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Sitting 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:

  1. 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.
  2. 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.
  3. 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. nine0015

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. nine0003

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:

  1. 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. nine0044
  2. 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.
  3. 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. nine0015

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. nine0015

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. nine0003

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. nine0015

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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Infant Reflux: Symptoms and Treatment

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Signs and what to do


Post-feed spitting up is common in the first few months of life. This is usually harmless and completely normal, but parents should read about gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) in infants and how long it lasts to give them peace of mind.

We look at signs of reflux in babies, symptoms of different types of reflux, and how to help a child with signs of reflux. If you require further information, always contact your healthcare provider. nine0003

What is reflux in babies?


So we know reflux is common, but what causes reflux in babies? Because young children have not yet fully developed the lower esophageal sphincter (LES), that is, the muscle at the bottom of the esophagus that opens and closes to let food into the stomach and keep it there, food can easily pass back up the esophagus.


Acid reflux, also known as gastroesophageal reflux (GER), is a normal reflux that occurs in babies. This type of reflux is considered normal and occurs in 40-65% of babies. nine0003

How do I know if my child has acid (gastroesophageal) reflux?


If a baby is spitting up milk after a feed, it is most likely acid reflux. As babies get older, GER usually goes away on its own without any intervention. If a baby has complications beyond just spitting up a small amount of milk (such as feeding difficulties and discomfort), they may have gastroesophageal reflux disease (GERD). nine0015

Symptoms of GERD include:

  • baby arching during or after feeding;
  • crying more than three hours a day for no apparent reason;
  • cough;
  • gag reflex or difficulty swallowing;
  • irritability, restlessness after eating;
  • eating little or not eating;
  • poor weight gain or loss;
  • difficult breathing;
  • severe or frequent vomiting. nine0015

GERD usually occurs when the muscle tone of the LES muscles fails in time, causing stomach contents to back up into the esophagus.

How do I know if my child has Laryngopharyngeal Reflux?


Another type of reflux, laryngopharyngeal reflux (LPR), also called silent reflux, is when the contents of a child's stomach leak back into the larynx, the back of the nasopharynx. This type of reflux does not always cause external symptoms, which is why it is called "silent". Babies can have GERD and silent reflux at the same time, but their symptoms are somewhat different. nine0015

The following are some of the symptoms of laryngopharyngeal reflux:

  • trouble breathing;
  • gag reflex;
  • chronic cough;
  • swallowing problems;
  • hoarseness;
  • regurgitation;
  • poor weight gain or weight loss.

We have looked at the signs of reflux in infants, now we will move on to the treatment and duration of silent reflux in children, as well as the treatment of GERD. nine0003

How to deal with laryngopharyngeal reflux in babies while breastfeeding?


Breastfeeding mothers may need to review their diet if their babies show signs of reflux. The American Academy of Pediatrics (AAP) recommends breastfeeding mothers cut eggs and milk from their diet for two to four weeks to see if their baby's reflux symptoms improve or disappear. It may be worth eliminating acidic foods from your diet. nine0015

In most cases, GER and laryngopharyngeal reflux go away on their own. Typically, children outgrow reflux in the first year of life. If a child has persistent symptoms of laryngopharyngeal reflux, parents should consult a doctor. If your baby has severe vomiting, blood in the stool, or any of the symptoms of GERD listed above, parents should contact their pediatrician as soon as possible.

How can I help my child with reflux or GERD? nine0008


Reflux symptoms in babies usually go away on their own, but the following tips can help relieve symptoms:

  1. Thicken your food with rice or a special milk thickener.
  2. Hold the bottle at an angle that fills the nipple completely with milk to reduce the amount of air your baby swallows. This can help prevent colic, gas, and reflux.
  3. Try the AirFree anti-colic bottle, designed to reduce air swallowing during feeding. nine0044

4. Let your baby burp during and after feeding. If the baby is bottle fed, parents can let him burp after every 30-60 ml. If the mother is breastfeeding, she may let the baby burp when changing breasts.

5. Hold baby upright after feeding. As a rule, in order for the milk to remain in the stomach, after feeding the baby, it is necessary to hold it in an upright position for 10-15 minutes. But, if the child has reflux, parents should keep him upright a little longer. nine0003


These tips may help relieve symptoms, but they do not replace a doctor's advice.


Parents should not change their infant formula without first talking to their doctor.


Don't panic! Reflux is very common in babies during the first three months of life, and most babies outgrow it without any consequences. Although GERD is a slightly more serious condition, there are many treatments, ways to manage it, and help newborns. Feel free to contact your doctor with any questions or concerns you may have. nine0003

4 Seattle Children’s Hospital

5 The National Institute of Diabetes and Digestive and Kidney Diseases - Treatment for GER & GERD in Infants

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