How to Burp a Baby: Positions, Timing and Technique

I was taught to burp a baby for twenty minutes after every feed and to keep going until something came up, and I did it faithfully with all five of mine, in two countries, at every hour of the night, and I now think a good deal of that time was spent achieving nothing at all except keeping a sleepy baby awake.

I say that at the start because reassurance on its own doesn't get anyone back to sleep. The technique below deserves doing well, and it also deserves doing briefly, and I didn't understand the briefly part for about twenty years, which is a long time to be patting a back.

The three holds

All three work, and which one suits you depends on the size of your hands, the state of your back and the temperament of the baby in front of you, and there's no hierarchy among them whatever anybody's mother says. Over the shoulder is the one most people picture. She sits high against your chest with her chin over your shoulder and her tummy pressed gently against you, supported underneath with one hand so the other is free for her back, and the height is what counts, because too low and your shoulder ends up in her stomach, which is uncomfortable for her and counterproductive for you. Sitting on your lap is the one I came to prefer, particularly once there were twins in the family and I needed to see two faces at once. She sits upright on your thigh leaning slightly forward, your hand supporting her chest with her chin resting in the web between your thumb and forefinger, never on the throat, and this gives you a clear view of her face, which the shoulder hold doesn't. Lying across your lap is for the sleepy baby who won't sit up. She lies tummy-down across your thighs with her head a little higher than her body and turned to the side, supported at all times, and you can do it in the dark.

How to get it out

The whole business is quieter and gentler than most of us were shown, and the commonest error by a distance is force.

• Get her upright and get her straight. A curled baby has a kink in the passage the air has to travel, and simply lengthening her back releases a surprising number of burps on its own.
• Rub upward along the back with a flat palm, from the bottom of the ribs toward the shoulder. Rubbing is more effective than patting and a lot kinder.
• If you pat, cup your hand and keep it light. You aren't dislodging anything. A firm pat on a newborn is much harder than it looks from the outside.
• Change her position after a minute or two. Movement between holds does more than persisting with one, and most burps arrive within a few seconds of being moved.
• Let her legs stay free. Bending her at the hip presses the abdomen and works against you.
• Have a cloth over your shoulder, because a burp frequently arrives with company.

If you can hear her breathing change or feel her stiffen, you're pressing too hard, so ease off. Nothing about this should be vigorous.

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How long before you give up

A minute or two. Five at the very outside, and only if she's visibly uncomfortable.

This is where my own practice changed most: there's no benefit to persisting beyond a few minutes and there's a real cost, because a baby held upright and patted for twenty minutes at three in the morning is a baby who has been prevented from going back to sleep, by a well-meaning person, for nothing. If nothing has come after two minutes and she's settled, she didn't have any air to bring up. I forget which of my five taught me that. Probably the fourth, by which point I'd stopped listening to the midwives and started watching the baby.

Put her down. If wind was the problem she'll tell you within a few minutes, loudly, and you can pick her up and try again, and waiting for a burst that isn't coming helps nobody, least of all the person waiting.

When in the feed

Halfway is a reasonable default for a bottle, and at the natural pause when you swap sides if you're breastfeeding.

Don't interrupt a feed that's going well to wind her, which was another thing I was taught and which I'd unlearn first. A baby feeding steadily and calmly is doing something more valuable than burping, and breaking off often means she doesn't settle back into it, so wait for a pause that she creates herself.

Breast or bottle changes the frequency, and not the method

The holds and the technique are identical. What differs is how much air went in, and so how often you'll get anything for your trouble.

A well-latched breastfed baby takes in relatively little air and may go days without producing a burp anyone notices, and a bottle-fed baby usually takes in more, particularly if the teat flow is fast or the bottle's been tilted so the teat isn't full, and both of those are ordinary and neither needs a different hold.

When it goes wrong

A short list of things I've done and would rather you didn't.

• Patting harder when nothing comes. Force doesn't help and it distresses her, and a distressed baby swallows more air.
• Winding for twenty minutes as a matter of routine. This was the standard when I had mine and there's no good reason for it.
• Sitting her with your shoulder pressed into her stomach, which is uncomfortable and makes spit-up more likely.
• Supporting her under the chin at the throat. The jaw, never the throat.
• Waking a settled sleeping baby to wind her, which trades something valuable for something that usually achieves nothing.
• Bouncing or jiggling to bring it up faster, which increases spit-up a good deal.

This guide is general information, written to help you understand a topic and ask better questions. It is not medical advice and does not replace your own doctor, midwife or paediatrician. Anything that worries you about your baby belongs with them.

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