Gripe water: what's in it and does it work?

What gripe water is

Gripe water is a liquid sold in pharmacies and shops as a remedy for colic, wind (gas) and fussiness in babies. Its recipe goes back to the 1840s (Adhisivam), and in many families the habit is passed down: in one study, some mothers gave it because older relatives insisted (Jain and colleagues).

It isn’t a medicine in the usual sense. A 2015 study of gripe water use in India notes that it has neither been scientifically studied nor approved by drug regulators for use in babies, yet it’s freely available over the counter (Jain and colleagues).

What’s in it

There’s no single recipe. Ingredients vary from brand to brand, so the only way to know what’s in a bottle is to read the label. A 2012 letter in a pharmacology journal, which looked at brands sold in India, describes common ones (Adhisivam). Brands sold elsewhere may differ:

• Sodium bicarbonate (baking soda). The original recipe used it, but the letter points out that too much stomach acid is not a cause of colic, and that large, regular doses may upset the body’s acid balance.
• Herbs or herbal oils, often dill oil, in varying combinations. The letter warns that herbal does not automatically mean safe.
• Sugar. Many brands are sweet, which may be part of why a baby seems to settle. The letter notes that a high sugar content can harm erupting teeth.
• Alcohol, historically. The original formula contained alcohol, and some older products had as much as 9%. The letter says alcohol is no longer a common ingredient, but it’s worth checking the label.

Check the label for honey and sugar. Never give a baby under 12 months anything containing honey, because of the risk of infant botulism (NHS): see honey and botulism. The NHS also says to avoid food and drink with added sugar or sweeteners for children aged 4 and under.

What the evidence says

Very little research has looked at whether gripe water works, and what there is isn’t encouraging:

• The NHS says remedies for colic, such as anti-colic drops and herbal or probiotic supplements, are not recommended and there’s no evidence they help colic.
• The AAP says the cause of colic isn’t clear and there’s no one specific treatment. It says probiotics, gripe water or gas drops “may be worth a try”, but to discuss it with your pediatrician first.
• A 2015 study of 335 mothers attending a baby clinic in India found that babies given gripe water were more likely to have colic-like crying, vomiting and constipation than babies who weren’t. The authors concluded that gripe water did not seem to prevent colic (Jain and colleagues). This kind of study can’t prove that gripe water caused the problems, but it found no sign of benefit.

There are safety reports too. The 2012 letter describes a 9-month-old who became seriously ill after drinking gripe water contaminated with bacteria, and a 2007 FDA warning to throw away one gripe water product after a 6-week-old became ill from a parasite found in it (Adhisivam).

The letter also warns that gripe water given in the first 6 months may bring in germs and irritate a baby’s gut, and that, given soon after birth, it may delay breastfeeding and reduce the milk supply (Adhisivam).

Before you try it

If you’re thinking about gripe water, talk to your pediatrician, GP, health visitor or pharmacist first, especially if your baby is very young. Ask them:

• Could something other than colic be causing the crying?
• Is this product suitable for my baby’s age?
• Does it contain sugar, alcohol or honey?

Never give it in place of a breast milk or formula feed.

What usually helps with colic

Colic is when a healthy baby cries a lot for no obvious reason. The NHS describes it as crying more than 3 hours a day, 3 days a week, for at least a week, often in the afternoon and evening. It usually starts a few weeks after birth and stops by 3 to 4 months (NHS). The AAP says it can sometimes last until 6 months.

Things the NHS and AAP suggest:

• Hold or cuddle your baby when they’re crying a lot.
• Sit or hold your baby upright during feeds so they swallow less air, and wind (burp) them after feeds (NHS).
• Rock them gently, walk with them in a carrier, or push them in the pram.
• Try a warm bath, swaddling in a thin blanket, or gentle white noise.
• Don’t overfeed your baby: the AAP says it can make them uncomfortable.

If you’re breastfeeding, the NHS says you don’t need to change your diet. The AAP suggests talking to your pediatrician before cutting out any foods yourself. If you’re formula feeding, talk to your doctor before switching formula.

Look after yourself, too. If you’re feeling overwhelmed, it’s fine to put your baby down safely on their back in their cot or crib and leave the room for a few minutes, or ask another adult to take over (AAP). Never shake a baby: shaking can cause brain damage or death (AAP). In the UK, the Cry-sis helpline is free on 0800 448 0737, 9am to 10pm, every day (NHS).

For gas and tummy discomfort once your baby starts solids, see gas after starting solids.

When to call the doctor

Talk to your pediatrician, GP or health visitor, or call NHS 111, if:

• you’re worried about your baby’s crying, or nothing seems to help (NHS)
• your baby isn’t growing or putting on weight as expected (NHS)
• they still have colic symptoms after 4 months (NHS)
• your baby has a fever and seems very fussy or unwell (AAP)
• the crying comes with vomiting, poor feeding, weight loss, unusual sleepiness or signs of dehydration: the AAP says a baby with colic shouldn’t have any of these (if your baby is floppy, very sleepy or hard to wake, use the emergency list below)
• you’re finding it hard to cope (NHS)

When to call for emergency help

Call 911 or go to the emergency room if your baby:Call 999 or go to A&E if your baby:Call your local emergency number (such as 112 in Europe or 000 in Australia) or go to the emergency department if your baby:

• has swelling of the lips, face, tongue or throat, or trouble swallowing or breathing (NHS): see signs of anaphylaxis
• has a weak, high-pitched or nonstop cry, or a cry that doesn’t sound like their normal cry (NHS)
• is floppy, very sleepy, hard to wake, or not responding as usual
• is struggling to breathe, breathing very fast, or grunting
• has blue, gray, pale or blotchy skin, lips or tongue, or skin that feels cold or clammy
• has a rash that doesn’t fade when you press it
• has a seizure (fit)
• hasn’t had a wet diaper or peed in 12 hours
• is under 3 months old with a temperature of 38°C or higher, or 3 to 6 months old with 39°C or higheris under 3 months old with a temperature of 100.4°F (38°C) or higher and you can’t reach your doctor right away: the AAP says to call the doctor right away for a fever at this age

These signs come from the NHS and AAP. Trust your instincts: if you think something is seriously wrong, get help.

Where US and UK advice differs

• Remedies. The AAP says gripe water, gas drops or probiotics may be worth a try after you’ve talked to your pediatrician. The NHS says colic remedies aren’t recommended and there’s no evidence they help. In both countries, ask first.
• Who to ask. In the US, call your pediatrician’s office.In the UK, talk to your health visitor or GP, or call NHS 111 if you’re worried.Talk to your doctor or child health nurse.