One of my five never burped. Not rarely, never, as far as I could tell, for the whole of her first year, and I spent a great deal of that year convinced I was doing something wrong, standing in a kitchen in Athens at two in the morning patting a perfectly contented baby, and I wasn't.
Some babies simply don't take in enough air to produce anything, and a baby who doesn't burp isn't a baby with a problem, she's a baby who doesn't burp.
The baby tells you, and not the clock
This is the piece I'd most like to hand over, because it replaces a rule with an observation, and observations are more use to a tired person than rules.
A baby with trapped wind is uncomfortable and shows it. She squirms, pulls her knees up, arches, grimaces, won't settle after a feed she ought to be content after, and often comes off the breast or bottle partway through crying and then goes straight back on, and that whole picture is the one that warrants persisting. Or so I think. I've been wrong about wind more often than about anything else in fifty years of babies.
A baby who's settled, sleepy and comfortable after a feed doesn't need a burp brought up, whatever the clock says or whatever your mother-in-law says. If she's content, you're finished. Put her down.
If she's uncomfortable, this is the sequence I'd work through, and you'll notice that most of it is about changing something instead of doing more of the same thing harder.
- Straighten her out. Get her fully upright with her back lengthened, since a curled baby has a kink in the way.
- Change the hold. Over the shoulder, then sitting on your lap, then across your lap. The movement between positions does more than any single one.
- Rub upward with a flat palm and don't pat, working from the lower ribs toward the shoulder.
- Walk about with her upright against your chest for a few minutes. Gentle movement while vertical works when stillness doesn't.
- Lay her down flat for a moment and then bring her back up. The change in position is often what releases it.
- Give it two minutes and stop. If nothing has come and she has settled, there was nothing there.
What I wouldn't do is any of it harder. Firmer patting and more vigorous jiggling both make things worse, and a baby who becomes upset swallows more air, which is exactly the opposite of what you set out to achieve, and I know this because I did it.
When the wind is lower down
Sometimes the air has already travelled past the point where a burp can reach it, and no amount of holding her upright will help, however patiently you do it. It has to come out the other way.
The signs are reasonably distinct: she draws her knees up to her chest, she goes red and strains, she's unsettled in a way that comes in waves and not steadily, and she's relieved for a little while after passing wind or a stool. That's lower wind, and it wants a different approach from the one you've been using on her back.
- Bicycle her legs slowly while she lies on her back, which helps the gas move along.
- Knees gently up to the tummy and held for a moment, then released, a few times over.
- A warm bath, which relaxes everything and often does more than any manoeuvre.
- Tummy time while she's awake and supervised, which puts helpful pressure on the abdomen.
- A slow clockwise massage on the tummy, following the direction the bowel runs.
- Carrying her upright against you, which is the least technical and frequently the most effective.
Simethicone drops, gripe water and the various colic remedies have weak evidence at best, and I've used all of them across five children, in three currencies, and I couldn't tell you that any of them did anything at all beyond giving me something to do. If you want to try one, ask a pharmacist and treat it as an experiment and not a treatment.
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Some babies simply never do
And that's the ordinary answer far more often than anybody tells you.
A well-latched breastfed baby may take in almost no air at all, so there's nothing to bring up, and some babies release it during a feed without anybody noticing, and some pass it downward instead, and none of these is a failure of technique on anyone's part.
The measures that count are the ones that have nothing to do with burping. She's feeding well, she's gaining weight, she has plenty of wet nappies, and she has stretches of contentment, and if those four are in order then a baby who never burps is a baby who never burps, and you can stop standing in the kitchen.
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When it was never wind
Occasionally the picture doesn't fit wind at all, and you should know what that looks like so you aren't still trying to burp a baby who needs something else entirely.
- Distress that arrives during feeds as well as after them, with arching and pulling away, which points at reflux.
- Crying that comes with eczema, blood or mucus in the nappy, diarrhoea or poor weight gain, which raises the question of cow's milk protein allergy.
- Frequent forceful vomiting, particularly projectile, which needs assessment.
- A baby who isn't gaining weight, or who has fewer wet nappies than usual.
- Inconsolable crying with the legs drawn up and vomiting, which needs immediate attention.
- A temperature of 38°C or above in a baby under three months, which is urgent regardless of everything else.
If the pattern does not fit wind
What I read before I wrote
- NHS: Colic
- American Academy of Pediatrics: Burping, hiccups and spitting up
- HealthHub: Ministry of Health Singapore
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.