You don't actually need to burp your baby or hold baby upright after feeds. Feb 23, 2022

She gazes down, amazed, as her little one snuggles in calmly against her breast and body, suck-suck-suck-suck-suck-swallow. Suck-suck-suck-suck-suck-suck-suck-swallow.

“All that burping we did, day and night!” she says, with tears falling down her cheeks.

“If only I’d known sooner!”

Six-week-old Darius has fretted and arched his back and pulled back at the breast since birth. She and her partner had been told he had gas pain. Everyone recommended she take him off the breast regularly to burp him. Even though Darius often grizzled and cried when they did this, his worried parents thought he was upset from the wind. Someone suggested he had air-induced reflux or food intolerance. Last week, their osteopath told them Darius swallowed a lot of air with feeds because of tongue-tie, and a lactation consultant referred him for laser surgery.

They came to me for a second opinion and when I checked him over, I could see a membrane running some way along the under-surface of his tongue. But normal baby oral anatomy is highly variable, and Darius had all the function he needed to transfer milk successfully. When his mother offered him the breast, I could see he was not in a stable position. This was why he fussed and arched his back so much during feeds!

He was enjoying the most stable and contented breastfeed

We worked together to correct the way her breast dragged off in a direction different from the direction of the vacuum he created inside his little mouth as he suckled. Before we knew it, he was enjoying the most stable and contented breastfeed they’d ever had. “I know from the research,” I explain, “that babies – even when they have feeding problems – are not swallowing large amounts of air at the breast or bottle, though this is often what you’re told.”

Burping is part of the routinised, sleep-training approach to infant care so popular in the West. Burping after feeds rouses a baby’s nervous system, which fits with the (mistaken) idea that you’re not supposed to let your baby fall asleep with the breast or bottle so that you avoid ‘bad sleep habits’. But it is biologically normal for babies to dial down into a relaxed and sleepy state due to the neurohormonal effects of milk and mealtime. Letting babies fall asleep with feeds doesn’t set up bad sleep habits, despite what you might hear, but can make the whole sleep thing a lot more difficult than it needs to be!

It’s normal for babies to wake

And burping babies doesn’t help them sleep better, either. It’s normal for babies to wake every couple of hours at night into toddlerhood. What matters is that everyone gets back to sleep quickly. If your little one wakes the minute you put them down during the day, it’s not because of gas or wind: it’s because a tiny nap took the edge of their rising sleep pressure, which was all they needed, and now they’re ready for more day-time sensory adventure!

If they wake every hour or more for whole parts of the night, it’s not because of gas or wind: it’s because their sleep pattern is disrupted and we need to work with her biological sleep regulators to align their sleep better with yours. If your little one grunts and groans and writhes half the night, so that you can hardly sleep, it’s not because of gas or wind: it’s because their sleep pressure is no longer high and their circadian clock is disrupted. Again, we need to work with their sleep regulators to make the nights more manageable.

Rousing up out of sleep activates the gut

Rousing up out of sleep activates the gut, which is why your baby might pass flatulence or puke or burp with all that grunting and groaning in the night. The gut is like a second brain, highly innervated, and when a baby rouses, you’ll often notice baby gut events. These can be ignored.

We don’t need to burp or hold the baby upright – or swaddle or wrap for that matter. And try not to change their nappy unless you absolutely have to. In fact, doing these things in the night can be a recipe for severe sleep deprivation, as you may find yourself awake for an hour or more each time the baby wakes. All the new neuroscience, gut science, and lactation science tell us that life with a baby can be easier than you hear. And not burping your baby is one important way of making the days and nights as enjoyable as possible.