Burping breastfed baby

[@llli*vedimama]

Hi,

My newborn is 3 weeks and 2 days old. She nurses for 5-15 minutes on one side per feeding, Although she is gaining weight and was 8 lbs 4 oz at 3 weeks. I am concerned about the less time spent on each feeding.
I am also concerned about burping her as I am unable to get her to burp. Most of the times she falls asleep after the feeding even during the day. Is it necessary to burp the breastfed baby? Has it necessarily to be done after each and every feeding.

[@llli*maddieb]

There is no need for a baby to burp every time they eat, and if they do need to burp, many need no help to do so. And when they do need help, they will let you know. For example, by waking up with a cry. At that point you can pick baby up or (if you are holding sleeping baby) bring baby to a more upright position, and either they will immediately burp just from the movement or being brought upright, or you can help them with some gentle pats etc. Burping as a rule during and after meals is something that became a "thing" after bottle feeding became dominant for a few different reasons that have nothing to do with biologically normal feeding. Many moms of breastfed babies find no need to worry about burping baby, and in fact when bottles are given properly (as much like breastfeeding as possible- meals both frequent and small) burping becomes less necessary for bottles as well.

She nurses for 5-15 minutes on one side per feeding

I am assuming baby is nursing one side per feeding, not one side for 5-15 and then the other. Do I have that right?

As long as this is baby's choice (mom is not limiting the session) nursing one sided and nursing for a short time is usually entirely normal and fine. The key is that baby get enough milk overall. Each meal is normally meant to be small, so if your milk flows quickly and baby is adept at nursing, baby can easily get enough to eat in 5-15 minutes. It does no harm to encourage baby to nurse a bit longer if you like, and many babies will continue to nurse once asleep, but as long as baby is getting enough milk overall, then no need to worry about getting baby to nurse longer or to take both sides per feeding.

But at this early age it is vital to be sure baby is nursing with normal frequency, which at this young age would be about 10-15 times in 24 hours. Also, just to be on the safe side in the early weeks, it is important to be sure baby is getting enough milk overall, and you can tell that in two ways. One is that baby is gaining normally. Since you do not say what baby's birth weight or lowest known weight after being born was, I do not know if baby's weight now indicates normal gain or not. Basically once baby starts gaining weight, which is usually at about a week or so, average gain after that is about 1/2 pound a week or more. Also a baby this age would normally be pooping several times a day, and poops frequency can be reassuring that baby is getting enough between weight checks.

This is a good article about what to expect in the early weeks: http://kellymom.com/hot-topics/newborn-nursing/

[@llli*vedimama]

Baby is nursing only one side, sometimes just for 5 minutes. I try to hold her upright for sometime after feedings. I also try burping on the lap technique, but it is very rare that she gives out a burp. I've read that if the milk flows too quickly babies may need to be burped. Sometimes she spits up even after 45 minutes to an hour has passed after feeding completes. Is the spit up in any way related to not being burped?

Nursing frequency is average 10 times in 24 hours. Baby's birth weight was 7 lbs 6 oz. She poops a lot, several several times a day.

[@llli*mommal]

Spit up has little to do with burping. Spit up happens because:
1. Babies have weak sphincters at the tops of their stomachs, making it easier for stomach contents to skip back into the esophagus.
2. Babies are small, which means there is less distance between stomach and mouth.
3. Babies eat a 100% liquid diet, so their stomach contents flow more easily.
4. Babies spend most of their time laying down, so gravity isn't helping them keep their stomach contents down.

When a baby has a has bubble in her stomach, it's more likely that she will spit up. But spit up happens even when baby has no gas bubbles in her. It's just a normal part of infancy, and nothing to worry about as long as the baby is generally healthy and gaining weight ta a normal pace.

[@llli*maddieb]

Is the spit up in any way related to not being burped?

Not usually. In fact I think people always trying to burp their babies when they do not need it makes babies spit up more! I agree with mommal. Spit up is normal and nothing to worry about. Your baby's gain sounds fine, nursing frequency good. As long as nursing is comfortable for you there is nothing else you need to worry about, really.

I've read that if the milk flows too quickly babies may need to be burped.

Sometimes some moms with overproduction and fast letdown find it is helpful to help baby burp more. I had OP and fast letdown with all my babies and I never found it helped in any way to try to burp baby unless/until baby indicated they needed help by 'telling" me they were uncomfortable one way or another. What did help was to encourage my babies to nurse frequently and to nurse in a reclined position.
Every baby is different! You will probably find you will discover what usually works for you and your baby by following baby's lead.

[@llli*vedimama]

Thanks for the reply. I am also concerned about how to alternate between the breasts with OP. I find that when I offer the one which is feeling little heavy/full she tends to spit up.

[@llli*maddieb]

Again spitting up is not hurting your baby. Most babies, whether breast or bottle fed, spit up frequently, and many spit up a lot at a time. It is 100% normal. A mess, but normal.

There are two sources of information a nursing mom can pretty much always trust to lead her in the right direction when trying to decide when to nurse, how long, when to switch sides, etc. These sources of information are her body and baby.

When a mom makes lots of milk, there are a few simple things to try.

Encourage baby to nurse more frequently. If you are starting to feel full, that is a good time to offer to nurse, even if baby is sleeping or not cueing.
If baby seems fine nursing one side at a time, then let baby nurse one side at a time. If baby is cluster nursing (nursing several times in an hour) then it is probably fine to offer the same side repeatedly if you like. But again, consider how YOU feel as well as what baby seems to be indicating. If one side is feeling full, that is your body telling you to offer that side.
If you are feeling full and baby will not nurse, you can try hand expressing a little bit of milk just to relieve the pressure. You probably do not want to do this too often or for two long, but hand expressing a little milk at times can help a lot when mom is making more milk than baby needs.
Next time baby nurses, the other side will likely feel pretty full. This is the side to offer baby because if you do not, it will just get more full! Again if baby spits up, that is the entirely normal and healthy way a baby handles having too much milk.

3-5 weeks is the peak time for milk production. If you just keep nursing with good frequency, your baby will tell your body how much milk they need and your body will adjust as needed. This may take a few weeks, but after that you will not feel so full, (eventually you will probably even feel "empty" which is normal after the first couple months) and baby may spit up less, etc.

If you are pumping, that will give your body the message to make more milk than baby needs. So if you are needing to pump for some reason, tell us why and how often you are pumping so we can help you troubleshoot that situation.

[@llli*mommal]

How does baby act when she spits up? Is she screaming and miserable, or does she spit and then go back to whatever she was doing before? There are 2 types of spitters- happy ones and miserable ones. You only need to worry about the miserable ones, because they might need some sort of intervention to make them more comfortable. The happy spitters just get their clothing changed more often, and you want to swab out their neck folds so they don't get that cheesy festering smell!

[@llli*vedimama]

She is generally normal after the spit up. Sometimes cries for a few minutes but otherwise goes back to being herself.
Since past few days we have been noticing she starts crying in the evening at around 7 pm. and nothing seems to pacify her. I have tried feeding her to calm her but that too doesn't work. She nurses and then again starts crying. Could this be due to gas build up? We give Gripe water which seems to work sometimes as she then calms down after awhile and goes to sleep.

[@llli*maddieb]

Since past few days we have been noticing she starts crying in the evening at around 7 pm. and nothing seems to pacify her. I have tried feeding her to calm her but that too doesn't work. She nurses and then again starts crying.

This sounds like colic, which can be hard to live through but is common and normal and temporary. It is also something of a mystery, because there is not one identifiable cause that includes all babies who have this behavior. There are many tips on how to help a baby who has colic. What seems to work the most is changing sensory input (exposing baby to different sounds, movement, environment, etc) What I have found is you just try whatever you can and some things work some of the time, but usually nothing works all the time or for very long.

I am not sure what "gas build up" means? Lower intestinal gas is a normal result of food digestion, and the gas has to come out by passing gas. Upper GI gas is why baby might need to burp. If someone has trapped gas, either upper or lower, it may cause a pain, and eliminating the gas is what helps it feel better. For a baby, changing baby's position in various ways is probably the best way to help them pass gas. Massage may help too, but I learned the hard way to not lay my baby down to do a massage, as this made him way more miserable! Luckily babies are easy to massage while being held.

Here is a good fussy baby tip sheet: http://www.llli.org/docs/00000000000...ybabyideas.pdf