Eructation, commonly known as burping, is the process of releasing air from the upper digestive tract through the mouth. Infants frequently need to burp because they tend to swallow air while consuming milk or formula. Since a baby’s digestive system is still developing, they often need assistance to expel this trapped air. Gentle back patting leverages basic principles of physics to relieve the discomfort caused by swallowed air.
Why Air Becomes Trapped in a Baby’s Stomach
Infants often ingest air through two primary activities: feeding and crying. During both bottle-feeding and breastfeeding, a baby may swallow air if the latch is not ideal or if the milk flow is very fast. Bottle-fed babies may ingest more air if the bottle is held incorrectly, allowing air to collect in the nipple, or if the nipple hole size causes gulping.
Air swallowing (aerophagia) is also increased when a baby cries intensely for an extended period. This swallowed air forms a bubble within the stomach contents, causing discomfort. Unlike adults, babies have not yet developed the muscular control to consciously relax the upper esophageal sphincter, the valve at the top of the stomach. Therefore, the trapped air remains until external forces facilitate its movement out.
The Mechanism of Patting and Positioning
The effectiveness of back patting lies in a combination of physics and anatomy. When a baby is held upright, gravity naturally causes the air bubble, which is lighter than the stomach contents, to float toward the top. Positioning the baby vertically helps ensure the air bubble rises to the junction of the stomach and the esophagus.
The gentle patting or rubbing introduces a mechanical force. This external pressure creates subtle vibrations and changes in internal pressure within the baby’s torso. These vibrations help dislodge the air bubble from the stomach lining and encourage it to consolidate into a larger, more easily expelled bubble. The goal is to facilitate the natural upward movement of the gas through the relaxed esophageal sphincter and out of the mouth.
Practical Methods for Inducing a Burp
The most common and effective burping methods utilize an upright position combined with external pressure. In the over-the-shoulder method, the baby rests vertically against the chest with their chin above the shoulder, ensuring head support. The caregiver uses a cupped hand to gently pat or rub the middle to lower back area. Cupping the hand is gentler than using a flat palm, which improves the baby’s comfort.
Another technique involves sitting the baby upright on the lap, leaning them slightly forward. The caregiver supports the baby’s head and chest with one hand, often by placing the heel of the hand on the chest and cradling the chin. With the other hand, the caregiver gently pats or rubs the baby’s back.
A third option is to lay the baby face-down across the lap, ensuring the head is slightly higher than the chest to maintain an open airway. In this prone position, the caregiver rubs the back to induce the burp, which also applies gentle pressure to the baby’s abdomen.
When and How Often to Burp
The timing and frequency of burping depend on the baby’s feeding style and individual needs. A good strategy is to pause and attempt a burp midway through a feeding session, even if the baby does not appear uncomfortable. For bottle-fed infants, this means taking a break after every 2 to 3 ounces of formula or milk. Breastfed babies should generally be burped when switching from one breast to the other.
Caregivers should also look for signs that trapped gas is causing discomfort. Cues include fussiness, squirming, pulling away from the breast or bottle, or arching the back. If a baby falls asleep during a feeding, a brief, gentle attempt at burping is still advisable. Following the burp attempt, keep them upright for 10 to 15 minutes to help prevent spit-up.