From the Guidelines
For toddlers with abdominal bloating, the most effective treatment approach is to start with simple home remedies and over-the-counter options, as recommended by the most recent clinical practice update 1. When managing abdominal bloating in toddlers, it's essential to consider the potential impact on their quality of life and morbidity. The American Gastroenterological Association (AGA) Clinical Practice Update 1 provides best practice advice for clinicians, covering clinical features, diagnostics, and management considerations, including dietary, gut-directed behavioral, and drug therapies.
Key Recommendations
- Start with simple home remedies like gentle tummy massage, warm baths, and encouraging physical activity to help move gas through the digestive system.
- Offer smaller, more frequent meals and avoid common gas-producing foods like beans, cabbage, and carbonated drinks.
- Ensure your toddler stays well-hydrated with water.
- Over-the-counter options include simethicone drops (like Infants' Mylicon or Little Tummies) at a dose of 0.3-0.6 mL given up to four times daily after meals and at bedtime, which works by breaking up gas bubbles.
- Probiotics formulated for children may also help restore gut flora balance.
When to Consult a Pediatrician
If bloating persists beyond a few days, is accompanied by severe pain, vomiting, fever, or changes in bowel movements, consult a pediatrician promptly, as these could indicate more serious conditions like constipation, food intolerance, or infection 1. Most cases of toddler bloating are temporary and respond well to these simple interventions because their digestive systems are still developing and learning to process different foods efficiently.
From the FDA Drug Label
Use for the relief of pressure and bloating commonly referred to as gas The treatment for abdominal bloating in a toddler is simethicone (PO), which is used for the relief of pressure and bloating commonly referred to as gas 2.
From the Research
Treatment Options for Abdominal Bloating in Toddlers
- Medical treatment with prokinetics, rifaximin, lubiprostone, and linaclotide could be considered in the treatment of bloating 3
- Dietary intervention is important in relieving symptoms in patients with bloating 3
- Treatment of constipation and avoidance of nutrients that are highly fermentable or rich in fructose may also be beneficial 4
- Probiotics are another promising option for treating abdominal bloating 4, 5
- A non-pharmacological therapeutic approach, mainly based on hypnosis, is discussed in some centers 4
Factors to Consider in Treatment
- Impaired transit of gas, particularly in the small bowel, or visceral hypersensitivity may contribute to abdominal bloating 4
- Abnormal viscera-somatic reflexes promoting abdomino-phrenic dyssynergia and relaxation of the muscles of the abdominal wall may also play a role 4
- Diet, small intestinal bacterial over-growth, constipation, visceral hypersensitivity, and abdomino-phrenic dyssynergia are common etiologies to consider in evaluating and treating symptoms of bloating and distension 6
Therapeutic Approaches
- Reducing the volume of intestinal gas, increasing intestinal gas elimination, or reducing its production may be effective in treating functional abdominal bloating 5
- Modifying the composition of colonic flora through the administration of probiotics may also reduce the production of intestinal gas and alleviate symptoms 5