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Burping and Spitting Up

Angela Oswalt, MSW

During and after feeding, infants need to be burped in order to release air bubbles that can cause discomfort and pain. It's normal for babies to take some air into their stomachs while they're drinking and breathing. The number of times a baby needs to be burped during the feeding process depends on the type and amount of milk drank and the baby's individual needs. It's ideal, especially in the first few months or if the baby has a problem with either acid reflux or spitting up, that they are burped every two to three ounces of formula. If a baby is breastfeeding, mothers often burp the baby when they switch breasts.

There are two positions caretakers can use to burp a baby. They can rest the baby on their shoulder with the baby facing away, or they can sit the baby up in their lap. It is important to remember to always support a baby's head and neck during the early months before they can do so themselves. This is another opportunity to discipline and to soothe babies, because often they do not enjoy burping, especially if it's mid-bottle, and will fuss and cry. Caregivers should continue to try to elicit a burp if the baby is squirming or appears to have stomach discomfort. If the baby appears comfortable and does not burp, they may not need to burp and can end the feeding without it. Caregivers should then gently but firmly pat or rub the baby's back in order to coax the air bubbles out and stop when they hear a healthy burp.

Spitting Up

In either position, caregivers will want to have a burp cloth, such as a receiving blanket or cloth diaper, on their lap or over their shoulder in case babies spit up as well as burp. Often caregivers become concerned that their babies are spitting up what appears to be a lot of milk. Most of the time, spitting up is normal and infants only spit up a teaspoon or two of milk, although it can look like much more. If parents are still concerned they can consult their doctors, especially if the spit-up is colored, bloody, projectile, seems excessive, or if the baby is failing to gain weight. Some babies do suffer from gastroesophageal reflux, or acid reflux, which is a condition that causes the stomach acid to back up into the throat. The doctor may prescribe medicine to make them more comfortable, but caregivers can also adjust their feeding technique to help as well. They can feed the baby in an upright position, keep them upright up for at least 30 minutes after the feeding, and burp after every few ounces. Normally, babies with this condition will outgrow it by the time they start eating solid foods.

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