Last updated on Jun 11th, 2021 at 11:51 am

It’s the middle of the night and your newborn’s been crying for hours on end. She’s fed, clean and doesn’t have a temperature, so now what? Although babies wail for many different reasons, an uncomfortable moan, involving cramping or pulling the legs in towards the chest might be linked to tummy troubles.

ALSO SEE: Newborn health basics

Your newborn’s digestive system

“Before birth your baby receives nutrients and excretes waste products through the placenta, but after birth this all changes,” explains Johannesburg-based paediatrician Dr Dewald Buitendag. “Your baby’s untrained digestive system must now suddenly change to an active and effective system which is supposed to handle about 500ml milk per day at one week of age, which can come with a fair share of complications.”

Babies are born with sterile intestines, making them more vulnerable to infections. Fortunately, within hours after natural birth they receive healthy bacteria (mostly from the mom’s vagina), which protects them from harmful organisms. But C-section moms should note the following, says paediatrician Dr Deon Smith: “To be colonised by the same bacteria as mom, skin-to-skin contact immediately after birth is crucial.” Breast milk contributes enormously to a healthy gut and is the preferred method of feeding in the early stages.

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ALSO SEE: Seeding – the new birth trend where doctors swab newborn babies with a mother’s vaginal fluid in the hope that it will boost their immune system. 

Symptoms of a troubled tummy

  • Poor weight gain
  • Not interested in feeding
  • Constipation
  • Vomiting or reflux
  • Gas and cramps.

Fussy feeding

According to Dr Buitendag, babies with an immature digestive system may feed slowly, swallow too much air while sucking or vomit from time to time. This can result in a 10% birth weight loss in the first week. Dr Smith agrees: “Often newborns have difficulty swallowing and struggle to digest milk.”
Dr Buitendag adds that air sometimes gets trapped in the tiny intestinal tract, causing bloating and tummy cramps.

ALSO SEE: Vomiting after breastfeeding – when to be concerned


Sometimes it can take a while for the normal squeezing motion in your baby’s tummy to settle into a rhythm. Until this happens, milk can sit in the stomach and then come back up in a reflux action.

Some newborns haven’t sufficient enzymes to assist digestion and absorption of milk. This can contribute to reflux. It can also be caused by the undeveloped valve between oesophagus and stomach, which will cause him frequently to spit up or vomit. It’s not painful, but can cause heartburn if stomach acid enters the oesophagus.

Most cases of reflux disappear between four and 12 months. However, the following symptoms may indicate you should see your doctor:

  • Poor feeding
  • Congestion and breathing problems.

ALSO SEE: How to cope with your baby’s acid reflux

Could it be colic?

“Although it’s not unusual for babies to cry for up to two and a half hours at a time, parents still feel stressed out,” says Dr Smith.

Many moms assume their newborns’ endless crying is linked to colic, but even doctors aren’t sure what causes the condition. Although research suggests several possibilities – allergies, lactose intolerance, maternal anxiety and overstimulation – it’s still not clear why some babies have colic and others don’t.

ALSO SEE: Everything you need to know about colic

“Mothers who are at their wits end, come to see me with their crying babies, convinced that I need to treat them for colic,” says Dr Smith.

“So we go through a process of elimination, where I ask them if there’s a pattern to their baby’s crying. In many cases, newborns are overstimulated after being passed around from person to person at a social event, or simply being out of the house for too long. So, by around 6 p.m. (when the crying is at its worst), their tolerance to a wet nappy, tiredness or hunger has run out and they end up screaming for various reasons.”

Although it could be colic, it’s important to interpret your baby’s cries, observe if there is a pattern and go through a checklist to determine if it’s linked to digestive problems. Rather than feel desperate and alone, see your doctor for comfort and support, if necessary.

Colic update

Although colic is difficult to diagnose, a study published in the Journal of Pediatrics discovered a link between a bacterium called klebsiella (usually found in the skin, mouth and intestines) and colic.
A study of 36 babies, half of whom had colic, found the bacterium and gut inflammation in the intestines of the babies with colic. “We believe that the bacterium may be sparking an inflammatory reaction, causing the gut inflammation,” said the study’s lead investigator.