Burping, Bubbling, Or Bringing Up Air

There is always air in your baby’s stomach. He swallows some while crying or just breathing as well as when he feeds. If you feed with the baby in a fairly upright position, the heavier milk will find its way to the bottom of the stomach and the lighter air will gather at the top. When the stomach is uncomfortably distended with milk and air the baby will burp some of the air out.

Burping Midway Through Feedings

Some babies swallow so much air that their stomach get uncomfortably distended before they have had enough milk. They need a half-time burp to make room for the rest of the feeding. A breast-fed baby who needs to burp will probably do so when he is shifted across from the first breast to the second. A bottle-fed baby will stop sucking. If you hold him upright for a moment, he will burp and then return to his feeding.

There is no need to remove the nipple from the mouth of a baby who is sucking happily, just in case he has too much air in his stomach. If he still sucking, he is not uncomfortably full and should be left to suck in peace.

Burping After Feedings

All your baby needs is the opportunity. Hold him upright against your shoulder; rub his back or pat it gently, and see what happens. If he has not burped after three minutes, he does not need to.

Don’t feel that you must not put him in his crib until he has burped. He may not have taken in much air this time. If he needs to burp later, he will do so, with or without your help.

A sitting up position is often recommended for burping. Be sure that while he is sitting forward with his chin supported in your hand, his stomach is not folded so that it is difficult for the air to rise above the milk level and escape. Don’t try to force air out of him; force will certainly bring milk with it.

If your baby is one of the few who really seems uncomfortable until he has burped, but is slow to do so, he may manage better if you put him to sleep lying on his stomach rather than on his side. In this position he can burp if needs to, and if he brings milk up with the air (see Spitting Up Milk below), there is no risk of him choking on it.

Burping

Burping is an overrated problem. Your baby will get air in his stomach. Milk, which is heavier than air, will fall below it if you hold him upright, so he will usually burp the air out. But if he does not, don’t waste time thumping him. His stomach may not be uncomfortably distended this time; he may burp later in his crib; either way it does not matter.

• Over-the-shoulder

Place your baby high on your chest with his head peeking over your shoulder. Support him well across his back and buttocks. Gently rub or pat his back until you hear a burp.

The best burping position: the baby is stretched out straight and upright.

• Over-the-lap

Place your baby on his tummy across your lap. Gently rub or pat his back until you hear a burp.

A burp in this position will almost certainly bring milk with it as air cannot rise above the milk level.

• Sitting and rocking

Sit your baby sideways on your lap. Place your thumb and first finger under his chin with your palm supporting his back. Gently rock him back and forth. You might lightly rub or pat his back until you hear a burp.

In this position, the baby’s stomach is folded, making it difficult for air to rise above the milk level and escape.

Spitting Up Milk

Almost all babies sometimes bring up some milk along with the air. Usually the quantity is very small, although it may look a lot because it is mixed with saliva and spread all over your shoulder! If you are worried, spill 1/4oz (5ml) on purpose to give you a standard of comparison. If it really is a lot, there are several possible reasons for it:

• The baby may have sucked more than he could comfortably hold. He is sensibly bringing back the overflow.
• You may have fed him in too flat a position, preventing the air from rising above the milk. Try holding him more upright.
• You may have bounced him about, mixing the air with the milk, or banged him on the back before the air had reached the top of the stomach. Handle him gently immediately after feedings.
• You may have delayed his feeding while he cried, or you may have made him cry mid-feeding by trying to make him burp when he wanted to suck. The crying will have put a lot of extra air into his stomach, followed by the rest of his milk.
• You may not have tilted the bottle sufficiently to ensure that the entrance to the nipple was always covered with milk. The baby will have had sucks of pure air between sucks of milk and it will all be mixed up together in his stomach.
• The hole in the nipple may have been too small so that the baby had to suck very hard and swallowed air with each mouthful of milk. Check that when you hold the bottle upside down, milk drips out at several drops per second. (Don’t check with water; because it is thinner it comes out faster than milk.)
• Some babies spit up a great deal, bringing back milk at every feeding – sometimes more than once. They may reduce your clothes to ruins and you to despair but they do themselves no harm. Check with your doctor if you are worried, but unless your baby is failing to soak his diaper (without being given extra drinks of water) or to gain weight, you can be sure he is not losing more from his feedings than he can spare.

Vomiting

If a baby brings up milk some time after feeding, it will be curdled because digestive juices will already have been working on it. If an hour or more has passed since the feeding, it may smell nasty. The baby may only have had some air trapped inside the stomach which has now come up bringing the partly digested milk with it, or there may be a digestive disturbance or it may signal the beginning of an illness.

If the baby seems unwell and especially if there is any fever or any sign of diarrhea, consult your doctor or clinic. If the baby seems perfectly well let hunger guide feedings as usual and just keep an eye open for any symptoms.

Projectile Vomiting

This is quite different either from hiccuping milk up with some air or from ordinary vomiting. The baby spurts milk out toward the end of a feeding with such force that it may hit the floor or a wall as much as three or four feet away.

A baby who does this regularly probably has a condition called “pyloric stenosis.” This is a fault in the muscles of the stomach outlet. It is much more usual in boys than in girls and is easily and permanently corrected by a small operation.