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Can anyone give an accurate description of what's happening inside a baby's body when you burp it and what the various aspects of burping process (patting, rubbing, leaning forward, bending legs, etc.) do? Science references would be great.

All I can find is instructions on how to burp and anecdotes.

What I understand so far is that you're trying to get gas bubbles in their stomach to escape through a valve in their esophagus which is usually closed and that patting is supposed to jiggle the bubbles upwards towards that exit valve. Rubbing and bending might be to deform the stomach to dislodge bubbles stuck in folds.

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    There's no valve in the esophagus; that would literally be deadly. (Valves are one-way only. Imagine never being able to burp or vomit when necessary.) There is a sphincter at the gastroesophageal junction (GEJ) through which air can escape. The rest, you've got pretty well. You change the baby's position to try to get the bubble to the GEJ of the stomach as it can sometimes get trapped in the fundus, a dome-like structure.
    – anongoodnurse
    May 3, 2021 at 21:32
  • @anongoodnurse Is this a difference between medical phraseology and vernacular? In the vernacular, "valve" does not imply one-way.
    – Wayne Conrad
    Jun 16, 2021 at 1:32
  • @WayneConrad - From the dictionary: "a device for controlling the passage of fluid or air through a pipe, duct, etc., especially an automatic device allowing movement in one direction only." (emphasis mine) I had to look it up, because to me, valves are one way only on/in things with which I'm familiar.
    – anongoodnurse
    Jun 16, 2021 at 2:08

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Balloon analogy

Think of a balloon that is partially filled with water, partially with air. The balloon wants to contract a small amount.

If we hold the opening of the balloon downward, at least below the water line, what happens when the balloon contracts? Water comes out. In the end, there will be the same amount of air in the balloon, but less water.

If we hold the opening of the balloon upward, at least above the water line, what happens when the balloon contracts? Air comes out. In the end, there will be the same amount of water in the balloon, but less air.

If we hold the opening of the balloon along the water line, what happens when the balloon contracts? A mixture of air and water comes out.

Burping a baby

Babies ingest air while feeding. That air sits in their stomach, and there's only two ways for it to go: coming back up as a burp, or going into their bowels.

Gas in baby's bowels leads to cramps which can be a major cause for babies crying incessantly and being unable to sleep, which leads to overtiredness and even more crying.

We want the air to leave their stomach via their esophagus, which is what we call a burp. To do so, we sit the baby upright, and we put some pressure on their stomachs using gentle patting, to coax the stomach into relieving some pressure. If there is air in the stomach, there is going to be some pressure, and our bodies try to keep the stomach contents inside. What we're trying to do when we burp a baby is to "lift the lid" that hold the stomach shut, enough that the air can escape but not enough that the baby throws up their entire stomach contents.

The gentle patting also helps the air bubbles to bubble up to the top of the stomach, in case they were trapped in a stomach fold somewhere. This is similar to how tapping a glass containing a fizzy drink causes the bubbles on the side of the glass to bubble up.

Just like the balloon analogy, by holding the baby upright, you ensure that mostly air comes up and not the milk which we want to remain inside the stomach.

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When kids suckle, they swallow air along with breast milk. You hold them upright to allow the air out of their stomach. THe pats and motion may be parental distraction or just trying to jar the esophageal sphincter open so the air can get out.

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    Since a baby's mouth and the breast nipple usually ( or at least they should) make quite a tight seal, excess air is less of a problem with breastfeeding than it is with bottle-feeding, where the seal is not as tight. But recent evidence shows that burping is not science-based after all. sciencenews.org/blog/growth-curve/…
    – suse
    Jun 8, 2021 at 17:11
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    @suse With inspiration from that study, I don't burp my baby anymore and it's just fine. Sometimes she wakes needing a burp and I just pick her up and she burps automatically then goes straight back to sleep. Tedious burping session gone-burger!
    – user1318499
    Jul 5, 2021 at 5:38

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