Question of the Day

I am raising a 20-day-old, or roughly 1-month-old baby. I am breastfeeding and also giving formula to my baby for mixed breastfeeding. I heard that burping is essential when feeding formula to a baby. But my child doesn't burp even when I pat them on the back. Will there be a problem if my newborn baby doesn't burp? Should we force it?

It's okay: do not worry too much. A formula-fed newborn baby might not be able to burp.

Why do babies burp?

Why do newborn babies need burping? This is to prevent neonatal reflux. Newborns have a different stomach shape than adults. The newborn's stomach is wide, low, and straight. The muscle that tightens the space between the esophagus and the stomach is also weak, so even a small amount of food in the stomach can make it easier for a baby to vomit.

When your baby is breastfeeding, they naturally swallows air as well. They have a stomach structure that makes it easy to vomit, but what if you add air pressure to it? Breast milk or formula reflux may cause a 1-month-old baby to vomit. The burp serves to prevent this reflux phenomenon. It is the process of expelling air from the baby's stomach during breastfeeding. Hold the baby upright with their chin resting on the mother's shoulder, rubbing the baby's back from bottom to top.

Comparison of Burping After Breastfeeding vs formula feeding

When breastfeeding, your baby may burp less than when taking formula. Compared to formula, breast milk is absorbed faster and digests well. If you are feeding directly from the mother's breast to the baby's mouth, the baby's lips are more tightly sealed, helping the milk to pass well into their stomach. Less air is swallowed, even if the same amount of milk is drunk.

Just because you're breastfeeding doesn't mean you don't need to burp your child, but t's okay not to force your child to burp if they are mostly breastfed. If your child does not show any adverse reactions, such as vomiting, you can assume that you are breastfeeding in the correct position. However, formula feeding also does not necessarily mean your baby will need lots of burping.

When to Burp Your Baby

1. If your child vomits frequently.

If your baby vomits frequently, burping is necessary.

Tip. Worried that your child vomits too often? About half of newborns experience regurgitation by 3 months of age. Even up to 6 months of age, children often recall what they ate. Most babies will hiccup after eating or vomit a little milk. If your baby's growth and development curve are going smoothly, don't worry too much. As your child grows older, this habit will gradually disappear.

However, if the baby regularly vomits more than five times a day or the child's growth and development is too slow, a specialist should be consulted.

2. About 10 minutes after feeding

If your child does not burp after 10-20 minutes, it is okay to lay your baby on their back. This is because an upright posture would have helped digestion to some extent, but if they are not burping and seem comfortable, then they have digested enough to be able to change positions.

5 Lifestyle Habits to Reduce Neonatal Reflux

1. Check your breastfeeding position to ensure your nipple is deep in the baby's mouth.

When breastfeeding, insert the nipple deep down to the areola, and when feeding formula, adjust the bottle to an angle that enables it to fit securely in their mouth. This is to prevent the entry of air as much as possible.

2. After feeding, wait for a while and then try to burp your baby.

If you try to burp right after breastfeeding, it may not come out well. Support your baby into an upright position and hold them for a while. Hold the baby for 2-3 minutes and then try burping again. It is better to sweep your hand across your child’s back from the bottom up than just patting the child hard on the back.

3. When your baby sleeps, make sure their head is higher than their hips.

Did your child fall asleep after breastfeeding? Elevating your baby's head above their hips will make digestion more comfortable for your baby because of gravity. If your baby vomits while sleeping, you can also prevent the vomit from passing into their airway by putting them in this position.

4. Burp in the middle of feeding.

If your baby is the type to vomit regularly, burp them in between feedings. If you are breastfeeding, you can burp them when changing your breastfeeding position or adjusting your feeding to match your milk flow.

5. If your baby tends to vomit frequently, hold them upright for 20 to 30 minutes.

If your child often has neonatal reflux, hold them upright for 20 to 30 minutes after burping.

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Author: Eun-Kyung Beom, Pediatrician

- Baby Sleep Education Expert
- Director of Baby Sleep Research Institute
- Formerly Director of Gwangju Central Children's Hospital