Along with changing diapers, mastering the swaddle, and figuring out how to get your wiggly newborn into a romper, one of the first new parent skills you'll get lots of practice at is burping. "Gas is air that gets trapped in the gastrointestinal system and needs to be released," says Shalini Forbis, M.D., a pediatrician and a Dr. Mom Squad blogger for Dayton Children's Hospital in Ohio. Burping is one way parents can help their baby get rid of that gas. Whether your baby is a big belcher or an infrequent burper, we've put together a primer for all your burning questions about burping.
What Is a Burp?
A burp is the release of gas bubbles up the esophagus and out of the mouth. These gas bubbles can also be released out the other end of your little bundle, resulting in a different noise -- and smell. Some burps, called wet burps or erps, bring up some of the stomach contents, too, hence the reason to always use a burp cloth when burping a baby.
Why Babies Need to Burp
When gas bubbles get stuck in your baby's stomach, they can cause a feeling of fullness and discomfort, which often causes babies to squirm or cry. Babies use crying as a signal to announce almost every feeling, whether they are tired, hungry, wet, or bored, so it can be hard to know if crying is due to gas discomfort. That's why the American Academy of Pediatrics (AAP) recommends burping your baby regularly, even if your baby doesn't show discomfort or release any gas when you burp her. "We do not know how much air gets in their little stomachs, so it is a good idea to burp the babies even if they do not get to the fussy stage," recommends Erika Landau, M.D., a pediatrician in New York City and coauthor of The Essential Guide to Baby's First Year.
These are three main ways babies get gas in their bellies.
Swallowing air -- When babies nurse or drink from a bottle, they inevitably swallow some air, which goes down into their stomach along with the milk or formula. "This happens more often with bottle-fed babies, who tend to eat faster," says Dr. Landau. "But breastfed babies swallow some air as well, especially if the mother has a lot of milk or has a fast letdown, or if the baby is very hungry and wants to eat fast."
Digestion -- The breakdown of certain foods in the large intestine by bacteria can naturally create gas. This includes both the food that the baby consumes as well as those the mother consumes and passes on in her breast milk. According to the National Institutes of Health, foods that contain carbohydrates are more likely to cause gas. Some of the most common offenders are beans, vegetables (such as broccoli, cauliflower, cabbage, and brussels sprouts), sugar-free candies and gum, and soda and fruit drinks.
When to Burp Your Baby
The AAP recommends burping your baby during feeding breaks and when he's done eating. For breastfeeding moms, try burping before switching breasts. For bottle-feeding moms, the AAP recommends burping between every 2 to 3 ounces for newborns up to about 6 months old.
The Best Burping Positions
There are two common burping positions: over your shoulder or sitting your lap. Try both to see what is most comfortable for you and most effective for getting burps out of your baby.
Whichever position you choose, be sure to have a burp cloth by your baby's mouth to catch any spit-up.
How to Burp Your Baby
Once you have him in position, you can start burping your baby. "Pat your baby on the back, gently for a minute or so," explains Dr. Forbis. For newborns, make sure you are supporting the head and neck. "If your baby is fussy and hasn't burped yet, you may want to try burping, then stop and let them lie on your lap for a minute and then try burping again." Changing baby's positions can help move those gas bubbles to a better position to be released.
What to Do if Burping Baby Isn't Enough
If burping doesn't seem to be relieving your baby's discomfort, try other positions and techniques to help get the gas moving. "Parents can help by giving infant massage or pushing the legs back and forth when the baby lies on her back -- bicycling," suggests Dr. Landau. "Letting the baby be on her stomach while she is awake can help as well."
If your baby is regularly uncomfortable due to gas, consider changing one of these potential gas-causers to decrease gas production.
Mom's diet - If you're breastfeeding, a food in your diet could be causing baby's discomfort. "Everyone is different but one of the most common culprits for gassiness is dairy -- milk, cheese, ice cream," says Leigh Anne O'Connor, a New York lactation consultant. Dietary changes are worth a try, but keep in mind that it can be tricky to find the offending food because some foods take weeks to get out of your system. Plus, foods that produce gas in one person may not cause gas in another.
Mixing formula -- Measure the water, dump in the formula, and shake, right? Actually, shaking vigorously adds lots of air to the formula that can lead to excess gas. Instead, try premixed formula or letting the bottle settle a bit before feeding your baby.
Nipple flow -- Bottle nipples come in a variety of flow options (that are usually classified by age (preemie, newborn, 3 to 6 months, 6+ months, etc.). If you use a nipple that is too advanced for your baby, it may be releasing the milk or formula too fast, making the baby gulp, sputter, and swallow a lot of air in the process. Choose an age-appropriate nipple to try to limit the amount of air swallowed during feedings.
Bottle style - If your bottle-fed baby struggles with excessive gassiness, consider switching to a bottle style designed to decrease the amount of air in the bottle. As babies drink, air gets into the bottle through the nipple, explains Dr. Forbis. "Some bottles are better angled to keep the milk towards the nipple, and these may help," she says. Parents can also try bottles with disposable liners, vents, or straw-like system bottles that allow fewer air bubbles from seeping in or allows the bubbles an alternate way out of the bottle, says Dr. Landau.
Over-the-Counter Meds to Help Relieve Gas
If nothing seems to bring gas relief, there are over-the-counter medicines for infant gas relief that parents can try. First, though, says Dr. Forbis, make an appointment with your pediatrician. "Your doctor will make sure your child is growing well and that there are no other signs that something else is going on." Once you get your doc's okay, you can try simethicone gas drops such as Mylicon or Little Tummy's gas relief drops. According to the AAP, though, these drops are thought to be safe but not particularly effective. And many aren't cheap, so check the bottle or store for a return policy if you find they don't work for your child.
Gripe water, an herbal-based remedy that often includes a combination of stomach-calming herbs such as chamomile, dill, ginger, or peppermint, can help some babies. Make sure your pediatrician recommends gripe water and be sure to choose an alcohol- and sugar-free version.
When You Should Stop Burping Your Baby
There is no definitive age to stop burping your baby, but as your little bundle gets older and his digestive system becomes more mature, burping will become less of a necessity, says Dr. Landau. You'll likely see this change around 4 to 6 months, when your baby starts eating solid food. That being said, if you still notice your baby is gassy, continue with burping and other gas-relief techniques until you feel they are not needed.
When to Worry About Burping
Burps, toots, and spit-up from babies are completely normal. Projectile vomiting is not. If your baby is violently vomiting up large amounts after feedings, contact your pediatrician to look for other causes. Normally, gassiness shouldn't come with additional symptoms. "If your baby has a temperature over 100.4 degrees F, diarrhea, bloody stools, or is so fussy that he can't be settled down," the burping may be a sign of something else going on, Dr. Forbis says.
On the other hand, if your baby is gassy, but is growing and feeding well, you likely don't need to worry. Someday, Dr. Forbis says, your baby will outgrow burping. And then you might even look back fondly on that time.
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