Do Breastfed Babies Need to Be Burped?

A mother feeding her baby under a draped muslin cover at an outdoor table, the father beside her and a pram alongside

Far less often than bottle-fed babies, and some breastfed babies never need it at all, which I didn't believe until I had one.

The reason is mechanical, and once you know it you can tell from watching a single feed whether wind is going to be a problem, which is a better use of ten minutes than anything I can write here.

Why the latch decides it

A baby who's deeply latched forms a seal with her mouth, and a seal means very little air travels in alongside the milk, because there's no gap for it to come through, and that's the whole of the mechanism. A shallow latch breaks that seal over and over. Air goes in with every suck, and the same shallow latch is inefficient, so she works harder and swallows more, and this is the reason the answer to a windy breastfed baby is nearly always the latch and almost never the winding technique, however much time the winding takes up. You can hear it. Clicking or smacking sounds, dimpled cheeks pulling in, milk escaping at the corners of her mouth, and pain for you, all of them signs that air is getting in, whereas a good feed is quiet apart from a soft rhythmic swallowing, and it shouldn't hurt beyond the first few seconds, whatever anybody told you about toughening up. If any of that sounds like your feeds, the most valuable thing available to you is having somebody experienced watch a whole feed in person. Not a video, not a description over the phone, somebody in the room looking at your baby on your chest, and it's the step most often skipped and the one that resolves the most, and I say that having been both the person watching and, a long time ago, the person too proud to ask.

When she does need more

There are particular situations that put air in even with a perfectly good latch, and each has its own fix, so they deserve being able to recognise.

Breastfeeding situations that put air in, and what to do
What is happening	Why it puts air in	What helps
Fast let-down; gulping, coughing, pulling off	She swallows air between gulps trying to keep up	Laid-back feeding position; express a little first; wind at the pull-off
Shallow latch, clicking sounds	The seal is broken and air enters alongside milk	Get the latch checked; wind at the change of sides
Crying hard before the feed starts	She swallows air while crying, before any milk	Feed at early cues, never late ones
Oversupply, or a very full breast	Flow is faster than she can pace	Feed one side per feed; upright or laid-back position
Feeding to sleep on and off	Repeated re-latching, each one a small air gap	Wind briefly at the end, then hold upright

The commonest by a distance is a fast let-down, where she gulps and splutters and comes off and goes back on, and every one of those is a mouthful of air. Feeding lying back so gravity works against the flow, or expressing a small amount before you start, changes it completely, and I wish somebody had told me that with my second, who I now suspect spent three months drowning politely.

If feeding itself is the problem

When to bother

Offer it briefly and stop. A minute at the pause between sides, and a minute at the end.

If she's settled, put her down, and if she's squirming or arching or pulling her knees up, spend two minutes on it and then think again, because there's no benefit in extending it and there's a real cost, particularly at night, when the cost is everybody's sleep.

It also drops away quickly. Most breastfed babies need very little of this after three or four months, and by six it'll have gone entirely without your having decided anything, which is how most of the best changes in the first year arrive. Mine did it somewhere around four months, or maybe five, I forget.

Mentioned above

Cambrass Moon Nursing PillowS$129.00Shop now

Cambrass Arm PillowS$39.00Shop now

Bamboo Wash Cloth 4pc (Rustic Rainforest)S$25.00Shop now

The wind burping can't reach

A great deal of what gets called wind in a breastfed baby isn't in the stomach at all, and no amount of holding her upright will help it, however long you stand there.

Gas produced further down comes out the other end, and the treatment is entirely different, so it's a distinction to have clear in your head. The signs are knees drawn up to the chest, straining and going red, discomfort arriving in waves, and visible relief after passing wind or a stool.

For that: bicycle her legs slowly, bring her knees gently up to her tummy and release, a warm bath, supervised tummy time while she's awake, and a slow clockwise massage on the abdomen, and carrying her upright against you does more than most of it, which is convenient because you were going to be carrying her anyway.

And a word on the remedies. Gripe water, simethicone drops and the colic preparations all have weak evidence, and I used every one of them across five children without ever being able to say one had worked, so ask a pharmacist if you want to try one, and hold your expectations lightly, and keep the receipt.