Is it ok not to burp baby after feeding
Burping Your Baby (for Parents)
Reviewed by: Madhu Desiraju, MD
Primary Care Pediatrics at Nemours Children's Health
en español Hacer eructar a su bebé
An important part of feeding a baby is burping. Burping helps to get rid of some of the air that babies tend to swallow during feeding. Not being burped often and swallowing too much air can make a baby spit up, or seem cranky or gassy.
How to Burp Your Baby
When burping your baby, repeated gentle patting on your baby's back should do the trick. Cup your hand while patting — this is gentler on the baby than a flat palm.
To prevent messy cleanups when your baby spits up or has a "wet burp," you might want to place a towel or bib under your baby's chin or on your shoulder.
Try different positions for burping that are comfortable for you and your baby. Many parents use one of these three methods:
- Sit upright and hold your baby against your chest. Your baby's chin should rest on your shoulder as you support the baby with one hand. With the other hand, gently pat your baby's back. Sitting in a rocking chair and gently rocking with your baby while you do this may also help.
- Hold your baby sitting up, in your lap or across your knee. Support your baby's chest and head with one hand by cradling your baby's chin in the palm of your hand. Rest the heel of your hand on your baby's chest, but be careful to grip your baby's chin, not the throat. Use the other hand to pat your baby's back.
- Lay your baby on your lap on his or her belly. Support your baby's head and make sure it's higher than their chest. Gently pat your baby's back.
If your baby seems fussy while feeding, stop the session, burp your baby, and then begin feeding again. Try burping your baby every 2 to 3 ounces (60 to 90 milliliters) if you bottle-feed and each time you switch breasts if you breastfeed.
Try burping your baby every ounce during bottle-feeding or every 5 minutes during breastfeeding if your baby:
- tends to be gassy
- spits a lot
- has gastroesophageal reflux (GER)
- seems fussy during feeding
If your baby doesn't burp after a few minutes, change the baby's position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over.
To help prevent the milk from coming back up, keep your baby upright after feeding for 10 to 15 minutes, or longer if your baby spits up or has GERD. But don't worry if your baby spits sometimes. It's probably more unpleasant for you than it is for your baby.
Sometimes your baby may awaken because of gas. Picking your little one up to burp might put them back to sleep. As your baby gets older, don't worry if your child doesn't burp during or after every feeding. Usually, it means that your baby has learned to eat without swallowing too much air.
Babies with colic (3 or more hours a day of continued crying) might have gas from swallowing too much air during crying spells, which can make the baby even more uncomfortable. Check with your pediatrician before giving your baby anti-gas drops.
Reviewed by: Madhu Desiraju, MD
Date reviewed: June 2022
How to burp a sleeping baby: Effective methods
When a baby falls asleep without burping, parents and caregivers can try a few methods to help them relieve wind while staying asleep.
The act of breastfeeding or feeding from a bottle often has a calming effect. As a result, it can make many infants fall asleep during or after their meal.
This can pose a problem if the baby has swallowed air during their feed. They may need to release air through a burp, which is more difficult to do when asleep. Their body may be too relaxed to get into a burping position, or the parent or caregiver may not wish to risk waking the baby from their slumber.
However, many people find that they must burp their baby after every feed — sleeping or not. If the baby does not release air through a burp after feeding, they may have discomfort later as it moves through the intestines and causes gas.
In addition, some babies are so sleepy at the breast or bottle that they fail to take in enough calories at their meals. It may sometimes be necessary to wake the baby during feeding to help them eat more. Burping the baby may help by eliminating some feelings of fullness and helping them stay awake longer.
A parent or caregiver will often need to decide on a case-by-case basis whether they should try to burp their sleeping baby or simply let them sleep.Share on PinterestBurping a baby may help relieve discomfort after feedings.
As air travels upward, burping positions usually require the baby to be at least partially upright. This position encourages any air bubbles to move upward, passing through the throat and out of the mouth.
It is possible to burp a sleeping baby, often without waking them completely. Each baby is different, so people may need to try various techniques to find one that works.
Method 1: Shoulder
This method is suitable for babies who are sound sleepers. It can also be useful if a person needs to wake a baby up to continue their feeding.
- Turn the baby upright and lean them against the upper chest. Put one hand under their buttocks for support. The baby’s head should be on top of the shoulder.
- Gently pat the baby’s back between their shoulder blades. Use an open palm to pat, being firm but gentle.
- If patting does not work, try rubbing their upper back in circular motions with the palm.
If the aim is to keep the baby awake, lightly bouncing them while they are on the shoulder may help wake them while also bringing up a burp.
Method 2: Chest
If a shoulder burp tends to wake the baby up, try a chest burp instead. Placing the baby on the chest can feel more comforting for them than the shoulder, so this position can often allow them to stay asleep after feeding.
- Gently lift the baby to the chest, putting one hand on their back and one under their buttocks.
- Avoid stretching their legs out. Allow their body to stay in a curled up position, which may make them less likely to wake up.
- Use the hand that is on their back to rub it, making circular motions first.
- If rubbing does not produce a burp, try gentle pats between their shoulders.
Method 3: Hip
The hip method works well for people who prefer to breastfeed their baby while lying down. It may help keep the baby asleep because the parent or caregiver does not have to sit up, and the baby is not fully upright.
- Gently place the baby’s tummy down over the hip or belly. Make sure that the baby’s head remains elevated above their body.
- Gently pat their back between the shoulder blades.
- Alternatively, rub their back in an upward circular motion.
Method 4: Arm hold
For smaller babies, the arm hold method can be useful. However, it is not always practical for older or larger babies.
- Place one arm under the baby’s back, allowing them to rest their body on the forearm. The baby may already be in this position for feeding.
- Carefully turn the baby’s body so that they are resting belly down on the parent’s or caregiver’s forearm with their head in the crook of the elbow. Place the hand between the baby’s legs, holding the baby for stability.
- Rub or pat the baby’s upper back with the other hand.
- When finished, gently roll the baby toward the body. They will then be face up to continue feeding or to go to sleep.
Method 5: Lap
If the parent or caregiver is already sitting in a chair or on a couch, the lap method may work well to keep the baby asleep. It does not require the baby to be upright, which may be more soothing for them.
- While in a sitting position, gently turn the baby over onto their tummy and allow them to rest on the parent’s or caregiver’s thighs.
- Place one arm under the baby’s chin and chest to raise their upper body slightly.
- Use the other hand to pat their back or rub it in circular motions.
- When finished, turn the baby back over onto their back.
The baby may not always burp during or after feeding. In some cases, this may be because the baby did not swallow much air.
Sometimes, however, it takes a little persistence to get a burp out. Here are some helpful tips for parents and caregivers in these instances:
- Burp the baby during the feed. When a baby has finished feeding, they may be especially drowsy and may have swallowed more air. Try burping them before switching breasts or when they are halfway through their bottle.
- If the baby does not burp after 5 minutes of trying, gently lie them down on their back, either in their crib or on another safe surface, such as a playpen. After a few minutes, carefully pick the baby up and try burping them again. Sometimes, lying down helps move the air bubbles around, making them easier to release.
- Keep the baby upright after their feed. Using a baby wrap or sling can be a good way to let the baby sleep in a semi-upright position, allowing the air bubble to escape without any work from the parent or caregiver.
- There is no need to stress if the baby does not burp. There are times when a baby will not burp or has no air to release. If the baby does not burp despite using the methods above, do not worry. One study found that burping does not significantly reduce colic episodes.
The best way to help prevent excess gas in a baby is to try to prevent them from swallowing too much air. Swallowing air is often the result of the baby eating too quickly.
When bottle feeding, follow these tips to help prevent gas:
- Use a slow flow nipple on bottles, especially for newborns. Fast flow nipples may cause the baby to swallow more air.
- Angle the bottle so that air is not getting into the milk or formula while feeding. Doing this usually means tipping the bottle upward at an angle and keeping it tipped as the baby finishes the bottle.
- Test the flow of a bottle’s nipple before giving it to the baby. Tip it upside down and allow a few drops to come out. If the liquid comes out quickly, the nipple may have become worn out.
- Replace bottle nipples if the hole gets bigger, or the nipple shows signs of wear.
When breastfeeding, follow these tips to help prevent gas in the baby:
- Watch for signs of a fast letdown of milk from the breast. If the milk comes out too quickly at the beginning, and the baby is gulping or gasping, take the baby off the breast for a few seconds. Catch the excess milk in a towel or cloth if necessary. Once the milk flow has slowed down, put the baby back on the breast.
- Experiment with different breastfeeding positions. Different babies and women find that certain positions allow them both to breastfeed comfortably. It may help to ask a lactation consultant for tips.
- Make sure that the baby has latched on correctly. The baby’s lips should be sealed and spread out around the nipple. Their lips should not turn inward.
There are ways to burp a sleeping baby without waking them, but no method is foolproof. Parents and caregivers may need to experiment with different burping methods to find which ones work best for them and the baby.
While many babies fall asleep while breastfeeding or bottle feeding, it is important to follow the American Academy of Pediatrics‘ safe sleep guidelines for babies. Following these guidelines may help prevent sudden infant death syndrome (SIDS) and sleep-related infant deaths.
Babies should have regular checkups with a pediatrician to be sure that they are feeding and gaining weight as necessary.
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Breastal feeding - completely special time for mom and her newborn baby. Together with the feeling of closeness and affection that feeding brings, understanding its nuances cannot but raise many questions, including the question of how to help an infant spit up. Regurgitation in a newborn is by no means always the result of a simple pat on his back.
In this article, we'll talk about the basics of helping a newborn spit up, as well as other questions you may have about spitting up.
Why do babies spit up?
Let's get it straight: why do newborns need to burp in the first place? During feeding, children usually swallow extra air - this is called aerophagia. Spitting up helps prevent this air from entering the intestines, as well as vomiting, gas, and crankiness in the baby. To avoid the return of milk after feeding, you should give the baby the opportunity to burp more often.
How to help a newborn spit up?
During the first six months, the baby should be kept upright in a column for 10-15 minutes after each feed. This will help keep the milk in his stomach, but if the baby occasionally burps anyway, parents need not worry. While carrying your baby in an upright position, you can put a baby diaper or wipes on your shoulder to keep your clothes clean.
We've already seen why spitting up is important, now let's find out how to help your baby spit up. Parents should gently pat the baby on the back with a hand folded in a handful until he burps. Folding your hand into a handful is important because clapping with a flat palm may be too strong for an infant.
Every baby is different and there is no one right position for spitting up. To get started, you can try the following options:
- Sitting position with the baby on the chest. In this position, the parent puts the baby's head with his chin on his shoulder and with one hand supports the baby under the back. With the other hand, you can gently pat the baby on the back. This method is most effective in a rocking chair or when the baby is gently rocking.
- Holding the child upright on your legs. With one hand, parents can hold the baby by the back and head, supporting his chin and placing his palm on the baby’s chest, with the other hand, you can gently pat him on the back. At the same time, it is important to be careful: do not press the child on the throat, but only gently support his chin.
- Holding a baby on your lap while lying on your tummy. Make sure his head is above his chest and gently pat your baby on the back until he burps.
Here are some tips on how best to help your newborn spit up:
- Let your baby spit up during feeding. If the baby is restless or has swallowed air, it is worth giving him the opportunity to burp during feeding, and not just after.
- When bottle feeding, let the newborn burp after every 50-60 ml.
- When breastfeeding, let the baby burp at every breast change.
It is important to let your baby spit up after eating, even if he spit up during feeding!
If your baby is gassy, spit up more often. Also, if he vomits frequently or suffers from gastroesophageal reflux disease (GERD), have him spit up after every 30 ml bottle-feeding or every five minutes while breastfeeding.
How long should a baby be held for it to burp? It's different for everyone, but generally keeping a newborn upright for 15 to 20 minutes after a feed helps the milk stay in the baby's stomach.
Minimize the amount of air you swallow. Gas production and regurgitation result from aerophagia during feeding. The baby will inevitably swallow air, but there are ways to prevent it from swallowing too much. Whether you bottle feed your baby or combine breastfeeding with bottle feeding, the Philips Avent anti-colic bottle with AirFree valve is designed so that the nipple is always filled with milk without excess air, even in a horizontal position, thus preventing the baby from swallowing excess air during feeding.
Reducing the amount of air your baby swallows can help reduce your baby's risk of colic, gas, and spitting up.
Breastfeeding is a wonderful time to strengthen the bond between parent and baby. Every mom and every baby is different, so learning to help your newborn burp properly can take time and practice.
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Preventive measures against regurgitation in children
Regurgitation is the spontaneous reflux of gastric contents into the esophagus and mouth. This condition is not uncommon in infants and is often a cause for concern for parents. The frequency of regurgitation syndrome in children of the first year of life is 18-50%: up to 4 months - 67%, up to 6 months 24%, up to 1 year 5%. In most cases, regurgitation is "benign" and disappears on its own after 12-18 months. At the same time, “benign” or physiological regurgitation characterizes:
the age of the child is up to 12 months;
spitting up 2 or more times a day for 3 or more weeks;
sufficient weight gain;
The child has no signs of metabolic disorders, diseases of the gastrointestinal tract or the central nervous system. The child does not experience difficulty in swallowing or feeding, there is no forced position of the body.
Do not confuse regurgitation with vomiting. When a child burps, the abdominal muscles do not tense up. With vomiting, on the contrary, muscle tension occurs and food is ejected by pressure not only through the mouth, but also through the nose. In some cases, there may be general anxiety, pallor, cold extremities. Often with vomiting, the temperature rises, loose stools appear, which is a sign of an infectious disease. Vomit may contain unchanged milk, mucus, blood or bile.
What causes physiological regurgitation
What is the tendency of babies to spit up? This phenomenon is explained by the peculiarity of the structure of the gastrointestinal tract of young children. At the age of one year, the esophagus is shorter and wider, physiological narrowing is weakly expressed. The stomach is located horizontally, its capacity is small, and the muscles that close the entrance to the stomach and prevent the contents from being thrown back into the esophagus are poorly developed. As the child begins to walk, the axis of the stomach becomes more vertical. The capacity of the stomach increases by the year from 30-35 ml to 250-300 ml. The secretory apparatus matures, the work of the closing muscles (sphincters) improves, which leads to a gradual decrease in the frequency and disappearance of regurgitation. These features explain the predisposition of young children to regurgitation and even the inevitability of this condition. However, there are measures to help reduce the frequency of regurgitation.
Factors contributing to physiological regurgitation include:
Overfeeding. As a rule, actively sucking babies begin to suffer from overfeeding, with abundant milk secretion, as well as when switching to artificial or mixed feeding with an incorrect calculation of the required amount of milk formula. Regurgitation appears immediately or some time after feeding in the amount of 5-10 ml. Milk can flow out unchanged or curdled.
Swallowing air during feeding (aerophagia). A similar situation arises if the child suckles greedily at the breast, and the mother's milk is not very plentiful; due to the retracted, flat nipple of the mother's breast, since the child fails to fully capture the nipple and areola; with artificial feeding, if the hole at the nipple of the bottle is large enough or the nipple is not completely filled with milk. Babies with aerophagia often experience anxiety after feeding, bulging of the abdominal wall (belly inflates). After 10-15 minutes, the swallowed milk flows out unchanged, which is accompanied by a loud sound of air eructation.
Intestinal colic or constipation. These conditions lead to an increase in pressure in the abdominal cavity and a violation of the movement of food through the gastrointestinal tract, causing regurgitation.
Until the child is four months old, spitting up up to two teaspoons of milk after feeding, or one spitting up of more than three spoons during the day, is considered the norm. You can check the amount of spitting up in the following way: take a diaper, pour one teaspoon of water on its surface, and then compare this spot with the spot formed after the next spitting up.
Abnormal regurgitation may be due to:
surgical diseases and malformations of the digestive system;
pathology of the central nervous system, trauma of the cervical spine during childbirth;
food intolerance, lactase deficiency;
increased intracranial pressure.
Such regurgitation is characterized by intensity, systematicity, the child spits up a large amount of milk. At the same time, there is a violation of the general condition of the baby - the child is whiny, loses or does not gain weight, cannot eat the amount of food necessary for his age. In such a situation, a pediatrician, gastroenterologist, surgeon, allergist, neurologist should be examined. It also requires examination and exclusion of anomalies in the structure of the upper gastrointestinal tract, the preservation of regurgitation for more than 1 year.
Scale for assessing the intensity of regurgitation:
Less than 5 regurgitations per day with a volume of not more than 3 ml - 1 point.
More than 5 regurgitations per day with a volume of more than 3 ml - 2 points.
More than 5 regurgitations per day up to half the amount of formula or breast milk, not more often than in half of the feedings - 3 points.
Spitting up a small amount of milk for 30 minutes or more after each feeding - 4 points.
Regurgitation from half to full volume of formula or breast milk in at least half of the feedings - 5 points.
Regurgitation with an intensity of 3 or more points requires a visit to a doctor.
Preventive measures against regurgitation in children
If regurgitation is physiological in nature, then it is not worth treating or correcting in this case. It is necessary to deal with the elimination of the cause, if possible, and carry out prevention.
Prevention of regurgitation in children includes the following measures:
Postural therapy: when feeding, it is necessary to hold the baby at an angle of 45 °, make sure that he completely grasps the nipple with the areola; after feeding, hold the baby in an upright position ("column") for 20 minutes - to drain the swallowed air. Due to this, the air that has entered the stomach will be able to go out. If nothing happened, then put the baby down and after a minute or two, lift him upright again.
Make sure that the opening in the bottle is not too large and that the nipple is filled with milk. Experiment with nipples - perhaps the other will be better. Milk should come out in drops, not a trickle.
Before you start feeding your baby, lay him belly down on a solid base.
After feeding, try to minimize the baby's physical activity, do not disturb him unnecessarily, and change clothes only if there is an emergency.
Avoid squeezing diapers or clothes on the abdomen of the child.
If the baby's appetite is good, then it is better to feed him often, but in small portions, otherwise, due to the large amount of food, the stomach may overflow, and this, as a result, leads to regurgitation of excess food.