Keep baby upright 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

Holding Your Baby Upright After Feeding? Stop! It Doesn't Help

Spit happens! Even people who have not spent much time with babies know that spit up comes with the territory. But did you know that more than 2/3 of babies spit up regularly? More often than not, spit up is nothing to worry about. There are some tried-and-true methods out there that help reduce the frequency of spit up in babies. There are also some very common misconceptions. And, contrary to popular belief, holding your baby upright after a feeding doesn’t help. In this blog we will discuss:

why babies spit up.
the difference between spit up and vomit.
when to worry about spit up.
why holding your baby upright after a feed is not necessary.
myths and truths to reducing spit up.

Why do babies spit up?

Spitting up is physiologically appropriate in babies. This is because the lower esophageal sphincter (LES) has not fully matured – and doesn’t until around 18 months of age. You can, however, expect to see a decrease in spit up as baby gains core control (ie when they begin sitting up). The floppiness of this sphincter is why you may notice your baby spitting up over an hour after they’ve finished feeding.

Your baby may also spit up if they have had too much to drink and their stomach is full. The excess fluid can put additional pressure on the LES, leading to spit up. You can compare that to feeling ‘uncomfortably full’ after a holiday meal. However, you don’t spit up your food because your LES is fully matured.

What is the difference between spit up and vomit?

Spit up and vomit are not the same. The distinction between the two has nothing to do with the volume of fluid that is ejected. Spit up tends to leave your baby’s mouth at a slower speed; it may even dribble out. This can happen when you’re burping your baby. Vomiting is a forceful event. The liquid projects out from the mouth and may travel several inches.

When should I worry?

Every baby is different. Keep in mind, it may appear that your baby has spit up an ‘entire feed’ but the amount of spit up usually looks like more than it actually is.

Typically if your baby is continuing to gain weight and doesn’t seem bothered by spitting up, it is not a reason to worry. These babies are often dubbed “happy spitters” and the spitting up is more of a “laundry problem” than a medical one.

If you feel your baby is spitting up excessively, I definitely recommend calling their pediatrician. Other scenarios which may be a cause for concern include:

when it occurs after every feeding.
if your baby is not gaining weight.
if the spit up looks like anything other than milk/formula (undigested or partially digested). This includes spit up that is green, yellow, bloody, or looks like coffee grounds.
a baby who cries for more than 3 hours daily and is irritable.
if spitting up begins after your baby turns 6 months old.

Why isn’t holding your baby upright after a feeding necessary?

I realize this idea may be different than what you’ve heard in the past, but hear me out. It takes approximately 2 hours for your baby’s stomach to empty. While holding your baby upright for 30 minutes after a feeding may allow for some of the feed to leave the stomach, the majority of the feed remains in their stomach after that time. When you lay your baby down, their immature LES could still open, causing them to spit up.

So unless you are holding your baby upright until their stomach is completely empty, the chance of them spitting up still remains. Now if you were to hold them up until their stomach emptied, you would bring yourself to the time of their next feeding. This strategy would be grossly inefficient. It would result in you getting no rest, or your baby getting into the habit of having to be held or worn at all times.

You may wonder about propping your baby up to reduce spit up. It is unsafe for a baby’s sleep surface to be elevated (that means those crib wedges are not a safe option). Products like nursing pillows, baby loungers, and bouncy seats put your baby at risk for positional asphyxiation. And they don’t diminish the incidence of spit up!

Myths and Truths to Reduce Spit Up

Many pediatricians will, wrongfully, recommend switching to formula because it is “heavier” than breastmilk. The heaviness only means it takes longer to digest than breastmilk, not that it will be less likely to come back up. And adding rice or oatmeal cereal to the bottle will not help reduce spit up either (but it can create a choking hazard!).

The best ways to help reduce spit up in your baby include:

avoiding overfeeding.
burp your baby, well, during and after feeding. Trapped air in the stomach can increase the incidence of spit up.
avoid rigorous activity soon after a feed.
if you’re bottle feeding your baby, opt for a slower flow nipple. This helps baby to recognize when they are full before they become overly full.

Other Blogs You May Like

What is the Best Bottle?
Does Breast Milk Cause Cavities?
Pass the Bottle, Please!

The information contained in this blog is the opinion of Rebecca Tucci, certified doula and lactation counselor. It is not meant to take the place of consultation with your child’s healthcare provider. The above information cannot diagnose, treat, cure, or prevent any disease or condition.

How to help the baby when regulating

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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 aerophagy. 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.

Articles and tips from Philips Avent

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How to hold a baby properly

Bagdasaryan Kristina Genrihovna

Obstetrician-gynecologist, Ultrasound specialist

Clinic "Mother and Child" St. Petersburg

So, how to take the child from the supine position. Grasp his chest with both hands - thumbs in front, and the rest hold the back. If the baby is not yet able to hold his head, support it with your index fingers. Gently lift your baby up. Do not forget, your face turned to the child should always express the kindest feelings. Talk to the baby, tell him what you are doing, the voice should not be very loud, gentle.

Those who take a small child in their arms are divided into two categories: relatives who live with him under the same roof, and visitors. You should not allow a visitor to the child who has not taken off his outerwear, hat, street shoes, has not washed his hands with soap, has not freed his hands from rings, rings, watches, bracelets. The baby can be frightened by sharp extraneous odors, for example, the smell of tobacco, alcohol, perfume.
Sick people should not be allowed near the child - coughing, sneezing, as well as complaining of indigestion, suffering from skin diseases.

Even if loving relatives have come a long way on trains and planes to visit the baby, be persistent and keep the guests “in quarantine” for several days - will the infection picked up on the road show up? They may be offended, but the child will remain healthy! In order to more reliably protect the psyche and immune system of the child, it is useful in his first six months of life to limit the circle of people admitted to him. These are the rules, and no one - neither the formidable mother-in-law, nor the neighbor, nor the beloved boss - deserves an exception.
Some parents take the baby in their arms with unthinkable precautions, others, on the contrary, snatch it from the crib so famously. All these are extremes. So how should it be?

do not make sudden movements when taking the baby
never take it with one hand - only with both
do not raise or lower the baby quickly, rapidly
do not take it out of the crib by pulling on the handles

The position of the baby in the arms of the mother (or another adult), first of all, depends on his age, as well as on whether he will sleep or be awake. Up to 2-2.5 months (and sometimes longer), the baby’s head must be supported, so in a horizontal position (face up), arrange the baby on your arm so that the back of his head lies on your elbow, the back rests on your forearm, and your hands should support the buttocks and hips of the baby. You can put the baby on your forearm and stomach. In this case, the baby's head should be in the crook of the elbow, and your hands will close on the baby's stomach, and one hand will pass between the legs of the little one. If you want to hold the child in an upright position, for example, in order for him to burp excess air, then support his head and back: put one of your palms on the back of the baby’s head, with your forearm firmly press his body to you. With the other hand, fix the buttocks of the crumbs. In no case do not sit the child on your arm until he has confidently mastered the skill of sitting, which happens on average at the age of 6 months. From 2.5-3 months, you can already carry the baby, turning him away from you, holding him with one hand at chest level, with the other at hip level.

Depending on the age of the child, there are 6 ways to hold him in your arms.

Hanging. This method is good for babies up to 3 months when they still have trouble holding their head. With one hand support the neck and back of the baby's head, with the other - the buttocks, while his torso may be slightly bent, and his face turned towards you. This situation opens up scope for the much-needed emotional contact with the mother and other loved ones for a small child. Do not forget that in order to avoid the development of one-sidedness, the baby's head must be supported either with the left or with the right hand - periodically changing them.

On the arm. Ideal for babies aged 3-6 months, although you can keep your baby this way almost from birth. He rests his head on your shoulder, you hold his feet with your hand, and your arms with your forearm. With your other hand, you support the baby under the buttocks. At the same time, the child's legs should be bent at the knee and hip joints and bred. Don't forget to alternate hands.

In front of bust . Starting from 6 months, this way of holding the baby provides him with the same position as in the position on the back. The baby leans back against your chest, his legs are bent and divorced, the soles are in contact. Hold the baby's shins with your thumbs, the feet with the index, middle and ring fingers, and the buttocks with the little fingers. This position is useful for the development of the child: as well as on the back, he can play with his legs, improving movements, mastering his body and gaining an idea of \u200b\u200bspace.

In front of the stomach . In children from 7 months old, this method allows you to reproduce crawling in a plastunsky way - a motor skill that they just need to master at this age. With one hand, take the child under the chest, and pass the other between the legs, supporting the stomach. Don't forget to switch hands.

On the side. Suitable for babies from 10 months, when they are already sitting confidently. Take the child so that he wraps his legs around your side, and rests his back on your forearm. You should support the baby's knee with your hand, giving it a slightly bent position. One arm of the child is on your chest, the other is free. Please note: you need to wear a child in this position alternately from one side to the other.

And, finally, a universal and completely international way to carry children of any age. Holding the palm of your right hand under the breast of the baby, firmly press his back to your chest. With your left hand, grasp the child's right thigh, bending his legs at the hip joints. Please note: the weight of a child under 6 months should not fall on your hand supporting the baby's pelvis - this is harmful to his spine and can ruin his posture in the future.

The baby grows, his body weight increases, and it becomes difficult to carry the baby in his arms for a long time (especially after 3 months of age, when the weight of the child reaches an average of 7 kg). Here, assistive devices for carrying children, such as a baby sling and a kangaroo backpack, can help out for a while. A baby sling is a modern modification of a piece of fabric that provides close physical contact between mother and child. In addition, with it, if necessary, it is easier to breastfeed a child while on the street or in another public place. You can use a baby sling from birth to a year and a half. It all depends on the weight of the baby and your physical capabilities. It is also very important to find the optimal position for the child and for the mother, which would provide both with maximum comfort. The basic positions of the baby in a baby sling are horizontal, with support for the spine, and (for older children) raised vertical or sitting, when the baby is tightly pulled by the fabric. A kangaroo backpack can be used only after the baby learns to hold his head confidently and his back muscles get stronger. Preference should be given to backpacks with a rigid back. But, nevertheless, you should not get too carried away with a baby sling and a kangaroo backpack. Firstly, it is still more useful for the baby to lie on the hard mattress of the crib or stroller. Secondly, it is unlikely that the child will like to sleep while sitting in a backpack. And, thirdly, a long stay of a child in the same position, which causes an uneven load on different parts of the spine, can provoke a pathology of the musculoskeletal system. Therefore, it is not recommended to keep the baby in a baby sling and "kangaroo" for more than 40 minutes a day. When the child grows up a little, you can practice the pose when the baby sits on his mother's side, facing her. The advantages of this position: the mother has one hand free, and the child has an excellent view. If the mother, for health reasons, is not recommended to take the baby in her arms, then you can often put him on her stomach, put him on her knees.

And, finally, many parents are concerned about the question, is it possible to spoil him by often taking the baby in his arms? If the needs of the child are not ignored, they are not denied affection and tactile contact, then this does not mean at all that he is spoiled and poorly educated. Love is not a synonym for bad parenting, especially if we are talking about a baby who is only a few weeks or months old. There is an opinion that it is impossible to spoil a child up to 12 months - until this age, all his "whims" are justified by needs, so an adult should indulge the baby in everything. And only when the baby reaches the year, parents should selectively treat his requests - based on what they are caused by. From this age, it is already possible to instill in the baby the concept that not only he, but also the people around him have needs.

Harsh parenting methods, according to which taking a child in your arms means pampering him, ignore the natural need of the baby for the constant presence of the mother (or the one who cares for him). While promoting the principle of early formation of "independence", they have significant negative features. Firstly, a child who is deliberately separated from his mother does not develop a trusting, kind attitude towards the world, and this will certainly have a negative impact in his adult life. Secondly, the restriction of bodily contact between mother and baby does not contribute to the emergence of mutual feelings between them. It is not surprising that the child in such cases is perceived as a hindrance to the usual way of life and ordinary affairs. And the baby constantly needs communication and his crying is a call to everyone, and first of all to his mother. Indeed, even in those cases when, it would seem, there are no reasons for tears, the baby may burst into offended or angry crying - because he is not yet ready for loneliness, his biological connection with his mother is still too strong. Thirdly, it should be borne in mind that a strict attitude towards a child, when adults try not to show their feelings and emotions in relation to a child, is not a guarantee of a good upbringing of a child and his further success. Most often, a young mother has a lot of chores around the house. Therefore, if she often takes the baby in her arms, she will have to sacrifice some things. In addition, carrying a child in her arms is also physically not very easy. In general, if desired, there are many reasons for minimizing physical contact with a child. Here you need to prioritize and decide what is more important for you - the daily routine or the development of the child. If you want to properly take care of the child and at the same time not start life, look for helpers-allies with whom you can do everything.

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Clinic "Mother and Child" St. Petersburg

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