Farts don’t hurt: The truth about gas

The Pediatric Insider

© 2012 Roy Benaroch, MD

“My baby seems gassy. Should I use Mylicon drops? My doctor says they don’t work, and I don’t want to give medicine unnecessarily. What else can I do?”

I wrote about this recently, though the post was a little bit silly. I’ll try again, seriously this time.

Little babies do seem gassy a lot. They squirm and fart and kind of ball up, and sometimes getting pretty upset. But one thing I know for sure: farts don’t hurt. They just don’t. They don’t hurt me, and they don’t hurt you, and I can’t imagine why they would actually cause pain in a little baby.

Though farts don’t hurt, they might feel kind of weird. To a little baby, all sorts of sensations are new: the feel of air on the skin, breathing, seeing, stretching out little legs– all of that’s new, and all of that might feel weird and surprising. I’m surprised, honestly, that newborns aren’t more upset, more of the time. Think about how you’d feel with all of this new stuff going on. Add on to that the perfectly normal (but new) feeling of gas burbling around and passing out, and you might get one worried little baby.

When little babies get upset, parents wonder what’s wrong, and what they ought to do about it. No one likes to see a baby cry! Drug companies know that, and are happy to provide a remedy. In this case, it’s a product called “simethicone”, the so-called “active ingredient” in Mylicon and dozens of other “gas medicines.”

Simethicone has been around a long time, as an anti-foaming agent. Add simethicone to a sudsy bath, and all of those little bubbles coalesce into a few larger bubbles. It can’t make the gas actually disappear or go away. But it can reduce the surface tension on the little bubbles, turning them into fewer, larger bubbles. (Simethicone, you’ll be happy to know, is used in industrial applications as an agent to reduce foaming from some soaps and detergents.)

But think about it: what possible good would it do to turn a bunch of foamy, little bubbles into a few larger bubbles? Are larger bubbles easier to pass? Would one large bubble “hurt” less than 100 small bubbles?

There are no human studies– none, ever– that have shown that simethicone helps with any symptoms in any people of any age. It does seem to help, some, with endoscopy procedures by reducing the little foamy bubbles that might make it hard to see through a scope. But that’s it. That’s the only situation in medicine where it might conceivably help in any way.

Simethicone does seem safe. There are no reported side effects, though at least one report suggests that giving simethicone to a baby might interfere with the absorption of other medications. Other than that, though, since it doesn’t do much of anything, it’s not surprising that there are no side effects. (As an aside: any ‘real’ medicine that has real, genuine biologic effects must have at least some side effects. If any sort of herb or homeopathic stuff is promoted as being free of any side effects, it’s because it has no biologic effects whatsoever.)

If it’s safe, why not try it? I suppose it’s OK to try, but my biggest problem with simethicone (and other placebos) is that it sends the wrong message to parents, and seems to contribute to a long-term philosophy of health and illness that I think is a big mistake. Gas,  farts, and most cases of newborn fussiness are not a medical problem. Babies with these symptoms should be evaluated to make sure there is nothing medically wrong, and then parents should be reassured and taught good soothing techniques. By encouraging the use of medicine for gas (and other benign, normal things humans put up with), we’re perpetuating the idea that all symptoms need medicine, and all problems need a medical approach. This is wrong, wrong, wrong. Parents shouldn’t be taught that their kids need medicine for every problem. What parents need is to make sure their kids are OK, and how to help them feel better when they’re upset, and the warning signs to look for that might mean the doctor needs to be contacted. What we don’t need is more parents relying on the medicine cabinet to solve their problems.

What about herbal and other more “natural” cures for gas? Those are, at best, just different placebos, and possibly something worse. Since there’s essentially no regulation of the market for “supplements”, parents have no idea what’s in those bottles. It’s probably just a nothing-safe-placebo, but who knows? If you’d like a placebo, at least choose one you know is safe. How about plain water? That’s exactly what homepathic products are.

Better yet, save your money. Stay away from Mylicon, and stay away from the “alt-med” cures too.

If you’ve got a fussy baby, your first step is to try to figure out if there’s a medical problem that needs to be addressed– I’ve written about that before. As long as there’s no medical issue, your best bet is calm, soothing things to help your baby relax. Often a tight swaddle, gentle rocking, a pacifier, and/or a white noise machine can be a big help. You’ll also need to make sure you get some rest and have someone else who can help give you a break during those long evenings! If mom (or dad) is having an especially hard time handling baby fussiness, they ought to talk to their own doctors about their own health problems—postpartum depression is very real, and can certainly contribute to making babies fussy and difficult. Fortunately, the weird feelings of “gas” go away by the time babies are about 3 months old, once they’ve gotten used to the normal sensations of their bodies. Until then, gentle & calm reassurance is the best “medicine.”

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Tags: fussy baby, gas, gassy baby, mylicon, newborn

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