Postpartum with a Gassy Newborn: A Warm, Evidence-Based Guide for New Moms
You’ve just done an incredible thing. As you recover from birth and get to know your baby, gas, fussiness, and crying can feel overwhelming—especially when sleep is scarce. This guide offers compassionate, practical steps to help you soothe a gassy newborn while also caring for your postpartum body and mind. You’re not alone, and with a few steady tools, this phase can become more manageable.
What’s “Normal” in the First Weeks
Most newborns swallow air during feeds and cry more at certain times of day, typically peaking around 6 weeks and easing by about 3–4 months. “Colic” is prolonged crying in an otherwise healthy baby (often defined as 3 or more hours a day, 3 or more days a week, for at least 3 weeks) and frequently overlaps with gas symptoms. While distressing, colic and gas are usually benign and self-limited. Still, it’s important to watch for red flags (see below) and to use safe, soothing strategies while keeping sleep and feeding on track. (American Academy of Pediatrics [AAP])
How Gas Shows Up
Common signs include a firm belly, grunting, pulling legs up, arching, passing gas, crying during or after feeds, and brief settling after a burp. Gas can result from air swallowing (during crying or rapid feeds), immature digestion, or sensitivities. Sometimes reflux or cow’s milk protein allergy (CMPA) can mimic “gas.” Your pediatrician can help distinguish these.
Red Flags: When to Call the Doctor Urgently
Call your pediatrician or seek urgent care for your baby if there is a fever ≥100.4°F (38°C), green/bilious vomiting, blood in stool, persistent projectile vomiting, poor feeding, poor weight gain, extreme lethargy, a very distended/tense abdomen, or inconsolable high-pitched crying with illness signs. For you: heavy bleeding soaking a pad in an hour or passing large clots, fever, severe headache with vision changes, chest pain or shortness of breath, calf pain/swelling, painful breast with fever, or thoughts of harming yourself. (AAP; ACOG; CDC)
Feeding Strategies That Reduce Gas
Breastfeeding: Optimize Latch and Flow
A deep, comfortable latch helps your baby swallow less air. Try these steps:
Step 1: Position your baby tummy-to-tummy with you, nose level with your nipple, and wait for a wide-open mouth.
Step 2: Bring baby quickly to the breast (not breast to baby) so the nipple reaches deep toward the palate and more of the lower areola is in the mouth.
Step 3: Aim for a “laid-back” or reclined position if you have a fast let-down—gravity slows the flow and reduces gulping. (ABM Protocol on Hyperlactation)
Step 4: Pause to burp midway and at the end of feeds.
If you suspect a strong let-down or oversupply (baby coughing/sputtering at the breast, clicking sounds, short feeds with fussiness, very forceful milk spray), try one breast per feeding or reclined positions and consult a lactation professional (IBCLC) before making big changes. (Academy of Breastfeeding Medicine)
Bottle-Feeding: Pace the Feed
Paced bottle-feeding can slow intake and reduce air swallowing.
Step 1: Hold your baby fairly upright; support the neck but avoid tipping the head back.
Step 2: Hold the bottle more horizontal so the nipple is just filled with milk; use a slow-flow nipple.
Step 3: Tickle the baby’s lips with the nipple and let baby draw it in; avoid pushing the bottle into the mouth.
Step 4: Let baby suck for 20–30 seconds, then tip the bottle down briefly to pause. Resume, watching for cues.
Step 5: Stop when baby shows signs of fullness: slowing, releasing, relaxed hands. Don’t force the last ounce.
Burp after every 1–2 ounces. If you’re combo-feeding, paced bottle-feeding can also support breastfeeding by respecting satiety cues. (AAP)
Burping, Positions, and Gentle Moves That Help
Burping Techniques
Try several positions and see what works for your baby. Aim to burp:
• Breastfed: midway and after each feed. • Bottle-fed: every 1–2 ounces and at the end.
Over-the-shoulder: Hold baby upright with chin resting on your shoulder. Support the bottom and back; pat or rub upward from low back to shoulders for 1–2 minutes.
Sit-up burp: Sit baby on your lap facing sideways. Support the chest and chin with one hand (avoid pressure on the throat), and pat/rub the back with the other.
Across-the-lap: Lay baby tummy-down across your thighs with head slightly higher than hips; gently pat/rub. (AAP)
Positions and Motion
After feeds, hold baby upright for 20–30 minutes to allow air to rise and stomach contents to settle—especially if reflux is suspected. For wake-time comfort, try:
Bicycle legs: Lay baby on the back and gently move legs in a pedaling motion for 30–60 seconds.
Tummy pressure hold: While awake, hold baby on your forearm, tummy down, head supported, and gently sway.
Infant massage: Using warm hands and a small amount of safe oil, stroke the belly clockwise (the direction of digestion). Try “I-L-U” strokes: draw an “I” on the left side of baby’s belly, then an inverted “L” across the top from baby’s right to left and down, then an inverted “U” starting at baby’s right, over the top, and down the left.
Always place your baby on the back for sleep in a flat, empty crib or bassinet. Avoid inclined sleepers, car seats, or swings for routine sleep. (AAP Safe Sleep)
Soothing a Fussy, Gassy Baby
• Swaddling (for sleep until rolling starts) can reduce startle and promote calm. Make sure the hips can move and the swaddle is not tight around the chest. Stop swaddling at the first signs of rolling. (AAP)
• White noise or shushing mimics the womb and can be calming.
• Rhythmic rocking or walking can help release gas and soothe.
• A clean pacifier (once breastfeeding is well established, typically around 3–4 weeks) can help satisfy the need to suck and may reduce SIDS risk. (AAP)
What About Drops, Probiotics, or Diet Changes?
Simethicone and “Gripe Water”
Simethicone gas drops are considered safe but have not consistently been shown to reduce colic symptoms in studies; some families find them helpful, others don’t. Use as directed and discuss with your pediatrician. “Gripe water” and herbal remedies are not well regulated and lack evidence of benefit; some formulations have posed safety concerns—best to avoid unless your clinician recommends a specific product. (Cochrane; AAP)
Probiotics
Lactobacillus reuteri DSM 17938 has evidence of reducing crying time in breastfed infants with colic; benefits are less clear in formula-fed infants. If you try it, discuss dosing and duration (often 2–4 weeks) with your pediatrician. (Sung et al., Pediatrics 2018)
Maternal Diet and Formula Options
Routine diet restriction while breastfeeding isn’t necessary. If your baby has signs suggesting cow’s milk protein allergy (blood or mucus in stools, persistent eczema, vomiting, poor weight gain, family history of atopy), your clinician may recommend a 2–4 week maternal elimination of dairy/soy (if breastfeeding) or a trial of an extensively hydrolyzed formula (if formula-feeding). Reintroduction under guidance helps confirm whether dairy was the trigger. Don’t restrict your diet without a plan—your nutrition matters for recovery. (WAO DRACMA 2023; AAP)
Daily Rhythm: Simple Habits That Help
• Keep feeds calm and unhurried; watch baby’s cues rather than the clock.
• Offer frequent burp breaks; don’t worry if a burp doesn’t come every time.
• Track a few days of feeds, diapers, and crying to spot patterns (e.g., evening fussiness) and share with your pediatrician if concerns arise.
• For refluxy babies, smaller, more frequent feeds and upright holds can help. Avoid tight waistbands after feeds. (NICE; AAP)
Your Postpartum Recovery Matters
Rest, Fuel, and Fluids
Your body is healing. Aim for small, frequent meals with protein, fiber, and healthy fats; keep a water bottle where you feed. Accept help with meals, laundry, and baby holding so you can nap. Gentle walks and diaphragmatic breathing can aid recovery. If you had a cesarean or perineal repair, follow your care team’s wound and activity guidance. (ACOG)
Breast and Nipple Care
A deep latch protects nipples and helps milk transfer. Air-dry after feeds; use expressed breast milk or a simple lanolin or hydrogel if sore. Watch for clogged ducts (tender lump) and mastitis (fever, redness, flu-like feeling); feed or pump frequently, rest, hydrate, and call your clinician if fever or worsening pain occurs. (ACOG; AAP)
Mood and Mental Health
It’s common to feel weepy or overwhelmed in the first 1–2 weeks (“baby blues”). If sadness, anxiety, irritability, guilt, or hopelessness last beyond 2 weeks, interfere with daily life, or you have thoughts of harming yourself, reach out immediately—postpartum depression and anxiety are treatable. Talk to your obstetrician, midwife, pediatrician, or a mental health professional. In the U.S., you can call or text 988 for support any time. (ACOG; CDC)
Partnering with Your Pediatrician and Support Team
Bring your questions to well-baby visits—nothing is too small. Ask about weight gain, feeding efficiency, stool patterns, and safe sleep. Lactation consultants (IBCLCs), postpartum doulas, and parent support groups can offer hands-on help. If gas and crying are severe, persistent, or affecting feeding and growth, your clinician may evaluate for reflux, allergy, or other causes and tailor a plan.
Quick, Real-Life Plan for a Gassy Day
• Feed on early cues (rooting, lip smacking) to reduce frantic, air-gulping feeds.
• Breastfeed in a reclined position or pace the bottle with a slow-flow nipple.
• Burp midway and at the end; try two positions if the first doesn’t work.
• Hold upright 20–30 minutes after feeding; then offer a brief tummy time while awake.
• Use bicycle legs and a gentle clockwise belly massage before the next feed.
• For evening fussiness, dim lights, swaddle for sleep, use white noise, and walk/rock rhythmically.
• Keep sleep safe: on the back, flat surface, no loose items.
• If trying a probiotic or simethicone, track symptoms for 1–2 weeks and review with your pediatrician.
Encouragement for the Journey
This season is intense—and temporary. Your baby’s digestive system and your routines will mature. In the meantime, your loving presence, responsive feeding, and safe soothing are exactly what your baby needs. Take care of yourself, ask for help, and celebrate small wins. You’re doing beautifully.
References and Resources
• American Academy of Pediatrics (AAP), HealthyChildren.org: Colic and Crying; Gas in Babies; Burping Your Baby; Safe Sleep: Back to Sleep, Tummy to Play; Pacifiers and SIDS. https://www.healthychildren.org
• AAP 2022 Policy on Sleep-Related Infant Deaths: Summary for Parents on HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/a-parents-guide-to-safe-sleep.aspx
• Academy of Breastfeeding Medicine (ABM) Clinical Protocol #32: Management of Hyperlactation. Breastfeeding Medicine. 2020. https://www.bfmed.org/protocols
• Sung V, et al. Lactobacillus reuteri to treat infant colic: An individual participant data meta-analysis. Pediatrics. 2018;141(1):e20171811. https://pubmed.ncbi.nlm.nih.gov/29295805/
• Cochrane Review: Probiotics for managing infantile colic (and reviews on simethicone). https://www.cochranelibrary.com
• NICE Guideline NG1: Gastro-oesophageal reflux disease in children and young people: diagnosis and management (updated 2019). https://www.nice.org.uk/guidance/ng1
• World Allergy Organization (WAO) DRACMA Guidelines 2023: Cow’s Milk Allergy update. https://www.worldallergy.org
• American College of Obstetricians and Gynecologists (ACOG): Postpartum Care; Postpartum Depression. https://www.acog.org/womens-health
• Centers for Disease Control and Prevention (CDC): Depression During and After Pregnancy. https://www.cdc.gov/reproductivehealth/features/postpartum-depression/index.html