What is gripe water?
Gripe water is a popular home remedy intended for the treatment of colic and constipation in infants. It usually contains sugar and herb extracts that supposedly soothe the stomach.
What is infant colic?
Infant colic is defined as intense crying for at least 3 hours a day, at least 3 days per week for at least 3 weeks for an unknown reason in an otherwise healthy baby (5). An affected baby typically expels excessive gas and draws his or her legs toward the trunk; in most cases, symptoms resolve by the 4th or 5th month of life (5).
Gripe water ingredients depend on the brand and country of the production and can include:
- Deionized water
- Sweeteners: sugar, vegetable glycerin
- Sodium bicarbonate, that is baking soda (in India called sarjikakshara)
- Citrus bioflavonoid extract
- Preservatives: bronopol, sodium methyl/propyl paraben, sodium benzoate, citric acid, potassium sorbate
- Flavors: apple, fennel or others
- Herb extracts or oils: aloe, Amalaki, caraway, cardamom, chamomile, dill oil, fennel, Giloy, ginger root, himsra, horsemint, Kasamarda, lemon balm, peppermint, pippali or Indian long pepper, vegetable charcoal
- Rarely used ingredients, mostly in Europe: alcohol, phenobarbital (a sedative)
- References: (1, producers)
Is gripe water regulated by FDA?
In the US, most gripe water products fall into the category of dietary supplements, which do not require Food and Drug Administration (FDA) approval.
On the other hand, gripe water products that are sold as over-the-counter homeopathic drugs are regulated by FDA, which means they need to meet FDA labeling requirements and need to be produced by Current Good Manufacturing Practices (11). These products can be recognized by National Drug Code (NDC) numbers on the bottles.
Gripe water homeopathic drugs, despite being regulated by FDA, are not necessary more effective than the non-regulated gripe waters, but their producers need to report all cases of side effects to FDA. Homeopathic drugs are reviewed for efficacy, toxicology, adverse effects and clinical use by the Homeopathic Pharmacopeia Convention of the United States (HPCUS) (11).
What is organic or natural gripe water made of?
The terms “natural” or “organic” on the product label may not be reliable unless the product has an “USDA organic” (in the US) or other appropriate certificate. The United States Department of Agriculture (USDA) determines “organic product” as the one that is processed without the use of synthetic and non-agriculture substances, ionizing radiation and sewage sludge (10).
Benefits in Infants or Adults
There are some anecdotal reports that gripe water can help in colic or constipation in infants.
There is insufficient evidence (no randomized controlled clinical trials) about the effectiveness of gripe water in the prevention or treatment of colic, constipation (as a laxative), acid reflux, excessive gas, hiccups, pain during teething or other problems in infants or adults (1,5,6).
Even if gripe water works, it is not known how it works. Some researchers believe the sweetness of gripe water may have a soothing effect (6).
Safety and Dangers
Some doctors believe gripe water is safe and may cause no harm when used for the mildly upset stomach but is not appropriate for treatment of full-blown colic (7,8).
Few reports of infections after consuming gripe water:
- According to one 2004 report, a 9-month girl developed a septic shock after getting gripe water contaminated by a bacterium Pseudomonas aeruginosa (2).
- In 2007, the US Food and Drug Administration (FDA) reported a case of infection with a parasite Cryptosporidium in a 6-week old infant after consuming gripe water (3). Symptoms of an infection can appear from 2 to 10 days after contamination and can include diarrhea, stomach cramps, nausea, vomiting and fever and can last 1 to 2 weeks (3).
- In 2009, FDA recalled one brand of gripe water because of yeast contamination (9).
Other dangers of gripe water use:
- Continuous use of gripe water that contains sodium bicarbonate may cause a drop of blood acidity (alkalosis) (1).
There is no general instructions about the dosage. Recommended dosage is usually provided on the package of each individual product.
Possible side effects of gripe water (1):
- Irritation of the intestine causing diarrhea
- Allergic reactions in sensitive babies
Exclusive Breastfeeding and Gripe Water
The well-accepted rule, encouraged by World Health Organization (WHO) and many other medical authorities is that breastfed infants age 1 to 6 months should not be given any other food or fluid unless medically indicated (4).
Is gripe water safe for newborns?
Gripe water should never be given to newborns, whose immune system is not mature enough to effectively fight against eventual microbes (8).
Who should avoid gripe water?
- Anyone allergic to any of gripe water ingredients
- Individuals with chronic heart failure, gallstones, serious kidney problems with decreased urination, recent operation, water retention, diabetes and blood clotting disorders (12)
Is it appropriate to mix gripe water with formula?
No. Formula should be prepared exactly according to instructions and should be not diluted by any fluids. A baby that does not accept gripe water well may start to refuse a formula mixed with gripe water as well.
What is the difference between gripe water and gas drops (simethicone)?
Gripe water is intended to treat colic, while simethicone is an anti-foaming agent intended to prevent excessive bloating and gas.
- Adhisivam B, 2012, Is gripe water baby-friendly? PubMed Central
- Sas D, et al, 2004, Pseudomonas aeruginosa septic shock secondary to “gripe water” ingestion PubMed
- 2007, FDA Warns Consumers about the Risk of Cryptosporidium Illness from Baby’s Bliss Gripe Water US Food and Drug Administration
- Exclusive breastfeeding World Health Organization
- Oshikoya KA et al, 2009, Self-medication for infants with colic in Lagos, Nigeria PubMed Central
- Blumenthal I, 2000, The gripe water story PubMed Central
- Woolston C, 2011, Gripe water is safe for babies with colic, but no studies show that it works Los Angeles Times
- Woodwards Gripe Water NHS Choices
- Enforcement report for December 2009 US Food and Drug Administration
- Organic certification United States Code
- FAQs about homeopathic medicine Consumer Healthcare Products Association
- Gripe water contraindications WebMD