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Will a baby burp after every feeding


How to burp your baby

Baby burps are cute – and they serve a purpose. Pint-size belches release air trapped in your baby's stomach, making them more comfortable. Burping also frees up room in your baby's tummy so they can settle in and feed longer. And if you don't get the air up, your baby may become fussier and swallow even more air. Experiment with different positions (up on your shoulder, sitting on your lap, or lying across your lap) to find the best way to burp your baby.

Some babies need to burp during every feeding, while others rarely need to burp at all. Some take a lot of time to burp, while others burp with the first couple of pats. You'll soon learn your baby's burping needs – here's how to meet them.

How to burp a baby

There's more than one way to get the job done. Here are three different burping methods you can try. Experiment to find the one that's most comfortable and effective for you and your baby.

Burp your baby on your chest or shoulder
  • Put a cloth over your shoulder (letting it fall down your back) to protect your clothes from spit-up.
  • Hold your baby against your chest so their chin is resting on your shoulder.
  • Support their bottom with one hand and gently pat or rub their back with the other.

Or, try this as an alternative when your baby has more head and neck control:

  • Hold your baby farther up on your shoulder – high enough that your shoulder presses lightly on their belly, creating gentle pressure that will draw out the burp.
  • Support them with one hand and gently pat or rub their back with the other.
  • Make sure your baby is able to breathe comfortably and isn't slumped over too far. A quick peek in the mirror to check their head placement can be helpful.

Burp your baby while they're sitting on your lap
  • Put a cloth bib on your baby or a cloth over your lap to catch any spit-up.
  • Sit your baby on your lap facing away from you or to the side.
  • Use one hand to support their body, the palm of your hand supporting their chest while your fingers gently support their chin and jaw. (Make sure you're not putting your fingers around their throat.)
  • Lean your baby slightly forward and gently pat or rub their back with your other hand.

Burp your baby face-down across your lap
  • Put a cloth over your lap to catch any spit-up.
  • Lay your baby face down on your legs so they're lying across your knees, perpendicular to your body.
  • Support their chin and jaw with one hand. Make sure your baby's head isn't lower than the rest of their body so blood doesn't rush to their head.
  • Pat or rub their back with your other hand.

Whichever position you use, here are some general tips for burping your baby:

  • Make sure their back is straight, not curled over.
  • Use firm but gentle pressure.
  • Try circular motions, too.
  • If you're bottle-feeding, you may find that certain types of bottles help your baby swallow less air and reduce the need to burp.
  • If your baby tends to spit up a lot, you may want to avoid positions that put added pressure on your baby's tummy during burping (high on your shoulder or lying face down across your lap, for example).

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When do babies need to be burped?

One good strategy is to take a burping break after every 2 or 3 ounces if you're bottle-feeding, or when your baby switches breasts if you're breastfeeding.

If your baby seems uncomfortable while feeding – they're squirmy, or they pull away and start crying, arch their back, or pull up their legs – it may be because they have some air in their tummy. This is a good time to give burping a try.

If you don't burp your baby when they need it, air will take up the room they need to fill with breast milk or formula. (Their tummies are small!) Trapped air can make a baby gassy or spit up often. It can also cause a vicious cycle – if your baby is unhappy because they need to burp, they may cry and swallow more air, making them need to burp even more.

Burping can also be beneficial for babies who spit up often or have gassy tummies or symptoms of gastroesophageal reflux disease (GERD).

That said, there's no rule that babies have to burp during every feeding. If your baby rarely burps and falls blissfully asleep after feeding, you may not need to burp them. In fact, some babies may not need to be routinely burped.

"If your baby is a good eater – is gaining weight well – and doesn't seem affected by gassiness or reflux, then skipping the burping sessions altogether is reasonable," explains Liz Donner, M.D., a pediatric hospitalist in Orlando, Florida.

When to stop burping your baby

As babies get older, their digestive systems become more mature, and they may learn to eat without swallowing a lot of air. This may happen around the time they start solid food, at around 4 to 6 months. There's nothing wrong with continuing to burp your baby after this time, though, if you think they still need some help.

How long do you have to burp a baby?

Some babies burp easily and others need a little (or a lot of) help. Most will let out a burp within a few moments, but others may take longer and need more coaxing.

You can stop burping your baby once they get a burp or two up and seem comfortable. If they're not full, they'll eat more – and likely need to be burped again.

If your baby hasn't burped after a few minutes and seems fussy, try a different position. If they still seem uncomfortable, lay them down for a minute on their back. Gently rub their tummy and /or bicycle their legs. Then pick them up and gently try to burp them again.

If you've tried burping your baby for a few minutes and nothing's happening, it's fine to stop – your baby may not have any air trapped that needs to come up. If you know your baby generally takes longer to burp, though, keep trying. Taking the time to make sure your baby has all the air bubbles out will make them happier – and help them rest better if they're about to nap or sleep.

Do breastfed babies need to be burped?

In general, breastfed babies don't need as much burping as bottle-fed babies because they tend to swallow less air when feeding. In fact, some very efficient nursers don't need to be burped at all.

But some breastfed babies definitely do need to be burped. If you have a fast letdown and/or a lot of milk, your baby may swallow some air as they adjust to the flow and need burping later. A breastfeeding baby may also swallow a lot of air if they're very hungry or upset when they start nursing. Every baby is different, so follow your baby's cues.

Learn more:

  • Swaddling a baby
  • Why babies spit up
  • How to care for a newborn
  • Baby hiccups

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Burping Your Baby (for Parents)

en español: Hacer eructar a su bebé

Reviewed by: Madhu Desiraju, MD

Primary Care Pediatrics at Nemours Children's Health

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

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Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation - Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day, at least 50% of babies from 0 to 3 months old can spit up, more than 60% of children 3-4 months old, and in 5% of children spit up continues up to the year 1 .

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

  • Features of the structure of the upper digestive tract in babies
  • In newborns and infants up to a year of life, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year 2 .
  • Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
  • Normally, the lower esophageal sphincter should tightly "close" the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well 2 .
  • Slow movement of food through the gastrointestinal tract
  • The neuromuscular system of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters - if it is too large, the newborn swallows a lot of air 3 .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled 3 .

Promotes regurgitation after feeding and a predominantly horizontal position of the baby during the day, combined with relatively high intra-abdominal pressure 4 . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be provoked by other situations in which pressure in the abdominal cavity increases and stomach contents are thrown into the esophagus, in particular 3 :

  • tight swaddling;
  • stool disorders, in particular constipation;
  • long, forced cry and some others.

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How can you tell the difference between normal spitting up and vomiting?


Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation 1 .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more 1 .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 - 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. When the range of the jet of vomit is up to 50 cm, doctors talk about "vomiting a fountain." A variant of atonic vomiting is possible, when the contents of the stomach flow "sluggishly". It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus 1 .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor's consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day 1.3 .

Physiological regurgitation: symptoms


Regurgitation in newborns, which is considered a normal variant and does not cause concern to pediatricians 3 :

  • usually continues for a certain period of time;
  • is characterized by slow, "passive" leakage; if the baby spits up a fountain, it is better to consult a doctor;
  • has a sour smell of curdled milk;
  • occurs without the participation of muscles - the baby does not strain during regurgitation;
  • does not affect the general well-being of the baby.

How to help a newborn who spit up often?


If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

  • Frequent feeding of the baby
    It is known that the baby is more prone to spit up if his stomach is full. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all - on demand 5 .

  • Correct feeding technique
    Every feeding, the mother must ensure that the baby does not swallow too much air during suckling. When sucking, there should be no loud, smacking, clicking sounds. You also need to control that the baby captures the nipple along with the areola.

  • Choosing the right bottle and nipple
    If the newborn is bottle-fed and receiving formula, it is important to choose the right bottle and nipple. The hole in it should be such that the milk flows out in drops, and not in a stream. The nipple must not be filled with air

    New Anti-colic bottle with AirFree valve

    The AirFree valve prevents air from entering the baby's stomach.

    • Baby standing upright after eating

    To allow air that has entered the digestive tract during meals to escape, it is important to keep the newborn upright for 10-20 minutes after feeding 4 .

    • Ensure the correct position of the baby during sleep

    To reduce the negative impact of the acidic contents of the stomach on the esophagus, it is necessary to put the baby to sleep in the supine position. The side or prone position, which many pediatricians used to recommend, is no longer recommended. It was found to be associated with an increased risk of sudden infant death syndrome 5 .

    If parents notice alarming symptoms, such as spitting up too often or large volume, etc. , it is important to consult a pediatrician without delay. This will allow you to identify the real problem in time and help the baby grow up healthy and happy.

    References

    1 Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. V. 7. No. 4.

    Nagornaya 2900 V., Limarenko M. P., Logvinenko N. G. Experience with the use of domperidone in suspension in young children with regurgitation syndrome // Child Health, 2013. No. 5 (48).

    3 Zakharova IN Regurgitation and vomiting in children: what to do? //Pediatrics. Supplement to Consilium Medicum, 2009. No. 3. S. 58-67.

    4 Zakharova I. N., Sugyan N. G., Pykov M. I. Regurgitation syndrome in young children: diagnosis and correction // Effective pharmacotherapy, 2014. No. 3. P. 18-28.

    5 Vandenplas Y. et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) //Journal of pediatric gastroenterology and nutrition. 2009; 49(4): 498-547.

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    Preventive measures against regurgitation in children

    08.03.2017

    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:

    1. 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.

    2. 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.

    3. 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;

    • diaphragmatic hernia;

    • 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:

    1. Less than 5 regurgitations per day with a volume of not more than 3 ml - 1 point.

    2. More than 5 regurgitations per day with a volume of more than 3 ml - 2 points.

    3. 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.

    4. Spitting up a small amount of milk for 30 minutes or more after each feeding - 4 points.

    5. 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:

    1. 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.

    2. 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.

    3. Before you start feeding your baby, lay him belly down on a solid base.

    4. After feeding, try to minimize the baby's physical activity, do not disturb him unnecessarily, and change clothes only if there is an emergency.

    5. Avoid squeezing diapers or clothes on the abdomen of the child.

    6. 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.

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