Why does a 20-day-old baby have very smelly gas, and what should be done?

Farting refers to the passage of gas through the anus. In general, foul-smelling anal gas in a 20-day-old infant may be related to improper feeding, dietary factors, indigestion, lactose intolerance, or irritable bowel syndrome. If discomfort occurs, it is recommended to seek medical attention promptly and receive symptomatic treatment under a doctor's guidance. Specific analyses are as follows:

1. Improper Feeding

If a 20-day-old infant swallows excessive air during breastfeeding, or if the mother’s nipple does not fully fit into the baby’s mouth, causing the baby to ingest large amounts of air during feeding, this air can break down in the intestines and produce particularly foul-smelling gas. It is recommended to adopt proper feeding positions, ensuring that the baby takes most of the areola or nipple into the mouth to avoid swallowing excess air.

2. Dietary Factors

If the mother consumes excessive high-protein or high-fat foods, these components may be passed to the baby through breast milk, increasing protein breakdown in the baby’s intestines and producing odorous gases. The mother should adjust her diet by moderately reducing intake of high-protein and high-fat foods, increasing consumption of fresh vegetables and fruits, and maintaining a balanced diet.

3. Indigestion

Due to insufficient gastric motility or inadequate digestive enzyme secretion, indigestion may occur. Food may remain in the stomach of a 20-day-old infant for too long without being fully digested, then ferment further in the intestines, generating large amounts of foul-smelling gas. This may be accompanied by symptoms such as postprandial fullness, early satiety, upper abdominal pain, or burning sensation. Under medical guidance, medications such as Xingpi Yang'er Granules, Ying'er Jianpi Granules, or Clostridium butyricum live bacteria powder may be used to relieve symptoms.

4. Lactose Intolerance

A congenital deficiency of lactase in 20-day-old infants may lead to lactose intolerance, causing undigested lactose in the intestines to be utilized by bacteria, producing gas and foul-smelling substances. Symptoms may include diarrhea, bloating, and increased bowel sounds. Under medical guidance, medications such as montmorillonite powder, Bifidobacterium triple viable capsules, or Bacillus subtilis bivalent live bacteria granules may be used to alleviate symptoms.

5. Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome may result from chronic stress, surgery, medications, or other factors. It may increase the infant’s intestinal sensitivity to food components or cause abnormal intestinal motility due to stress responses, leading to increased flatulence with stronger odor. Additional symptoms may include abdominal pain, diarrhea, or constipation. Treatment may include medications such as lactic acid bacteria tablets, Bacillus licheniformis live bacteria granules, or lactulose oral solution, used according to medical advice.

Mothers are advised to closely monitor their baby's health and adjust their own diet appropriately, which may help alleviate symptoms.