Will burping, pausing for 'rest and digest', or holding baby upright after feeds make your baby more settled?
Burping your baby after feeds doesn't help and can even make sleep worse (believe it or not!)
As strange as this is going to sound, you don't need to burp your baby, or hold her upright after feeds. Actually, most human cultures don't burp their babies. On the contrary, both burping your baby and holding her upright after feeds can make the days and nights much harder than they need to be, by unnecessarily disrupting sleep.
Feeding your baby dials him down. You can find out about this for breastfed babies here and bottle fed babies here. Offering frequent flexible feeds is one of your two superpowers when you have a baby, which makes the days and nights as easy as possible. But burping dials babies up, making sleep harder. Here are other things to know.
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You don't need to worry when your baby refluxes, as the reflux doesn't do harm or cause pain - but burping makes babies puke more, too. You can find out about this here.
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Your baby will swallow some small amounts of air, or perhaps generate small amounts of gas in the stomach as the milk is digested. You might even be able to feel her milk being swallowed down as you cuddle your baby to you during the feed. But we know from imaging studies that babies don't swallow air or have significant amounts of air in their stomachs either as they feed or after feeds, even when they have feeding problems.
Your baby will release any stomach air in whatever position she has drowsed off in. You don't need to do anything. She will burp all by herself, if she needs to, often very loudly, whatever position she's in.
The usual burping positioning is not good for your baby's motor development
The usual burping positions on your lap are not the best for your baby's motor development. This is because
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Holding your baby out on your lap, away from the support of your own chest and abdomen, means that your baby's spine collapses over on itself in a c-shape. Your baby hasn't developed adequate core stability yet for this posture.
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Supporting your little one under the chin suspends your baby's body from his cervical spine, no matter how gentle you're being. This posture is also not the best for your baby's motor integration and development.
You can find out about how best to support your baby's motor development here and here, and why the strategies that are ideal for motor development are also very good for healthy sleep.
Holding your baby upright against your shoulder after feeds doesn't help and can even make sleep worse
Feeling that you need to hold your baby upright after a feed can be hard work, without benefits for your baby.
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From a biological perspective, the upright position turns on an arousal response in the brainstem, the most archaic part of the brain.
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Being upright also doesn't help your baby better digest the milk.
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There's no reason to try and stop your baby from refluxing, since the reflux is harmless and it doesn't matter if your baby pukes up some milk.
What really matters is that we make the nights, and the days, just as easy (and as enjoyable) as possible. Below the video, you can read a story about how one family found their life was so much easier when they stopped burping their baby.
You might have heard that your baby needs 'rest and digest' time lying over your lap in the middle of a breastfeed or feed, but this isn't true
You might have heard that you should give baby 'rest and digest' time by lying him over your lap, between offering the first breast and before offering the second. You might have heard this if you're bottle feeding, too.
But 'rest and digest' time is completely unnecessary, and may be especially disruptive if you have an unsettled baby. It's true that your little one might enjoy any kind of postural change and stretch after being in the one position for a period of time at the breast, but there's no need to do this in any particular way.
Here are other things to know about the 'rest and digest' advice.
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Most often, babies are happy to go straight to the other breast. If not, your baby has had enough for now and it's time to get on with the day!
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You don't need to think of a breastfeed as a meal-time, when you're supposed to get as much milk in as you possibly can to have a settled baby. Thinking about breastfeeds this way can actually backfire and cause problems, like fussiness at the breast or conditioned dialling up. You can find out about the benefits of frequent, flexible (often short) feeds, which dial your baby down, even from just one breast, here
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All you need to do is tune in to your baby's little signs and communications, and do what suits you at the time. 'Rest and digest' advice shifts your attention away from making everything as easy as possible, and can be disruptive to baby sleep because it interferes with your own easy, relaxed experimenting, as you fit breastfeeding in around lots of rich sensory motor nourishment for baby and you, outside the home.
If something works for you, there's no need to change it. But the more instructions breastfeeding women receive which lack evidence of benefit, the harder everything seems to become!
Recommended resources
The story of baby Daisy who fussed a lot with breastfeeds: how NOT burping made her and her family's days and nights much happier
The burp and puke chat. A podcast by Dr Pamela Douglas with Emma McCabe
Selected references
Kaur R, Bharti B, Saini SK. A randomized controlled trial of burping for the prevention of colic and regurgitation in healthy infants. Child: Care, Health and Development. 2014;41(1):52-56.
Mills N, Lydon A-M, Davies-Payne D, Keesing M, Mirjalili SA, Geddes DT. Imaging the breastfeeding swallow: pilot study utilizing real-time MRI. Laryngoscope Investigative Otolaryngology. 2020;5:572-579.
