What’s in Gripe Water? Ingredients, Risks & Dosing

Gripe water is a liquid supplement given to fussy infants, and its ingredients vary widely by brand because no single standardized formula exists. Most versions contain some combination of herbal extracts, sweeteners, and sodium bicarbonate, though older and overseas formulations sometimes still include alcohol. The lack of regulation means that what you get depends entirely on who makes it, and the clinical evidence behind any of these ingredients is thinner than the packaging suggests.

What Is Actually in the Bottle

Walk down the baby aisle and you will find gripe water sold as a dietary supplement, not a drug. That distinction matters because it means manufacturers do not need to prove the product works before selling it, and formulations are not held to the same standards as over-the-counter medicines. The U.S. Food and Drug Administration does not approve gripe water, and the ingredient lists differ from brand to brand.

That said, most commercial gripe waters share a few common categories of ingredients:

• Herbal extracts: Fennel seed is the most common, but ginger root, chamomile, lemon balm, dill, and peppermint also appear. Fennel has a long folk history of use for digestive complaints, and lab studies have documented various biological activities including anti-inflammatory and antispasmodic properties.¹
• Sodium bicarbonate: Essentially baking soda, added to neutralize stomach acid. This is one of the more controversial ingredients because of its potential side effects in very young infants.
• Sweeteners: Sugar, fructose, or agave syrup are used to make the product palatable. Some formulations use artificial sweeteners instead.
• Preservatives and flavorings: Citric acid, vegetable glycerin, natural flavors, and sometimes sorbic acid or citrus seed extract appear on labels as inactive ingredients.
• Alcohol: Traditional British gripe water recipes contained alcohol, and some formulations sold outside the U.S. still do. Most products marketed in the United States today are labeled alcohol-free, though this was not always the case.²

The lack of standardization is the central problem. Two bottles both labeled “gripe water” can have entirely different active ingredients at different concentrations. One brand might rely on fennel and ginger with no sodium bicarbonate; another might be built around sodium bicarbonate with only trace herbal flavoring. When parents say “gripe water worked for us,” there is no way to know which ingredient, if any, deserves the credit.

Fennel, the Star Ingredient

Fennel seed oil is the ingredient with the closest thing to actual clinical data behind it. One randomized, placebo-controlled trial found that a fennel seed oil emulsion eliminated colic in about 65% of treated infants, compared to roughly 24% in the placebo group.³ No side effects were reported in that trial. A separate study comparing fennel essence directly with gripe water syrup found both reduced crying time with similar effectiveness by the end of a week, with neither outperforming the other.⁴

These results sound promising, but they come with major caveats. Both studies were small. The fennel oil emulsion used in the first trial was a controlled preparation with a known concentration, not the variable extract you get in a commercial gripe water bottle. And fennel’s documented pharmacological properties in lab settings do not automatically translate to meaningful effects when diluted into a sweetened infant supplement. The gap between “fennel oil works in a controlled trial” and “this particular gripe water product works” is larger than most parents realize.

Why the Sodium Bicarbonate Deserves Scrutiny

Sodium bicarbonate is the ingredient pediatricians tend to worry about the most. The idea behind its inclusion is straightforward: if stomach acid is causing discomfort, neutralizing some of that acid should help. The problem is that infant kidneys are immature, and sodium bicarbonate introduces risks that simply do not apply to adults taking an antacid.

In young infants, sodium bicarbonate can cause a condition called metabolic alkalosis, where the blood becomes too alkaline. It can also lead to elevated sodium levels in the blood, and there is a rebound effect where the stomach responds to the neutralization by producing even more acid afterward.² For a baby who weighs a few kilograms, even modest amounts of sodium bicarbonate represent a proportionally large dose. The fact that newborn kidneys have reduced function and difficulty regulating fluid balance makes this especially concerning.⁵

Not every gripe water brand includes sodium bicarbonate, so if you are already using or considering gripe water, this is an ingredient worth checking the label for. Some brands have dropped it in response to these concerns.

The Sugar and Alcohol Problem

Sweeteners in gripe water serve a practical purpose: babies accept sweet liquids more readily. But giving sugary supplements to infants under six months raises its own concerns. Early and repeated exposure to sweet liquids can interfere with breastfeeding, as babies sometimes develop a preference for the sweeter taste. Sugar also feeds oral bacteria, which matters once teeth start coming in.

Alcohol is a more alarming ingredient, and while it has been largely phased out of U.S.-market gripe waters, it persists in some formulations sold internationally. Older recipes contained enough alcohol to effectively sedate a fussy baby, which was the real reason the product “worked” in previous generations. Alcohol in any amount is unsafe for infants and can cause intoxication and developmental harm.² If you are purchasing gripe water from an international market, online reseller, or while traveling abroad, check the label carefully for alcohol content.

Does Gripe Water Actually Work

The honest answer is that no one has proven it does, at least not by the standards used for medicines. There is no large, rigorous clinical trial demonstrating that any commercially available gripe water product reduces colic symptoms more than a placebo. The fennel oil data discussed earlier comes closest, but again, those studies used standardized preparations, not off-the-shelf gripe water.

A real-world survey of over 1,200 parents in Israel found that those using an herbal colic product reported fewer symptoms and perceived the treatment as successful in about 65% of cases, with most improvements noticed within 30 minutes.⁶ Parent-reported surveys like this are interesting but scientifically weak. Parents who chose to give a remedy and then noticed improvement were reporting their own impressions, without blinding or a control group. This is exactly the kind of setting where a phenomenon called “placebo by proxy” becomes relevant.

Placebo by proxy describes what happens when a caregiver’s belief that a treatment is helping leads them to perceive improvement in the child, and possibly even to behave differently toward the child in ways that genuinely do soothe them. When a parent administers gripe water, feels reassured that they have done something, and then holds the baby more calmly or relaxes their own tension, the baby may actually cry less. But the improvement comes from the change in parental behavior, not from the liquid in the bottle.⁷ This is not a criticism of parents. It is a real, documented effect that makes it genuinely hard to tell whether infant colic remedies are doing anything pharmacological.

Colic Usually Resolves on Its Own

One reason gripe water has such a loyal following is that parents start using it during the worst of the crying and then the crying gets better. This looks like cause and effect, but the timing is misleading. Infant colic follows a well-documented pattern: distress typically begins to increase around two weeks of age, peaks around the sixth week, and then declines on its own by about 12 weeks.⁸ Individual babies vary in their timing, but the general arc is the same. Any remedy introduced during the peak is going to look like it helped, because the natural trajectory is downward from that point.

Emerging research suggests that colic may involve gut inflammation and shifts in the infant’s gut microbiome that affect brain function and development.⁹ If that is the case, a remedy would need to actually modify the gut environment to have a real effect, which is a much higher bar than simply neutralizing some stomach acid or providing a sweet taste.

How Gripe Water Can Undermine Breastfeeding

An often overlooked risk of gripe water is its impact on exclusive breastfeeding. The World Health Organization recommends nothing but breast milk for the first six months, and introducing any other liquid, even a supplement marketed as “natural,” counts as a disruption. A cross-sectional study of infants aged one to six months found that gripe water administration was a common practice and a significant barrier to exclusive breastfeeding.¹⁰

The mechanism is partly behavioral and partly physiological. A baby who fills up on a sweetened liquid may nurse less enthusiastically at the next feeding, which can reduce milk supply over time. In cultures where gripe water use is widespread, it can become a routine supplement that gradually replaces feeding sessions rather than complementing them. For parents committed to breastfeeding, this is worth weighing against whatever short-term soothing benefit gripe water might provide.

Dosing and Administration

Because gripe water is sold as a dietary supplement, dosing instructions on the label are manufacturer recommendations, not clinically validated doses. Most brands suggest giving half a teaspoon to a full teaspoon, often before or after feedings, and many specify not to exceed a certain number of doses per day. These instructions vary by product and by the baby’s age and weight.

A few practical points are worth noting. Gripe water should never be given to a newborn under two weeks old, and many pediatricians recommend waiting until at least one month. The product should be administered slowly with an oral syringe, not poured into a bottle of formula or breast milk, because mixing it in disguises how much the baby is actually consuming and can alter the osmolality of the feed. Hyperosmolar feeds pose a risk to immature infant kidneys and can cause gastrointestinal problems.⁵

If you do choose to use gripe water, introduce it in the smallest recommended amount and watch for any reaction: rash, increased fussiness, vomiting, or changes in stool. Allergic reactions to herbal ingredients, while uncommon, have been documented. And because these products are not standardized, switching brands means starting over with an essentially new product.

Alternatives With Stronger Evidence

If your baby has colic and you want to try something with more clinical support, the probiotic Lactobacillus reuteri DSM 17938 has the most robust evidence base. A meta-analysis of randomized controlled trials found that this specific probiotic strain reduced daily crying time by roughly 40 to 50 minutes per day compared to placebo after two to three weeks of use.¹¹ A separate systematic review using network meta-analysis confirmed that L. reuteri and dietary approaches both significantly outperformed other interventions.¹² One trial reported that daily crying time dropped from over three hours to about 30 minutes in the probiotic group, with treatment success in all infants receiving the probiotic compared to about 16% in the placebo group.¹³

The probiotic data is especially interesting in light of the emerging gut-microbiome theory of colic. If colic really does involve microbial imbalance in the infant gut, then a targeted probiotic makes more biological sense than neutralizing stomach acid or delivering diluted herbal extracts.

Simethicone, another popular over-the-counter colic remedy, fares poorly in the evidence. A systematic review of reviews found moderate to low evidence showing no benefit from simethicone.¹⁴ A Cochrane review reached a similar conclusion, finding no difference in daily crying hours or treatment response rates between simethicone and placebo.¹⁵ Despite this, simethicone drops remain one of the most commonly purchased colic products. Their continued popularity is probably another example of natural resolution being mistaken for treatment effect.

Dietary changes can also help in certain cases. For breastfed infants, maternal elimination of cow’s milk protein sometimes reduces colic symptoms, particularly when the baby has other signs of cow’s milk sensitivity. For formula-fed infants, switching to a hydrolyzed protein formula may help. These dietary approaches performed well in the same network meta-analysis that favored probiotics.¹²

Gripe Water Around the World

Gripe water originated in England in the 1850s, and its use spread throughout the British Commonwealth. It remains deeply embedded in infant care traditions in parts of Africa, South Asia, the Caribbean, and the Middle East. In a study of infant colic management in Lagos, Nigeria, about two-thirds of infants with colic were treated through self-medication rather than medical consultation, and gripe water was one of the two most frequently used products, given to over 40% of self-medicated infants.¹⁶

In many of these settings, gripe water is not just one option among several. It is the culturally expected first response to a crying baby, recommended by grandmothers, neighbors, and sometimes even healthcare workers. The formulations available in these markets can differ substantially from what is sold in the U.S. or Europe, sometimes containing alcohol, higher sodium content, or herbal ingredients with less safety data. For families navigating between cultural expectations and pediatric advice, the conversation around gripe water can feel loaded. Understanding what is actually in the product and what the evidence says makes it easier to have that conversation honestly.