Burping is the process of releasing swallowed air from the stomach through the mouth. This action is difficult for newborns, leading to discomfort and fussiness. Trapped gas creates pressure in an infant’s digestive system, often resulting in squirming and spit-up. Since babies cannot independently generate the force needed to expel this air, they rely entirely on external assistance.
The Physiological Reasons for Inefficient Burping
A baby’s anatomy is the primary reason they cannot self-burp like an older child or adult. The lower esophageal sphincter (LES), the muscle that acts as a valve between the esophagus and the stomach, is not yet fully developed. This muscle is often relaxed or weak, which is why infants frequently spit up as stomach contents easily flow back into the esophagus.
While LES immaturity makes it easier for air to escape upward, the baby still lacks the muscular coordination to intentionally push the air out. Adults use strong core and abdominal muscles to generate the internal pressure required for a forceful burp. Infants spend much of their time lying down and possess limited control over these muscles, which are necessary for efficient gas expulsion.
Furthermore, the infant stomach is small and positioned more horizontally compared to an adult’s vertically oriented stomach. Air bubbles naturally seek the highest point in a liquid-filled space. In a horizontal stomach, the air bubble must travel a greater distance and may not easily rise to the top opening without external movement or pressure applied.
This combination of a loose valve, underdeveloped core strength, and the stomach’s anatomical position explains why gravity and external manipulation are necessary to help the air bubble reach the esophagus. Caregiver intervention remains necessary until these systems mature, typically around four to six months of age.
Sources of Trapped Air in Infants
The air that causes discomfort enters the digestive system primarily through two routes: ingestion during feeding and inhalation during crying. During both breast and bottle feeding, a baby can swallow air along with milk or formula. A poor latch or a fast-flowing bottle nipple can cause the baby to gulp, significantly increasing the amount of air swallowed.
Even when not feeding, infants swallow air. Prolonged crying causes a baby to take in large amounts of air, which then travels to the stomach. Therefore, a baby who has been crying for a long time may need to be burped even before a feed begins.
A smaller amount of gas is also produced internally as a normal byproduct of milk digestion. This gas typically moves through the intestines and is passed as flatulence, but the majority of the air requiring burping is swallowed air trapped in the upper digestive tract.
Techniques for Successful Burping
Caregivers must use specific techniques to create the necessary pressure for air release. The most common position is holding the baby upright over the shoulder, with the chin resting on the shoulder. Supporting the baby with one hand, the caregiver uses a gentle, rhythmic patting or rubbing motion on the back.
Another effective method involves sitting the baby on the caregiver’s lap, facing away, and leaning the torso slightly forward. The caregiver supports the baby’s head and chest with one hand, cupping the chin rather than pressing on the throat, while gently patting the back with the other hand. This slight forward lean helps compress the abdomen, urging the air bubble upward.
A third position involves laying the baby face-down across the caregiver’s lap, ensuring the head is slightly higher than the rest of the body. Gently rubbing or patting the back in this position can help move the trapped air.
For all techniques, it is beneficial to burp the baby during the feed—ideally every two to three ounces for bottle-fed infants or when switching breasts for breastfed infants—to prevent a large air pocket from accumulating. If no burp occurs after five minutes, it is safe to stop, as the baby may not have swallowed enough air to need relief.