Baby Hiccups: Everything You Need to Know

Have you ever wondered why your baby hiccups so often? Hiccups are part of an immature nervous system. In utero, babies practice breathing by swallowing amniotic fluid and programmed exercise of the inspiratory muscles. Newborns are notorious for jerking twitchy movements while their nervous system is still developing after birth. Similarly, the diaphragm will also learn to relax, usually around 4-6 months of age. Additionally, when a baby’s stomach distends, it pushes against the diaphragm, which causes it to spasm, leading to hiccups.

We frequently see hiccups in newborns during or soon after a feed. Anything causing the stomach to distend, such as a baby overfeeding, eating too quickly, or swallowing a significant amount of air, can lead to hiccups. It’s no wonder your little one hiccups often! A sudden change in stomach temperature can also trigger hiccups, such as cold and warm fluids or foods being consumed close together. If a baby begins hiccuping during a feed, consider it a hint to slow the feeding or take a break to assess if this could mean your baby’s belly is full. You may even be able to prevent hiccups by slowing down feeds and taking more frequent breaks for burping.

Baby Hiccups: What You Need to Know

What are hiccups?

The medical term for hiccups is singultus, which derives from the Latin “singult,” meaning ‘to catch one’s breath while sobbing.’ Hiccups are an involuntary spasm of the diaphragm, the large dome-shaped muscle that separates the chest from the abdomen, and our intercostal muscles, the muscles between our ribs. This contraction causes inspiration and ends with the abrupt closure of the glottis, the opening between the vocal folds. This mechanism is what generates the characteristic “hic” sound.

In babies with gastroesophageal reflux, partially digested food and acidic juices from the stomach flow back up into the esophagus. Since the esophagus passes through the diaphragm, it can irritate it, leading to more frequent hiccups. If a baby with reflux is otherwise asymptomatic, also known as a “happy spitter,” mainly gaining weight appropriately and not in significant pain, then this is unlikely to be something that needs to be treated. But, of course, discuss this with your child’s pediatrician.

How long do hiccups usually last?

Hiccups typically last anywhere from a few minutes to a couple of hours. Bouts of acute hiccups, defined as those less than 48 hours in duration, are typically self-limited and benign. However, persistent hiccups (lasting over two days) and intractable hiccups (lasting one month) are much rarer. They are likely to be manifestations of other serious diseases, which require evaluation by a doctor. The list of possible reasons is extensive, including structural, infectious, or inflammatory disorders that impact the central nervous system, including the vagus nerve (connecting the brain to the stomach) or phrenic nerve (connecting the neck to the diaphragm), which are essential parts of the breathing process.

Alcohol, tobacco, and certain medications, notably dexamethasone, benzodiazepines, opioids, chemotherapeutics, and anti-Parkinson medications, are also associated with the development of hiccups. Toxic-metabolic causes include renal impairment and electrolyte imbalances. Psychogenic factors associated with hiccups include anxiety, stress, excitement, and malingering. As you can imagine, prolonged hiccups can decrease quality of life by impacting one’s nutrition, sleeping, conversation, and mental health.

Are hiccups harmful?

Thankfully, hiccups in children are nearly always harmless, temporary, and self-resolving. While you don’t have to do anything to treat hiccups, some caregivers wonder if there is something they can do to help limit them. Interestingly, there are hundreds of supposed “cures” for hiccups you can find on the internet, many of which have zero bases in science and are downright silly. However, some maneuvers can be effective as they are designed to interrupt normal respiratory function and increase partial pressure of carbon dioxide, stimulate the nasopharynx or uvula, stimulate the vagus nerve, or relieve irritation of the diaphragm.

Case reports and observational studies have suggested these maneuvers, but there are limited confirmatory studies. However, they are relatively easy to perform, and the risk of complications is low. Examples of vagal type maneuvers include a quick blow in the face, prolonged suck, and placing an ice pack over the eyes for 15-30 seconds (a frozen bag of vegetables works really well, but be sure to avoid placing anything around the infant’s nose!) and pressing the infant’s knees to the chest for 15-30 seconds. You may consider resetting the diaphragm and suboccipital release with gentle osteopathic manipulation if you have a trusted osteopathic physician (a DO) nearby.

Rest assured and take a deep breath, mama. Hiccups are completely normal and will, by and large, work themselves out. Soon your baby will be taking those deep breaths again with you!

RESOURCES:

• Kolodzik PW, Eilers MA. Hiccups (singultus): review and approach to management. Ann Emerg Med. 1991 May;20(5):565-73. doi: 10.1016/s0196-0644(05)81620-8. PMID: 2024799.

• Steger M, Schneemann M, Fox M. Systemic review: the pathogenesis and pharmacological treatment of hiccups. Aliment Pharmacol Ther. 2015 Nov;42(9):1037-50.

• Kahrilas PJ, Shi G. Why do we hiccup? Gut. 1997 Nov;41(5):712-3. doi: 10.1136/gut.41.5.712. PMID: 9414986; PMCID: PMC1891574.

• Hosoya R, Uesawa Y, Ishii-Nozawa R, Kagaya H. Analysis of factors associated with hiccups based on the Japanese Adverse Drug Event Report database. PLoS One. 2017 Feb 14;12(2):e0172057. doi: 10.1371/journal.pone.0172057. PMID: 28196104; PMCID: PMC5308855.

• Petroianu GA. Treatment of hiccup by vagal maneuvers. J Hist Neurosci. 2015;24(2):123-36. doi: 10.1080/0964704X.2014.897133. Epub 2014 Jul 23. PMID: 25055206.

Disclaimer: While I am a doctor, I am not your doctor. All content presented in this article is for educational purposes only. It does not constitute medical advice and does not establish any kind of doctor/patient relationship. Speak to your healthcare provider about any questions or concerns you may have.