Q. My 9-week-old gets the hiccups every day -- sometimes even two or three times a day. What causes the hiccups, and how can I prevent my baby from getting them?
A. Hiccupping is a harmless nuisance of the digestive system that can occur at all ages -- even in the womb. Hiccups are actually strong contractions or spasms of the diaphragm (the muscle that goes up and down when you take a deep breath). While seldom painful, and not usually a signal of an underlying medical problem, hiccups can be unsettling and startling for an infant. Here are some ways to ease your baby's hiccupping:
Keep a hiccup trigger diary. What situations seem to trigger the hiccups? Do they occur during or shortly after a feeding? Hiccups associated with feeding are quite common since the diaphragm muscle lies in close relation to the stomach. If you see a relationship between feeding and hiccups, try the following preventative feeding strategies.
* Feed twice as often and half as much. Overfeeding is a common cause of hiccups. If the stomach distends too fast or becomes too full, this can trigger the diaphragm muscle to go into spasms. When breastfeeding, try slowing down feedings, and stop and burp your baby as you switch from one breast to the other. Or, if you bottle-feed, pause halfway through the bottle, burp her, and then finish off the feeding a few minutes later.
* Reduce air swallowing. Besides gulping too much milk too fast, young infants typically swallow too much air during feedings, also distending the stomach. Review your latch-on techniques during breastfeeding: Be sure your baby's lips open wide and form a tight seal around your areola, not just the nipple. Listen to your baby: You will hear a lot of gulping and air swallowing if she's nursing too quickly and sucking in air. If bottle-feeding, tilt the bottle to a 45-degree angle so the air rises to the bottom of the bottle. Try a bottle with collapsible bag inserts -- these are designed to minimize air swallowing. Lastly, be sure to sit her upright in your lap (at a 30- to 45-degree angle) while feeding, as that will help prevent air from settling in the stomach. Keep her sitting up for at least twenty minutes after a feeding to allow any air to rise the top of the stomach, which will relieve pressure on the diaphragm and enable burping.
Could it be reflux? Persistent hiccups may also signal the possibility that your baby has gastroesophageal reflux (GER), a common and usually temporary condition in which babies regurgitate some of the stomach's contents up into the esophagus, triggering pain and often hiccups. Other clues that your baby could be suffering from reflux are painful night-waking, general "colicky" behavior, abdominal pain after feeding, and spitting up. If you suspect reflux, mention your concerns to your doctor.
For the most part, your baby's hiccups will decrease in frequency and severity as both she and her digestive system mature.