Babies be cray.
-Dr Young
The Black Magic Culture of Infancy
It’s just a fact. We all know that infants can’t tell us what’s bothering them and it can become an exhausting and frustrating guessing game of trying to figure out what your little guy needs. This game is worse for some parents/babies than others. And all parents of a “colicky” baby are nodding their heads. However, modern American society has sort-of embraced this culture of mystery (and parental helplessness) around infants. And I get it! Often times we never figure out what was keeping our baby up for so long at 3AM … but when that phase ends, we don’t care! But this kind of thinking encourages parents to embrace the feeling of helplessness. Often you hear parents saying (or you have said!) “I’ll try anything!”
My sweet sweet nephew JJ certainly gave my brother and sister-in-law a rough go in his first few months. He’s now outgrown his “colicky” phase, but in the midst of it, I remember my brother saying: “If a witch doctor told me that smearing poop on my door and running around my house naked would help … I would be naked right now!” Nasty mental image, but the point is clear!
Gripe water is often viewed as just such a “magic potion” that no one really understands. You even see this kind of language in the marketing! Well, I think parents deserve to know exactly why Gripe Water may help a baby. OR if Gripe Water doesn’t work – what information does that give you about your baby There’s a new thought! Either way, you should be able to get some useful knowledge about your angel if you understand exactly what you are giving her. The same goes for gas drops! So let’s get into the differences and details so we can all start getting to know our special and unique infant’s biology a little better.
This is a complete guide! It goes into a lot of detail because I think it’s all important information. So prepare your inner information-junkie for a treat (and maybe go pour a glass of wine).
I did a Happy Hour about this topic, so if you want to watch instead (and don’t mind the distraction of my crazy babies), here’s the video.
Here are the ingredients for two of the most popular brands of Gripe Water: “Little Remedies” and “Mommy’s Bliss”.
- Little Remedies: Zingiber officinale (ginger) root extract (5mg per serving), Foeniculum vulgare (fennel) seed extract (4mg per serving), purified water, agave, vegetable glycerin, glycerin, natural ginger flavor, potassium sorbate, citric acid, xanthan gum
- Mommy’s Bliss: Deionized Water, Vegetable Glycerin, Sodium Bicarbonate, Citrus Bioflavonoid Extract, Citric Acid, Potassium Sorbate, Organic Zingiber officinale (Ginger Root) Extract (5mg per serving), Organic Foeniculum vulgare (Fennel Seed) Extract (5mg per serving), Natural Fennel Flavor.
Here’s the nerd break-down of what you’re providing your baby, and why it may help:
Ginger Root Extract: Ginger has been used for centuries to help with all sorts of stomach and intestinal issues. Medically, it has been very well studied in the context of cancer patients receiving chemotherapy and pregnant women – who both deal with terrible nausea (1-4). Biologically, ginger improves gastrointestinal motility and increases gastric emptying rate (5). Translated to babies – this means ginger may help breast milk/formula empty out of the stomach and help the intestines keep things moving along steadily. All these sound like great things to me, and may truly provide relief to a baby suffering from digestive pain.
Fennel Seed Extract: Research has shown that Fennel Seed Oil reduces intestinal spasms and increases motility of the small intestines – which may encourage natural peristalsis (the natural rhythmic smooth movement of the intestines). There’s some pretty great research that shows fennel is one of the only treatments that may actually improve colic! (6, 7).
*In short, both ginger and fennel help intestinal muscles to relax and do what they are supposed to.*
Agave (or other sugar): Little remedies has Agave (which is fructose) in it. Other brands sometimes have sugar (or sucrose). This is not just for taste. There is extensive research showing that Sugar has a powerful analgesic effect on infants (8). It literally acts like a numbing agent! Fructose has the same effect (9). Parents (including myself!) often avoid sugar in medicines and foods, but Gripe Water is the rare exception where I actually prefer to see some sugar because of its medicinal properties in this age group. Plus, in these small doses, it is not contributing much to your baby’s caloric intake.
That’s research-proven. Here’s another reason I personally think sugar helps in Gripe Water. For certain types of babies, I think the sugar can act like a “Snap Out Of It!” slap. This is only relevant to a certain temperament. My Petey was a “drama-king” newborn. He was highly excitable, had an over-active startle reflex, was easily over-stimulated, and could work himself up to a screaming frenzy pretty quickly. Once he got so worked up, I swear he had forgotten whatever he started crying about, and now he was just crying because he was so worked up! This is when a little sugar may help. If you can get your baby to swallow some Gripe Water (which can be a challenge), it can snap them out of the screaming trance by distracting them with that sweet flavor and analgesic effect. When you see a video on YouTube of a baby instantly calmed by Gripe Water… this is why! Instant calming is too fast for ginger or fennel to have affected digestion. It’s the “Snap Out Of It!” and analgesic effects of the sugar that do this.
So, if Gripe Water works for you – pay attention to the timing. The timing of the effect will tell you something about what was bothering your baby in the first place. And remember, not all Gripe Waters have sugar in them.
Citric Acid and Sodium Bicarbonate: In essence, these are alkalizing agents. This means, they may help neutralize stomach acid. This will help if your little one is being bothered by excess acid coming back up that little esophagus. Citric acid can help decrease the acidity of the stomach contents, and is even used medically (in much much larger doses in adults) to de-acidify urine. It appears in other Gripe Waters as Sodium Citrate as well. Sodium Bicarbonate is the active ingredient in baking soda and is a quick acting antacid. Judging by the ingredient list, I guess that Mommy’s Bliss has more antacid properties than Little Remedies.
Excess consumption of sodium bicarbonate can cause the pH of your blood to go too high (this is called alkalosis). There was a case report published of a baby admitted for alkalosis that was caused by overconsumption of a Gripe Water with high concentrations of sodium bicarbonate (10). Don’t worry, she ended up being fine. But, this is why Little Remedies doesn’t use that ingredient anymore. So, be sure to check with your doctor and don’t exceed the maximum dosage. But in the appropriate dosages, a Gripe Water like Mommy’s Bliss may provide relief to stomach-acid-related discomfort, whereas Little Remedies probably won’t be effective if acid is the culprit. See how understanding the label may help you figure out what’s bothering your baby!
Other “inactive” ingredients – Here are the other ingredients that don’t have much impact on biology.
Glycerin is a clear viscous (which means thick like oil or honey) solvent. It’s in Gripe Water so the Ginger and Fennel extracts stay in solution. It also is relatively sweet (roughly half as sweet as sugar) which helps your baby accept the dose.
Potassium Sorbate is an antimicrobial preservative. It helps to keep bad bacteria from growing in this yummy sweet solution. This is pretty important since we don’t want to be giving our babies harmful bacteria accidentally!
Citrus Bioflavonoid Extract comes from citrus fruits (duh Bridget!). It is a powerful antioxidant and one of the reasons citrus fruit has health benefits. However, the research is relatively new, so I’m not going to say much more. I think it’s probably healthy for your baby but I can’t think of how it would have immediate impact on digestive distress. I’ve only seen this ingredient in the Mommy’s Bliss Gripe Water.
Last Potential Mechanism = The Placebo Effect – Hey, don’t knock the placebo effect if it works! I think some proportion of effectiveness of Gripe Water is due to placebo. Let me explain. Babies are very emotionally sensitive little creatures. They are very aware of their caregivers’ emotions, mood, and anxiety. If providing Gripe Water calms YOU down (because you are trying something new instead of just crying yourself … we’ve all been there!), this may calm your baby down! Anything that decreases your own anxiety can trickle down to calm your baby as well. But hey, if that works – then everyone’s happy! Win win!
Choosing Brands and Collecting Data
I gave two examples of Gripe Water since the ingredients can differ from brand to brand! So pay attention to the label in the store. The differences mean that one brand may work better for your baby than another.
For example, based on the ingredients, Mommy’s Bliss may provide more comfort to a baby with some acid-reflux issues because of the Sodium Bicarbonate. But, Little Remedies may provide more relief to an easily-overstimulated baby because of the agave. If one brand works for you and one doesn’t, what does that tell you about your baby’s biology?
Also, what does the timing of relief tell you?
- Instant relief suggests your baby needs a little help calming himself down.
- Relief 2 – 10 minutes later may suggest that the antacid effect helped soothe your baby.
- More delayed relief (more than 10 minutes) likely suggests that fennel and ginger helped calm the intestinal muscles so digestion and stooling could occur normally.
Use this info along with your intuition to figure out what the source problem was. You got this!
Gas Drops – Ingredients and Mechanism of Relief
So what about gas drops? As opposed to Gripe Water, which has lots of ingredients that all address different types of intestinal issues, gas drops have one active ingredient: Simethicone. The biggest name brand is Mylicon. Simethicone is an anti-foaming agent. Basically, it helps break up large bubble of gas into lots of smaller bubbles. Let’s get real and talk baby farts – because you know it controls your life anyway. Large pockets of air are tooted out in those explosive sounding, often loud toots. Simethicone can help change that gas to the more “machine gun” sounding gas that comes out as loads of tiny bubbles.
The idea is – smaller bubbles are easier to pass through the rectum, and are less likely to get “stuck” in the intestines. Simethicone works great if large bubbles of air are your problem. It can also be mixed right into the bottle, which is nice. Simethicone is also very safe and is just excreted with those toots/poop.
Babies are most likely to develop painful gas at night when they are laying still for a long period of time. I have clients who have had great luck mixing one dose of gas drops into the last bottle before bed. Simethicone is worthless to you if your baby is uncomfortable because he has some reflux, or he doesn’t like the new onesie you put him in. But then at least you know it isn’t gas!
Unlike Gripe Water, simethicone is universal in all gas drops that I have seen, so go ahead and save yourself some money and get the generic version!
Final thoughts on using Gas Drops and Gripe Water
That’s it! You’ve broken the magic spell over Gripe Water and Gas Drops! Turns out, it’s all just good-old-fashioned science! Now you can include these tools in your parenting toolbox to both treat your baby AND help figure out what is actually bothering your baby!
In closing, always check with your doctor about anything you give your baby. And also tell your pediatrician about what you learned about your baby from watching how they responded to either one.
Also, remember that your baby is always changing. He won’t have gas/reflux/colic forever. So, if Gripe Water or Gas drops have become a consistent part of your routine, try to have a weaning-off strategy since the underlying source of the problem will likely resolve itself as your baby matures.
Were you able to use gas drops or Gripe Water to learn something about your baby? I’d love to hear about it! Leave it in the comments!
Here’s to happy-digestion and easy-tooting,
xo Dr Young
References
1.Borrelli F, Capasso R, Aviello G, Pittler MH, Izzo AA. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol. 2005;105(4):849-56.
2.Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, Leeprakobboon K, Leelasettagool C. The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol. 2006;194(1):95-9.
3.Ghayur MN, Gilani AH. Pharmacological basis for the medicinal use of ginger in gastrointestinal disorders. Dig Dis Sci. 2005;50(10):1889-97.
4.Giacosa A, Morazzoni P, Bombardelli E, Riva A, Bianchi Porro G, Rondanelli M. Can nausea and vomiting be treated with ginger extract? Eur Rev Med Pharmacol Sci. 2015;19(7):1291-6.
5.Marx W, Ried K, McCarthy AL, Vitetta L, Sali A, McKavanagh D, et al. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review. Crit Rev Food Sci Nutr. 2017;57(1):141-6.
6.Alexandrovich I, Rakovitskaya O, Kolmo E, Sidorova T, Shushunov S. The effect of fennel (Foeniculum Vulgare) seed oil emulsion in infantile colic: a randomized, placebo-controlled study. Altern Ther Health Med. 2003;9(4):58-61.
7.Perry R, Hunt K, Ernst E. Nutritional supplements and other complementary medicines for infantile colic: a systematic review. Pediatrics. 2011;127(4):720-33.
8.Hatfield LA, Chang K, Bittle M, Deluca J, Polomano RC. The analgesic properties of intraoral sucrose: an integrative review. Adv Neonatal Care. 2011;11(2):83-92; quiz 3-4.
9.Akcam M. Oral fructose solution as an analgesic in the newborn: a randomized, placebo-controlled and masked study. Pediatr Int. 2004;46(4):459-62.
10.Feldon M, Bahat H, Gamsu S, Rosenfeld N, Bistritzer Z, Goldman M. Case 1: Recurrent Apneic Episodes in a 6-week-old Infant. Pediatr Rev. 2015;36(6):260-1.
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