Newborn Belly Concerns: Is My Baby's Big Tummy Normal?

A newborn baby with a big belly can be a normal part of their development, but it can also be a sign of a more serious health issue. Newborns tend to have larger bellies because their intestines are longer than their abdomen, and their abdominal wall muscles are not yet fully developed. This means their bellies will protrude more than their body size, and they will appear to have a big belly. This is usually nothing to worry about, and as the child grows, their height will increase faster than their intestine, causing the abdomen to slim down. However, an enlarged belly can also be a sign of digestive issues, constipation, or more serious conditions such as congenital gastrointestinal malformations, renal tumours, or intestinal obstruction. If your baby has not had a bowel movement in 12-24 hours, or is vomiting, it is important to call your pediatrician.

Newborns' big bellies are usually normal

Newborns with big bellies are usually perfectly healthy. A newborn's belly is typically larger in proportion to the rest of their body because their intestines are relatively long, and their abdominal wall muscles are not yet fully developed. As a result, a newborn's belly will often protrude and stick out, especially after eating.

A newborn's large belly is usually a normal physiological phenomenon, and there is often no cause for concern. However, it is important to monitor your baby's health and behaviour to ensure that their large belly is not a sign of an underlying health issue.

A newborn with a big belly is likely healthy if they are active, eating well, sleeping well, and gaining weight at a normal rate. You can also assess your baby's digestive health by observing their stool. During the first six months, a baby's stool will typically be liquid and lilac or mustard-yellow in colour. On average, a newborn will have a bowel movement about three to four times per day if they are breastfed, and every one to two days if they are formula-fed.

If your baby's stool is normal, you can be reassured that their big belly is likely just a normal part of their development. However, if your baby has not had a bowel movement in 12 to 24 hours, or if they are vomiting, it is important to contact your paediatrician. Although this is usually a sign of gas or constipation, it could indicate a more serious issue.

When to worry about a newborn's big belly

A newborn baby's belly is often quite large in proportion to the rest of their body. This is perfectly normal, and usually nothing to worry about. However, in some cases, it can be a sign of a more serious health issue.

Physiological causes

A newborn's belly may be large because they have just had a full feed. Their belly will likely feel quite soft, not tight, between feeds. Another reason for a newborn's big belly is that their intestinal structure is too big for their body. This is normal and will resolve as the child grows and their height increases relative to their intestine length.

Digestive problems

If your newborn's big belly is accompanied by other symptoms, it may indicate a digestive problem. Repetitive nausea, for example, can indicate intestinal disturbances. If your baby is constipated, or has not had a bowel movement in 12-24 hours, or is vomiting, you should call your paediatrician. A distended abdomen that is hard to the touch, accompanied by vomiting and a lack of bowel movements, could be a sign of gas or constipation, but it could also be something more serious.

Hernias

An umbilical hernia occurs when part of a child's intestines bulge through the abdominal wall inside the belly button. This is quite common, affecting about 20% of babies, and usually closes on its own by the time the child is 4 or 5 years old. If it doesn't close by this time, or if it becomes incarcerated (cannot be massaged back into place), surgery may be required.

Other health issues

A large belly in a newborn can be a sign of a life-threatening condition. Congenital gastrointestinal malformations and renal tumours are not uncommon in newborns, and can lead to intestinal necrosis or perforation. If your baby's belly is large and they are displaying other symptoms such as crankiness, pain, or discoloured skin, seek medical attention.

Tips to relieve a gassy baby's discomfort

It is normal for newborns to have big bellies as their digestive systems are still developing. However, an enlarged belly could also be a sign of digestive pathologies. If you are concerned about your baby's big belly, it is important to consult a doctor.

Burp your baby

Burping your baby can help release swallowed air before it reaches their bowels. Try burping your baby halfway through feeding and again after feeding. If you are bottle-feeding, burp your baby after every 2-3 ounces, and if you are breastfeeding, do so every 5-10 minutes.

Feed your baby before meltdowns

Crying causes your baby to swallow more air, leading to increased gas. Learn your baby's early hunger cues and feed them before they become too hungry and frantic.

Bicycle their legs

Lay your baby on their back and gently move their legs in a bicycling motion towards their tummy to help push out trapped air.

Encourage tummy time

Tummy time helps strengthen your baby's muscles and relieve gas. Wait at least 20-30 minutes after feeding before placing your baby on their tummy to avoid spitting up. Always supervise your baby during tummy time and do not put them to bed on their stomach.

Give your baby a massage

Massaging your baby's tummy in a circular motion can help them pass gas. Start with their tummy and then gently rub their shoulders, back, and legs.

Check your diet if you are breastfeeding

Certain foods in a breastfeeding mother's diet may cause gas in the baby. Some common culprits include dairy products, caffeine, onions, garlic, spicy foods, and cabbage. Consult your doctor or pediatrician before making any dietary changes.

Try gas relief products

Over-the-counter gas relief products such as gripe water or gas relief drops can help soothe your baby's tummy. Always check with your baby's doctor before introducing any new products.

How to recognise if a big belly is due to physiology

A big belly in newborns can be a normal part of their development, but it can also be a warning sign of digestive issues.

• Feeding habits: A big belly is often a normal physiological phenomenon, especially after a full feed. Newborns tend to have bigger bellies after eating, and this is usually nothing to worry about. However, between feedings, their bellies should feel quite soft, not tight.
• Intestinal structure: Newborns' intestines are relatively long compared to the size of their abdomen, and their abdominal wall muscles are not yet fully developed. As a result, their bellies may protrude more than their body size. This is typically a temporary situation, as the child's height will eventually catch up, and the abdomen will return to its normal size.
• Digestive activity: Observe the baby's poop. For breastfed newborns, stools are typically liquid, viscous, and lilac or mustard green, with about 3-4 bowel movements per day. Formula-fed babies, on the other hand, tend to have solid stools and a lower frequency of bowel movements, typically once every 1-2 days. If the child has these typical digestive signs without abnormal phenomena like crying, loss of appetite, or fullness, the big belly is likely due to physiology.
• Overall health: If the newborn is developing healthily and normally, gaining weight appropriately for their age, sleeping well, and has a healthy appetite, a big belly is likely part of their normal growth.

While a big belly in newborns is often physiological, it is important to monitor the baby's health and behaviour. If there are additional digestive symptoms, such as repetitive nausea, vomiting, or constipation, or if the baby shows abnormal signs such as crying, loss of appetite, or fullness, consult a doctor to rule out any potential health issues.

What to do if your baby hasn't pooped in a while

A big belly in newborns can be normal or could indicate a dangerous health condition. In the former case, the baby's belly may be big because they are full or because their intestinal structure is too big for their body. In the latter case, a big belly could be a sign of digestive problems or other health issues.

Now, here's what to do if your baby hasn't pooped in a while:

There is a range of what's considered healthy when it comes to how often a baby should poop. As long as your baby is feeding as expected and gaining weight (1 to 2 pounds a month), don't worry about the number of poops. Some babies 2 months or older poop once a day or more, while others poop once every few days or even once a week.

Pooping frequency depends on what your baby is eating

If your baby is only being breastfed, they may not poop every day. After the first 3 to 6 weeks, they can go even a whole week without a poop. If your baby is formula-fed, they should poop at least once every couple of days, but this can vary from daily to several times a day.

What to do if your baby is passing gas but not pooping

Your baby is still learning how to digest food, so this is normal. There are several reasons why your baby might not be pooping, and in most cases, it's not something to worry about. However, if your baby is formula-fed, poops less than once a day, and appears to be straining, talk to your doctor as it could be a sign of constipation.

Causes of gassiness but not pooping

Constipation can make your baby pass gas without pooping. On the other hand, your baby might get gassy between poops without being constipated. Babies sometimes swallow air, which can lead to gas, and some babies are just naturally gassier than others!

When to call your doctor

• If your newborn baby (under 6 weeks old) is not pooping at all, call your doctor immediately.
• If your baby is older than 6 weeks and has not had a poop for longer than a week, call your doctor.
• If your baby has constipation with hard stools more than once or twice, call your doctor.
• If your baby is formula-fed, poops less than once a day, and appears to be straining, call your doctor.

Home remedies you can try (with your doctor's permission)

• Liquids: If your baby is over 6 months old, you can give them a few ounces of water.
• Food: If your baby is eating solids, give them fiber-rich foods like puréed prunes, sweet potatoes, or fruits to help them pass stool.
• Exercise: Move your baby's legs in a bicycle motion or hold them up so they are "walking" in your lap to help get their digestion moving.
• Massage and a warm bath: Try massaging your baby's stomach and body, and give them a warm bath to help them relax and get their digestion going.

Frequently asked questions