Abdominal pain in babies - what really helps

You are tired, your heart tightens because your baby is crying - and you ask yourself: Does it have a stomach ache?Abdominal pain in babies is common, and many parents are looking for the causes and for help. As a midwife and sleep coach for babies and children, I see it every day: shrill, inconsolable crying is one of the hardest things for parents. In this article, I explain it to you in a scientifically sound and practical way, Why babies get tummy ache (causes) and what safe help is available - and I'll show you why fatigue also plays an important role.

Quick answer first: Is this normal?

Yes - recurring, seemingly indefinite abdominal pain or colicky crying attacks are common in the first few months of life. frequently and usually clear up within weeks to months as the digestive and nervous systems mature. However, warning signs should be clarified by a doctor (see below).

How to recognise abdominal pain in a baby

Babies can't tell you what hurts - so watch out for signals:

• Heavy, persistent cryingoften in the evening ("evening colic").

• Leg movementsfrequent pulling of the legs towards the abdomen or rhythmic pedalling.

• Bloated, hard tummy; frequent farting.

• Pain mimicry: red face, frown, tense body.

• Changed feedingCrying when drinking or refusing food.

• Changed bowel movementsvery soft or very hard stools.
  If the symptoms are unusually severe (fever, bloody stools, "bloated, hard stomach"), please seek medical help immediately.

Why babies often have tummy ache - the most important biological reasons

1. an immature digestive system

Enzymes, motility (movement of the intestine) and control by the nervous system mature in the first few months. This can lead to cramps, slow digestion or irregular bowel movements.

2. the gut microbiome is under construction

Newborns only develop their intestinal environment gradually - in studies, babies with colic often show a different colonisation (more gas-forming bacteria, fewer protective bifidobacteria). This can increase inflammatory markers and contribute to discomfort.

3. food intolerances are possible, but rare

A genuine cow's milk protein allergy (CMPI) or other immune-mediated reactions can cause abdominal pain - this does occur, but is not the most common cause. If this is suspected, a specialist investigation is advisable.

4. psychosocial factors and stress

Parental stress, overstimulation or a tense atmosphere affect babies. Studies show links between parental stress/prenatal stress and increased digestive problems in babies. Your baby senses when you are tense - this can exacerbate symptoms.

The underestimated factor: fatigue (and why it can increase stomach ache)

Often overlooked - but central: Fatigue makes babies more irritable, lowers their tolerance for discomfort and can massively increase crying behaviour. If a baby misses the sleep window, the body releases stress hormones (cortisol, adrenaline). This causes "high tension": instead of becoming tired and calm, the baby is agitated, difficult to calm down and sometimes seems completely over-excited - this can imitate or intensify abdominal pain.

Typical physical symptoms of overtiredness in infants

• Yawning, reddened eyelids, rubbing eyes

• Glazed or fixed gaze ("glazed look")

• Increased whining, loud, difficult to calm crying

• Body tension: tense back, bent backwards (back-arching)

• Appear "slap-happy" or hyperactive instead of tired

• Shorter, restless naps (catnaps)
  These signs will help you to intervene in good time and prevent the cycle of fatigue → stress hormones → heavy crying.

What really helps - evidence-based measures (practical & safe)

Here I have sorted the measures for you: what works immediately, what is supportive and what is scientifically proven.

First aid that often calms immediately

• Provide supportCloseness, skin-to-skin or with a sling/carrier. Physical contact promotes oxytocin and calms.

• HeatPlace a warm (not hot) hot-water bottle or cherry stone cushion on the tummy - many babies relax as a result.
• Cycling leg movementsGently move the legs towards the abdomen or "cycle" to release gas.
• Gentle abdominal massageClockwise, with little oil, at a calm pace - massage has a proven calming effect and can reduce colic symptoms.
• Upright posture during feeding & slower breastfeeding/bottle feedingReduces air swallowing and overfeeding. If you feed your baby with a bottle. Make sure that the teat hole is very small.

Medium to long-term: support that works

• Baby massage & soothing touchSystematic reviews show positive effects on crying time, sleep and bonding. A regular massage routine can therefore help.

• Probiotics (Lactobacillus reuteri)Meta-analyses show that certain strains (e.g. L. reuteri DSM 17938) for breastfed infants with colic can reduce the daily duration of crying - the effect on bottle-fed infants is less clear and not every preparation is the same. Discuss the issue with your midwife or paediatrician.
• Soothing rituals & sleep hygieneRegular sleep and breastfeeding windows prevent fatigue; this alone often significantly alleviates the symptoms.

Caution / little evidence

• Let it burpWaiting for the "burp" is a cultivated practice. But studies show that this does not lead to a reduction in abdominal pain. However, it cannot harm the baby either. 

My midwife's tip: 8-point instant routine for baby's tummy ache

1. Breathe calmly - your resting level helps.

2. Pick up baby, skin contact/carrying.

3. Check: Temperature, full nappy, visible bowel pain (hard, bloated tummy?).

4. Apply heat to the tummy (make sure that the baby does not overheat).

5. Gentle, calm abdominal massage (clockwise).

6. Bicycle" legs 1-2 minutes.

7. Quick breastfeeding/bottle check: Has your baby swallowed too much? Pause briefly, burp.

8. If overtiredness is visible: use a sleep window, calming ritual (dark, quiet, gentle rocking/rocking).

If you also experience fever, bloody stools, vomiting or apathy: take your baby to the paediatrician or paediatric clinic.

Your baby loves you

You're doing well - even if it doesn't feel like it right now. Your baby is attached to you, even if its reflexes make it "push away from you". Tummy aches and colic are an intense phase for many families, but often Temporary. Small, consistent measures (closeness, massages, respecting sleep windows) have a stronger effect than you think. If you like, I will be happy to accompany you personally: I will show you massage techniques, routines to prevent overtiredness and safe ways to calm down together.