Tommy's PregnancyHub

Your premature baby's digestion

Premature babies may have more digestion problems at home because their digestive systems are not fully developed. Your health visitor or GP can help.

Wind

Breastfed and formula-fed babies can sometimes get trapped wind. When your baby swallows, air bubbles can become trapped in their tummy and cause a lot of discomfort. These signs include:

  • crying
  • arching their back
  • drawing their legs up to their tummy
  • clenching their fists.

It will help to wind or burp your baby after (and sometimes during) a feed. NHS has more information about winding positions.  

Constipation

Constipation makes it harder for your baby to poo. 

Usually, formula-fed babies poo at least 3 times a week. Newborn babies who are breastfed may poo at each feed in the early weeks, but after about 6 weeks they may not have a poo for several days. If your baby is having a poo less often than this, their poo is dry or smelly and they seem uncomfortable, they may be constipated. 

Talk to your health visitor if you think your baby has constipation. You can help your baby by lying them on their back and gently moving their legs as if they’re riding a bicycle. If you’re feeding them baby formula, you could try giving them a little cooled, boiled water between milk feeds. 

Baby massage may also help with a baby’s digestion issues. Find out more about baby massage

If your baby’s constipation doesn’t get better, the GP will examine them and may give them laxatives to help them poo.

Reflux

Reflux (gastro-oesophageal reflux, also called posseting) is when the contents of the stomach come back up into the food pipe or mouth. It’s different from vomiting because you won’t see your baby tense their muscles and the milk comes up very easily.  

Reflux is very common in babies under 3 months, but it usually stops by the end of the first year. If your baby is putting on weight, they won’t usually need any treatment. 

Your baby may have reflux if they: 

  • cry or choke during a feed 
  • refuse feeds
  • regularly bring up milk during or after a feed
  • are in discomfort after a feed or just before they are due their next feed.

If your baby has these symptoms but they don’t bring up any milk, they may have silent reflux.  

Reflux can be stressful for parents. Your GP or health visitor can help you find ways to cope with reflux. For example, keeping your baby upright for an hour after feeding may help. If you’re using formula, you could give them smaller, more frequent feeds. 

Contact your GP if your baby: 

  • often vomits forcefully (projectile vomiting)
  • has vomit that is stained green or yellow or has blood in it
  • first starts having reflux symptoms after the age of 6 months
  • carries on having reflux symptoms after the first year
  • seems unwell, for example they have a high temperature or seem drowsy.

The GP will check your baby to see if they need treatment or whether something else could be causing their symptoms. 

Colic

Colic is when a healthy baby cries for more than 3 hours a day, 3 days a week, for at least 3 weeks. The crying can start and stop suddenly with no obvious cause.  

Colic is common. It sometimes starts when babies are a few weeks old and usually stops by the age of 4–6 months. Your baby may go red in the face, clench their fists, arch their back or pull their knees up. It can feel like nothing you do seems to help. 

The cause of colic isn’t clear, but it may be linked with babies’ immature digestive systems making it hard for them to digest their food. Other possible causes include food intolerances or allergies. Burping your baby during and after feeds may help. You could also try sitting your baby up during feeds so they swallow less air. 

If you think your baby has colic, the GP will check their overall health to see if there’s an obvious cause. Most babies do not need to be referred to the hospital unless there are other signs that they are unwell or if the colic is getting worse. 

Having a colicky baby can be exhausting and upsetting. Your health visitor can give you advice on coping. Friends and family may also be able to help, for example by looking after your baby while you rest. Try to remember that colic is usually just a phase and it often improves as your baby gets older. 

Ways to soothe your crying baby 

  • Keep the room quiet and dimly lit.
  • Cuddle them while they’re crying or give them kangaroo care (skin-to-skin care). 
  • Take them for a drive or a walk in the buggy.
  • Give them something to suck.
  • Gently push their knees into their tummy in a cycling motion, to help with wind.
  • Swaddle them.
  • Rock them or gently walk around the room with them.
  • Bathe them in warm water.

More information

Cry-sis support for parents with crying and sleepless babies.

NHS Start4Life has information on constipation, reflux and colic.
 

NHS Start 4 life. How to breastfeed. https://www.nhs.uk/start4life/baby/breastfeeding/how-to-breastfeed/burping-your-baby/

NHS. How to change your baby’s nappy. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/ (Page last reviewed: 8 August 2018. Next review due: 8 August 2021)

NICE (2010) Constipation in children and young people: diagnosis and management. Clinical guideline 99. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg99

NHS Start4life. Breastfeeding challenges: reflux. https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/

NICE (2015) Gastro-oesophageal reflux disease in children and young people: diagnosis and management. NICE guideline 1. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng1
  
NHS Start4life. Breastfeeding challenges: reflux. https://www.nhs.uk/start4life/baby/breastfeeding/breastfeeding-challenges/reflux/

Gordon M, Gohil J, Banks SSC. (2019) Parent training programmes for managing infantile colic. Cochrane Database of Systematic Reviews 2019, Issue 12. Art. No.: CD012459. DOI: 10.1002/14651858.CD012459.pub2.
 
NICE (2006) Postnatal care up to 8 weeks after birth. Clinical guideline 37. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/cg37