Looking back two years ago to the time when my husband and I brought our first-born home from the hospital, I remember my first-time mother feelings of inadequacy and nervousness when I attempted to burp my little boy. No matter what I did, or the way I tried it, my infant son would never produce a burp for me. Yet much to my dismay, when my husband took his turn during a nightly feeding session, our little bundle freely produced sounds of relief.
Feeding a newborn can be an exciting, challenging, yet intimidating experience for any parent, whether it’s your first or third baby. Getting your degree in the “art of burping” will take you on a journey filled with bumps, spittle and yes, extra loads of laundry.
Common Burp Positions
There are three common positions to use when you begin to burp your newborn: over the shoulder, face down on your lap, and sitting up. It is important to remember that if you are not getting the desired results from one position, you need to try another, since most babies burp better in one position rather than another.
Over the shoulder position requires you to hold your newborn firmly against your shoulder, and apply a patting or rubbing motion with your hand on your little one’s back. Support your baby’s lower back and bottom with your other arm. “A baby can be burped in several ways, but parents should always remember the position of the stomach. The most common way is over the shoulder, with Mom or Dad in an upright position and the child slightly over the shoulder, giving slight pressure on the abdomen and patting their back,” advises Rosemary Shy, MD, FAAP, and Assistant Professor of Pediatrics at the Children’s Hospital of Michigan.
The face down, on your lap position requires you to place your newborn on your lap with their head resting on one leg and their stomach over the other leg. You must support the baby with one hand, while you apply a patting or rubbing motion, or gentle pressure on their back with the other hand.
If you should decide to try the sitting up position, position your baby in your lap with his/her body leaning forward. Support the chest and head with one hand while you pat your baby’s back with your other hand.
“These three are the most popular methods,” states Mary Margaret Gottesman, PhD, RN, CPNP, and Pediatric Nurse Practitioner Specialty Program Director of the Ohio State University College of Nursing. She recommends, “Parents must take care to support the baby’s head and neck safely during positioning for burping, and move the baby in a gentle, slow manner so as not to startle and scare the infant. Babies usually do not like rapid movements.”
When Should Baby Take a Burp Break?
If you are planning to breastfeed your newborn, many healthcare providers and specialists agree about timing burps. “A good rule of thumb is to burp the baby each time he/she switches breasts,” says Karen S. Rance, RN, MSN, CPNP of Tidewater Pediatric Consultants in Virginia Beach, Virginia. “Babies tend to swallow air during their feedings and therefore can become fussy or spit up if they are not burped frequently. If a baby swallows too much air, they can become cranky and exhibit colicky behavior. Burping helps to slow down and interrupt the baby’s eating cycle, and decreases the amount of air that the baby will swallow during a feeding.”
Bottlefed newborns tend to experience more trapped gas or air bubbles than those who are exclusively breastfed. “Most bottlefed babies need to burp more frequently than those who are breastfed. It may depend on the type of formula, type of bottle, size of the baby and individual stomach, and fussiness,” says Dr. Shy. She cautions parents-to-be, “Remember that an infant’s stomach is only the size of a golf ball at birth, and so it is not so large as to easily have air and food at the same time.”
Gottesman says that whether feeding by breast or bottle, moms should observe the changes in their babies’ feeding behavior. “When their baby markedly slows down or stops feeding, gently remove the bottle and burp the baby. Also, at the end of a feeding, they should attempt to burp the baby again. Parents should be helped to identify the baby’s cues of fullness: a relaxed body, drifting off to sleep, cessation of active sucking and swallowing, and accepting these signs of fullness to stop feeding. Babies should not be forced to finish their bottles once they are clearly indicating their fullness.”
What If My Baby Still Won’t Burp?
“A mother need not feel a sense of failure if her baby doesn’t burp at every attempt,” says Rance. “When babies feed in a more upright position, they naturally will have less trapped air than if they are fed lying flat.” Every baby is different, and more often, breastfed babies may not need to produce a burp during feedings.
“If a decent attempt at burping has been made, especially for breastfeeding babies, parents do not need to obsess,” says Gottesman.
If Your Newborn Spits up During a Burp
One thing that I learned and experienced when I became a mother is that all babies will spit up. Spitting up is a common occurrence during a burp and does not necessarily mean that your baby is vomiting. “It is very common for infants to spit up a mouthful or two of formula or breastmilk when they burp because it is sitting on top of the gas bubble,” states Gottesman. “As the gas bubble breaks, it pushes up those small amounts of milk. Also, the muscle at the entrance of the stomach that holds the feeding in the stomach is weaker than it will be in later life, making it easier for infants to regurgitate portions of their feedings.”
Rance agrees. “Most often the spitting up will stop by the time the baby begins to sit upright or when they reach six months of age. Often, a healthy baby can spit up a tablespoon or two with each feeding. To decrease the amount of spitting up, try placing the baby in an upright position for 20 to 30 minutes after the feeding.”
If your newborn tends to be spitting up more frequently during each feeding session, seek consultation with your child’s pediatrician or professional caregiver. Gottesman also suggests taking a sample of the spit-up with you during your appointment. “If parents are concerned about whether the amount their baby spits up is normal, they should place a burp cloth from a recent feeding in a Ziploc baggie and take it with them to their health visit so that the health professional can see exactly the amount about which they are concerned.”
Sit Back, Relax, Enjoy, and Observe Your Newborn
“Most infants tell you that they need to burp, and mothers usually learn to recognize these signs very quickly,” says Dr. Shy. “A small frown, wiggling, faster eating are a few common ones.”
“Enjoy your newborn, since there is no ‘one right way’ to go about burping a baby. New parents need to feel the liberty to try multiple combinations of feeding and burping positions,” says Rance. “Newborn babies will communicate their needs to you through the type of cries they make, so keen observation and trusting your instincts are the key.”