Burping, Hiccups, and Spitting Up

Parenting Resources and Community Outreach

Burping: Young babies swallow air during feedings. Although this occurs in both breast- and bottle-fed infants, it happens more often with bottle-feeding. Burp your baby often, even if he shows no discomfort. The pause and the change of position alone will slow his gulping and reduce the amount of air he takes in. If he’s bottle-feeding, burp him after every 2 or 3 ounces. If he’s nursing, burp him when he switches breasts and when he’s finished.

Hiccups: Most babies hiccup from time to time. If hiccups occur during a feeding, they may distress the baby. Change her position and try to get her to burp or relax. Wait until the
hiccups are gone to resume the feeding. If your baby gets hiccups often, try to feed her when she’s calm and before she’s extremely hungry. This will reduce the likelihood of hiccups during feeding.

Spitting Up: Spitting up a small quantity of milk or formula after a feeding is usually nothing to worry about. Your baby may simply have eaten too much or brought a little milk up with a burp. Some children are more prone to spitting up than others, but almost all babies outgrow the tendency by the time they can sit up on their own.

You can minimize spitting up by feeding your baby in calm surroundings. Hold him in an upright position, not lying down, as he nurses. If you’re bottle-feeding, hold the bottle at an angle, so the baby sucks only formula, not air. Burp him. Placing him in an upright position in an infant seat or stroller immediately after feedings will also help keep his food where it belongs.

If these techniques don’t slow your baby’s tendency to spit up, he may need to be evaluated by your pediatrician. The stomach acid that comes back up with milk or formula can irritate the esophagus and cause pain. Rarely, children with chronic reflux might not hold down enough food to fuel normal growth.

A word of caution: the gentle spitting up caused by reflux or burping should not be confused with more worrisome forceful vomiting. Forceful vomiting could be a sign of infection or, if it occurs frequently after feeding, a constriction of the muscle that allows food to leave the stomach. Either of these conditions can be serious. Forceful vomiting in an infant requires an immediate call to the pediatrician, as does vomit that is yellow or green.