Hiccups are very common in babies and children. The diaphragm is a muscle that governs the respiratory function, performing a regulatory task by separating the thoracic cavity from the abdominal cavity through movements that allow an adequate amount of air to enter the lungs. In young babies, this muscle is still immature, and any stimulus causes the diaphragm to react, manifesting as hiccups.
Hiccups affect 80% of babies and generally do not represent any illness or cause for concern. They tend to disappear as the diaphragm matures around 6 months of age, and hiccups become less frequent. Hiccups do not bother babies; even babies in the womb around 7 months gestation exhibit what is called fetal hiccups, which are not worrisome but rather a sign of vitality.
Poor feeding technique causes the baby to swallow air, which takes up extra space in the stomach, causing it to expand and press against the diaphragm or phrenic nerve, stimulating the diaphragm to spasm, producing hiccups. As the air is expelled or moves into the intestines, the stomach stops pressing against the diaphragm, stopping the stimulation and ending the hiccups.
When the baby feeds but does not latch properly to the breast, they swallow air; or if bottle-fed, the baby can swallow air if the bottle is not held at an angle that keeps the nipple filled with milk or if the nipple holes are too large or too small.
Tips to prevent hiccups
- Use a good feeding technique to prevent air from entering between the baby’s mouth and the nipple or bottle teat. For breastfeeding babies, ensure a proper latch so the nipple and most or all of the areola are in the baby’s mouth with lips flanged outwards, preventing air from entering the stomach. For bottle-fed babies, make sure no air enters between the nipple and the baby’s mouth.
- Use an anti-colic nipple or bottle, which also helps prevent hiccups.
- Keep the bottle at an angle that ensures the nipple is always full of milk, so milk flows instead of air, maintaining a constant milk flow.
- Avoid delaying feeding time so the baby is not too anxious and can feed slowly. Always take breaks during feeding; even if the baby does not want to pause, you should pause at least halfway through the bottle and burp the baby.
- Overfed babies often get hiccups after feeding.
How to relieve hiccups
Hiccups usually last between 5 to 10 minutes, but if you want to stop them you can try the following:
- Burp the baby.
- Give a little cold water.
- Tickling the nose gently with a cloth to provoke a sneeze.
- Change the baby’s position.
- Massage the back with circular movements of your palm; the baby can be lying on their stomach or held against your chest; or place them on their back and massage the belly to help release swallowed air during feeding.
- If this is not enough, while the baby lies on their back, flex their legs toward their abdomen so the knees press against their belly, reducing stomach space and helping expel accumulated air.
When to be concerned
Hiccups indicating illness are rare, but consult your pediatrician if any of the following symptoms occur:
- Hiccups happen daily, even multiple times a day.
- The baby does not gain weight or has difficulty gaining weight.
- Hiccups occur at any time of day, not just after feeding.
- Hiccups cause discomfort making the baby cry or choke.
- The baby cannot suck properly.
- The baby cannot take food from a spoon.
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