How to relieve baby gas without the guesswork

Most baby wind clears with better burping, slower feeding and a bit of pressure on the tummy. Hold her upright after every feed, check the latch or the bottle teat, and try the legs-up and tummy-down holds. Gripe water and colic drops have little evidence behind them, and some of what is sold here for wind should not go on a baby at all.

Gassiness peaks in the first couple of months and then eases. That is cold comfort at 2am, so here is what to do in the meantime.

Why babies are so windy

A newborn gut is new at its job. Digestion is slow, the muscle coordination that moves gas along is still developing, and she swallows air every time she feeds or cries. Air in, air stuck, discomfort, more crying, more air swallowed.

That loop is the whole problem, and breaking it anywhere helps.

Signs it is wind

• Legs drawn up towards the tummy, then kicked out straight
• A tummy that feels tight and sounds hollow when tapped
• Squirming, arching and grimacing during or just after a feed
• Fussing that stops the moment a burp or a fart arrives
• Trouble settling flat on her back soon after feeding

Hiccups belong here too. They are harmless and they often mean she took in air.

Burping, done properly

A handful of positions cover almost everything, and the one that works for your baby is the one you will end up using every time.

Over the shoulder. Upright against your chest, her chin past your shoulder, your hand supporting her bottom. Pat firmly and steadily between the shoulder blades. Very light taps rarely bring the air up.

Sitting on your lap. One hand supporting her chest and jaw from the front, her back straight. This one works well for babies who fall asleep over a shoulder.

Across your lap, tummy down. Her head slightly higher than her bottom, turned to the side. Pat or rub the back.

Burp partway through a feed as well as at the end, especially with a bottle. If nothing comes after a couple of minutes, put her down and try again in ten. A burp that will not come is sometimes not there.

Holds and movements that shift trapped gas

Bicycle legs. Lie her on her back and cycle her legs slowly. Then press both knees gently up towards her tummy and hold for a few seconds.

Tummy time while awake. Pressure on the abdomen helps gas move, and it builds the muscles she needs anyway. Always supervised, never for sleep.

A clockwise tummy massage. Flat fingers, light pressure, following the path of the large intestine. Avoid it immediately after a feed.

Upright carrying. Twenty minutes against your chest after a feed lets gravity do the work. Our notes on babywearing cover the airway checks that matter if she falls asleep there.

A warm bath. Relaxes everything, including her.

Feeding changes that prevent it

Prevention beats relief, and most wind is created at the feed.

If you are breastfeeding. A shallow latch lets air in around the seal, so check that her mouth is wide and her chin is pressed into the breast. A very fast let-down makes a baby gulp, which you can slow by feeding more upright, or by expressing a little first. Our page on milk supply covers oversupply, which produces exactly this picture.

If you are bottle feeding. Hold the bottle at a shallower angle so the teat stays full of milk rather than half full of air. Use a slower flow teat if she is gulping. Pace the feed with pauses, and sit her more upright than lying flat. Bottle feeding properly goes through teat sizes and winding.

Either way, do not let her get frantic before feeding. A baby who has been crying for ten minutes swallows air for ten minutes.

The remedies sold here, assessed

This is where a Singapore shelf differs from an American one, and where the advice elsewhere is no use to you.

Gripe water. A fixture in local pharmacies and in every grandmother's cupboard. There is no good evidence that it works. Some formulations contain alcohol, others sodium bicarbonate, neither of which belongs in a newborn. Read the label.

Simethicone colic drops. Generally well tolerated, and not shown to outperform placebo in trials. If you want to try them, nothing is lost beyond the price.

Yu yee oil and other medicated oils. Widely used here for wind, and the one item on this list that warrants real caution. These oils typically contain camphor and menthol. Camphor is absorbed through infant skin and is toxic in more than trace amounts, and families whose babies have G6PD deficiency, which every newborn in Singapore is screened for, are advised to be careful with menthol-containing products. Ask your paediatrician before you use one.

Probiotics. A Cochrane review of probiotics for excessive infant crying found the evidence uncertain, with a possible effect in breastfed infants. Worth discussing with a doctor rather than buying on a recommendation from a parenting group.

Massage oils generally. Plain, unscented, and never on a face or near a nose. Essential oils and eucalyptus preparations are not for infants.

When it is not wind

Some things look like gas and are not. Bring her in if you see:

• Blood or mucus in the stool
• Forceful or projectile vomiting
• Poor weight gain, or weight loss
• A temperature of 38°C or higher in a baby under 3 months
• A hard, swollen, tender abdomen
• Crying that nothing touches, for hours, in a baby who also seems unwell
• Eczema, diarrhoea and wind together, which can point to a cow's milk protein allergy

Reflux and colic both overlap with wind and are managed differently. Signs of colic and what helps is the page for the crying itself, and KKH runs the paediatric gastroenterology service your polyclinic would refer to.

Getting through the worst stretch

Evening fussiness is very common and it clusters in the first couple of months, which is also when you are most short of sleep. Take the shifts in turns if there is someone to take them with. Put her down safely in her cot and step onto the balcony for two minutes if you need to, because a baby crying in a safe place is fine and a parent at the end of their rope is not.

A confinement nanny or a grandmother will have her own method, usually involving oil and firm hands, and some of it genuinely soothes. The part to hold the line on is what goes on the skin. Everything else about a settled baby and a settled routine is worth borrowing, and our sleep guide picks up where the wind leaves off.