To prevent discomfort caused by air bubbles in your baby’s tummy, it’s crucial to wind or burp them.
While some babies naturally burp easily, others may need a helping hand.
When to Burp Your Baby
There are no strict rules when it comes to timing – simply follow your baby’s cues.
During feeding, watch out for any signs of discomfort as an indication to pause for burping.
Always let your baby lead the way!
How to Burp Your Baby
To effectively wind your baby, support their head and neck, keep their body straight, and gently pat their back.
Experiment with different positions to find the most effective method.
Remember, burping helps release air trapped in your baby’s stomach, preventing discomfort and fussiness.
It’s important to burp your baby after feeding, especially if they have a tendency to spit up frequently.
If Burping Methods Fail
If traditional burping methods don’t work, consider gently massaging your baby’s tummy or moving their legs in a bicycle motion.
For further advice, consult with your health visitor.
Functional Aerophagia
Ingesting excessive air can result in various gastrointestinal issues.
Functional aerophagia is a condition where an individual unknowingly swallows excessive amounts of air, leading to bloating, belching, and flatulence. This can be caused by eating too quickly, chewing gum, drinking carbonated beverages, or smoking. It can also be a result of anxiety or stress, where a person may gulp air as a nervous habit.
To reduce symptoms of functional aerophagia, it is recommended to eat slowly, avoid chewing gum and carbonated drinks, quit smoking, and practice relaxation techniques to manage stress. In some cases, behavioral therapy or counseling may be beneficial for addressing the root cause of excessive air swallowing.
Case Studies
Two instances of aerophagia in children with persistent abdominal distension have been reported.
Aerophagia is a condition where excessive air is swallowed, leading to bloating and discomfort. It is often seen in infants who are bottle-fed or have certain medical conditions.
In both cases reported, the children had a history of frequent belching and bloating. Upon further evaluation, it was discovered that they were swallowing excessive amounts of air while eating or drinking. Treatment included counseling on proper feeding techniques and addressing any underlying causes of the aerophagia.
These case studies highlight the importance of recognizing aerophagia as a potential cause of abdominal distension in children and implementing appropriate interventions to alleviate symptoms.
Symptoms and Diagnosis
Common symptoms of excessive air swallowing include visible belching, abdominal pain, and bloating.
Early detection is crucial to avoid unnecessary tests.
In addition to the mentioned symptoms, other signs of excessive air swallowing may include frequent burping, feeling full quickly during meals, and even chest pain.
Diagnosis of excessive air swallowing can be done through various methods, including a physical exam, medical history review, and possibly imaging tests such as X-rays or endoscopy.
It is important to consult a healthcare professional if you experience persistent or severe symptoms associated with excessive air swallowing.
Further Support
For additional information and guidance, reach out to the National Breastfeeding Helpline.
Keywords: Bloating, Aerophagia, Pathologic Aerophagia, Pediatric Gastrointestinal Disorders
Discussion
Aerophagia is characterized by the excessive swallowing of air leading to progressive abdominal distension. Symptoms in children include a non-distended abdomen in the morning that becomes swollen during the day, visible and audible air swallowing, and increased flatulence. Symptoms typically resolve at night through gas absorption and passing gas. Correct diagnosis and history assessment are key in managing this condition, along with ruling out organic diseases through diagnostic studies. Overlapping symptoms with other gastrointestinal conditions may occur, including irritable bowel syndrome or constipation. The prevalence of aerophagia in pediatric populations without mental retardation is currently unknown, with common symptoms being progressive abdominal distension, increased flatulence, heightened parasympathomimetic activity during sleep, and cricopharyngeal sphincter openings.
Table 1.
The identification of aerophagia in patients is based on the Rome III Criteria for FGIDs:
- Abdominal distension due to trapped air
- Repetitive belching and increased flatulence
Pathologic childhood aerophagia is diagnosed as chronic aerophagia with symptoms like abdominal pain, excessive burping, and reduced appetite. Diagnosis of functional aerophagia in healthy patients requires meeting clinical criteria and having a normal physical examination. Further investigations depend on individual case history and physical examination results. Proper diagnosis helps alleviate anxiety and prevents unnecessary procedures and treatments. Diagnostic criteria include progressive abdominal distension, increased flatulence, louder bowel sounds, and specific findings on abdominal X-rays.
Table 2.
The clinical evaluation of patients with aerophagia involves:
| Implying past experiences | Feelings of bloating, burping, gas, swelling, trouble passing stool, stomach discomfort, previous stressful situations |
| General check-up | consistent development rate, heightened resonance in belly area, typical intestinal noises |
| Exploring the laboratory | In-depth analysis includes a variety of tests such as complete blood count, sedimentation rate, CRP, assessments of kidney and liver function, celiac screenings, examination of iron levels, calprotectin levels, and urinalysis |
Fig. 1.
Abdominal distension in patient 1 is a key diagnostic feature, particularly prominent in the later part of the day.
Fig. 2.
In patient 1, gaseous distension of the large bowel and rectum can be detected on an orthostatic abdominal radiograph.
Management strategies in clinical practice focus on distinguishing between primary and secondary aerophagia to provide personalized risk assessment and interventions. For patients with chronic symptoms or acute episodes, it is recommended to seek psychological consultations. Speech therapy, dietary adjustments, and medications such as simethicone can effectively help alleviate symptoms. Optimal management requires a multidisciplinary approach involving pediatricians and therapists.
References
- 1. Bredenoord AJ. Management of belching, hiccups, and aerophagia. Clin Gastroenterol Hepatol. 2013;11:6–12.
- 2. Loening-Baucke V. Aerophagia as cause of gaseous abdominal distention in a toddler. J Pediatr Gastroenterol Nutr. 2000;31:204–207.
- 3. Hwang JB, Choi WJ, Kim JS, Lee SY, Jung CH, Lee YH, Kam S. Clinical features of pathologic childhood aerophagia: early recognition and essential diagnostic criteria. J Pediatr Gastroenterol Nutr. 2005;41:612–616.
- 4. Helgeland H, Flagstad G, Grøtta J, Vandvik PO, Kristensen H, Markestad T. Diagnosing pediatric functional abdominal pain according to the Rome III Criteria: results from a Norwegian study. J Pediatr Gastroenterol Nutr. 2009;49:309–315.
- 5. Maurage CCHM et al. Air swallowing in non-deficient children: an under-diagnosed disease. J Pediatr Gastroenterol Nutr. 2004;39(suppl 1):S444.
- 6. Bredenoord AJ et al. Psychological factors affecting belching in patients with aerophagia. Am J Gastroenterol. 2006;101:2777–2781.
- 7. Benninga MA, Peeters B, Hennekam RC. Fifth European Paediatric Motility Meeting. J Pediatr Gastroenterol Nutr. 2011;53(suppl 2).
Articles from Case Reports in Gastroenterology are provided here courtesy of Karger Publishers
Babies, whether breastfed or bottle-fed, tend to swallow air during feedings. It is advisable to burp your baby once or twice during feedings. If the baby appears to be ingesting a significant amount of air or seems full before completing the feeding, more frequent burping is recommended. Different techniques for burping include holding the baby against your shoulder, across your lap, or in a sitting position. It is normal for babies to spit up a small amount of milk while burping.
Spitting Up, Reflux, and Vomiting
Most babies will spit up after feeding or while being burped. Reflux is common unless it affects weight gain, breathing, or causes discomfort.
To reduce spitting up, it is advised to keep the baby upright and avoid vigorous play for about 30 minutes after feeding. Increased burping frequency may also be beneficial. When laying the baby down to sleep, elevate the head of the bed by placing something under the bed legs or mattress. Avoid placing objects on top of the mattress to elevate the baby’s head, as this can increase the risk of SIDS.
If a baby experiences frequent forceful “projectile” vomiting, it is important to inform a healthcare provider.
Gassiness
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Most babies experience some degree of gassiness. If the baby is burping well and passing gas easily, there is usually no cause for concern. However, if the baby is experiencing excessive stomach cramps and crying due to gas, it is advisable to consult a doctor. Infant gas drops can be helpful for many babies, but not all. Based on 2020 research, probiotic drops containing Bifidobacterium or Lactobacillus may be considered.
For breastfed babies with gas, it may be beneficial to empty the first breast completely before offering the second side to increase hindmilk intake, which has a higher fat content and less lactose, reducing bloating and gas. Consultation with a lactation consultant may be beneficial if needed.
Bowel Movements
Stool color and frequency can vary in babies. Dark meconium stools in the first few days typically transition to yellow, seedy stools in breastfed babies. Bottle-fed babies may have stools that are green, brown, or yellow, and frequency is less significant. While stool consistency may vary, as long as it is not causing distress, it is generally normal. If constipation becomes an issue, introducing baby prune, grape, or apple juice may be helpful. For babies already consuming solid foods, pureed fruits can be incorporated into the diet. It is advisable to consult a doctor before using suppositories or enemas.
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