Burping and spitting up

Some babies will burp a few times while they are being fed, while others will burp only once or not at all. Many will also spit up. And this is all perfectly normal.

Why do babies need to burp?

Burping is a physiological mechanism that allows babies to expel excess air that they have swallowed along with the milk. Almost all babies burp immediately after feeding or within a few minutes, whether they are breastfed or bottle-fed.

Sometimes, burping is necessary during feeding. Such is the case if the baby tends to get restless and seems uncomfortable while feeding. Burping while feeding allows them to expel the air they’ve swallowed and continue to feed more easily.

How do you burp a baby?

The simplest way is to rest your baby on your shoulder in an upright position and gently rub or pat their back for a few minutes.

You can also sit them on your lap, place one hand under their chin to keep their head upright and put your other hand on their back. Then, gently rub or pat their back for a few minutes.

And if they don’t burp?

Burping can occur immediately after feeding, but also a few minutes later, or sometimes not at all. Some babies, especially those who are breastfed, almost never burp because they swallow less air.

If they still don’t burp after holding them against your shoulder for 10 minutes, try the other method. If your baby still doesn’t burp, don’t try to force it. They may have swallowed very little air while feeding, so they likely don’t need to burp.

How do you burp a sleeping baby?

Did your baby fall asleep on your shoulder while feeding without burping? You can put them to bed, no problem. If they need to burp, they’ll start to squirm or fidget after a few minutes. If so, hold them; they’ll burp and you’ll be able to put them back to sleep without a worry.

Why does a baby spit up?

Spitting up is safe and common. When a baby spits up, they expel a mixture of milk and saliva. It usually occurs just after feeding, when the contents of the stomach rise into the esophagus.

In babies, the cardia, the part of the stomach that prevents food from going back up the esophagus towards the mouth, is still immature. This is why regurgitation is also called simple gastroesophageal reflux. It’s painless, and doesn’t affect the growth of the baby.

Some babies spit up much more than others, which often worries their parents. But there’s no need to worry if your child continues to gain weight according to their growth chart.

A child will generally spit up most frequently beginning at around 4 months of age. However, they should stop spitting up by the time they are standing up more often, around 9 months to 1 year of age.

What do you do if your baby spits up a lot?

If your child spits up a lot, you might find some of these tips helpful:

• Give your baby three or four breaks during each feeding so they can burp and release air. Keep them upright for a few minutes after feeding.
• After feeding, place your child in a backward-tilting seat or high chair (if they’re old enough) for about 30 minutes. Baby carriers can also be a good way to keep your baby upright.
• Avoid putting pressure on their tummy, for example by not putting on their diaper too tight.
• If your child is old enough, try to give them solid foods.

Consult our fact sheet on gastroesophageal reflux if your baby experiences pain or irritability during or after feedings, problems sleeping or breathing (coughing, choking, recurrent pneumonia or bronchospasms), or insufficient weight gain.

Things to keep in mind

• If a baby hasn’t swallowed much air while feeding, it’s likely that they will not need to burp.
• Spitting up usually stops around 9 months to 1 year of age, when the child starts to be more upright.
• Spitting up after feeding is common and safe, but profuse, projectile vomiting requires medical attention.

Scientific review: Dr. Anne-Claude Bernard-Bonnin, pediatrician Research and writing: The Naître et grandir Team Updated: May 2020

Photo: iStock.com/Feverpitched