked to what they eat, despite scientific evidence to the contrary.16PubMed Central. “Something is wrong with your milk”: Qualitative study of maternal dietary restriction and beliefs about infant colic
The physiology here is clear: gas is produced by bacterial fermentation of fiber in the mother’s colon. Gas and fiber do not pass into breast milk. Strong flavors like garlic can change the smell and taste of breast milk, but studies have found that infants of mothers who eat garlic actually tend to feed longer, not less. Infants rarely react to specific foods in the maternal diet, and the few foods that have been observed to occasionally trigger reactions differ from one infant to another, making blanket dietary restrictions for all breastfeeding mothers unreasonable.17PubMed Central. Maternal food restrictions during breastfeeding
The one legitimate exception involves cow’s milk protein. A small percentage of breastfed infants have a genuine sensitivity to cow’s milk protein that passes through breast milk, and in these cases a maternal elimination diet removing dairy can make a measurable difference. But this is a specific immune-mediated reaction, not a vague “gassy food” phenomenon, and it should be explored with a pediatrician rather than through scattershot dietary restrictions that leave the mother nutritionally depleted and stressed.
When a Formula Switch Makes Sense
For formula-fed babies with persistent gas, excessive crying, and signs of cow’s milk protein allergy (such as blood or mucus in the stool, eczema flares, or vomiting in addition to gas), switching to a hydrolyzed formula can be genuinely helpful. In a study of infants with confirmed cow’s milk allergy, switching to an extensively hydrolyzed casein-based formula led to significant decreases in symptom scores for crying and regurgitation within 14 days.18PubMed Central. Tolerance and growth in children with cow’s milk allergy fed a thickened extensively hydrolyzed casein-based formula Formula alternatives for infants with confirmed or suspected cow’s milk allergy include hydrolyzed cow’s milk formula, rice-based formula, soy-based formula, and amino acid-based formula, all of which are nutritionally adequate substitutes.19PubMed Central. Formula choices in infants with cow’s milk allergy
The key word here is “confirmed or suspected allergy.” Switching formulas because a baby seems gassy, without any other symptoms pointing toward allergy or intolerance, is one of the most common and least productive things parents do. Hydrolyzed formulas are expensive and often taste worse, leading some babies to feed less, which creates a new set of problems. A formula switch should be a deliberate decision made with medical guidance, not a panic response to a bad Tuesday evening.
Infant Dyschezia and Why Straining Is Not Always a Problem
Many parents become alarmed when their newborn turns red in the face, grunts, strains, and draws their legs up, assuming the baby is constipated or in pain from gas. In many cases, what they are actually seeing is infant dyschezia: a normal developmental phase in which the baby has not yet learned to coordinate relaxing the pelvic floor muscles while bearing down to pass stool. The result looks distressing, but the stools themselves are soft and normal once they do come out.
Dyschezia is easily mistaken for constipation, and distinguishing between the two matters because the treatments are completely different.20Pediatric Gastroenterology, Hepatology & Nutrition. The New Rome IV Criteria for Functional Gastrointestinal Disorders in Infants and Toddlers Constipation in a newborn involves infrequent, hard stools and may require medical attention. Dyschezia involves normal stools preceded by a lot of dramatic straining and typically resolves on its own as the baby’s nervous system matures, usually within a few weeks. Rectal stimulation (a common folk remedy involving thermometers or cotton swabs) can actually delay the resolution of dyschezia by preventing the baby from learning the coordination on their own.
Physical Comfort Measures That Cost Nothing
While the evidence base for most commercial gas remedies is disappointing, several hands-on techniques have logical mechanisms behind them and carry no risk. Gentle abdominal massage, applying light pressure with your fingertips in a clockwise circular motion around the belly, follows the direction of the colon and can help move trapped gas along. A study on premature infants found that abdominal massage improved markers of gut blood flow and feeding tolerance, though this was in a clinical setting with very young preterm babies rather than healthy full-term newborns at home.21PubMed Central. The effects of enteral feeding improvement massage on premature infants: A randomised controlled trial
Bicycle legs, where you gently move the baby’s legs in a cycling motion while they lie on their back, apply rhythmic pressure to the abdomen and can sometimes help release gas. Tummy time during awake, supervised periods also puts gentle pressure on the belly. None of these have been tested in rigorous randomized trials for gas specifically, but they are free, safe, and many parents find them helpful. The honest framing is that they are reasonable things to try, not that they are proven to work.
When to Actually Worry
Most newborn gas is a nuisance, not a medical emergency. But some symptoms warrant a call to your pediatrician rather than another trip to the pharmacy:
- Bloody or mucus-laden stools: This can indicate a cow’s milk protein allergy, an infection, or other conditions that need evaluation.
- Vomiting that is forceful or bilious: Green-tinged vomit in a newborn can signal a bowel obstruction and needs urgent attention.
- Failure to gain weight: A baby who is gassy and not gaining weight may have an underlying feeding or absorption problem.
- Abdominal distension that feels firm or tense: A soft, slightly rounded belly is normal. A rigid, distended belly is not.
- Fever in an infant under three months: Gas with a temperature above 100.4°F (38°C) in a newborn always needs medical evaluation, regardless of how minor the gas seems.
The vast majority of gassy newborns are healthy babies whose digestive systems are simply maturing. Colic, which is functionally defined as excessive crying in an otherwise healthy infant, peaks around six weeks of age and almost always resolves by three to four months without any intervention at all. The difficulty, of course, is that three months of a screaming baby feels like an eternity, and “wait it out” is profoundly unsatisfying advice when you are operating on two hours of sleep. The evidence, frustratingly, suggests that patience combined with targeted interventions where appropriate is more effective than the shotgun approach of trying every product on the pharmacy shelf.