All Babies Get Wind
I can’t tell you how many times I have heard Health Visitors and Midwives and other Health professionals telling new parents that they don’t need to wind their baby because “breastfed babies don’t need winding”
This is simply not true – Breastfed babies need just as much winding as bottle fed babies.
All babies get wind, whether they are fed from bottles or breast or both. Some babies get more wind than others, and some are easier than others to wind, but they all get it and they all need some sort of help to bring it up.
I have also heard some people say that you don’t really need to wind any baby, that you can just sit them up and they burp themselves, or that if they don’t burp after a couple of pats on the back you can just leave them. Based on my 25 years hands on experience with hundreds of newborns, all I can say to this is that, for the majority of babies, this is a recipe for disaster !
A baby in pain from stomach wind can neither feed properly nor sleep well, and is therefore much more likely to be fretful and unhappy, a situation which has a knock-on effect on the parents.
Efficient winding can make a huge difference to a baby’s health and happiness, allowing routines to be implemented, sleep problems to be addressed, playtimes to be contented and relaxed, and is a vital factor in managing a baby with colic or reflux.
Why do babies get wind?
Babies get wind in the same way we do, by swallowing air along with something we are eating or drinking, and even from swallowing our own saliva. However, we barely feel it, and can bring it up ourselves easily, whereas babies insides are much more sensitive so they experience discomfort and pain, and usually only learn to bring it up themselves around the 6 month time.
As babies feed, from the nipple or teat, they create a vacuum with their tongue and their lips are pulled tightly around the nipple or teat, creating a seal.
The better the seal, the less air gets into the mouth, so less is swallowed down into the stomach, but air is still getting into the back of the baby’s throat as they breathe through their noses
This is why a breastfeeding baby, even with their mouth full of nipple and a seemingly perfect seal, can still get wind.
How well your baby is able to create an efficient seal is determined by their physical ability to manoeuvre their lips and tongue around the nipple or teat, and by their temperament, as to how patient and persistent they are when trying.
Some babies figure out making the seal and latch on immediately never having any problems, but others need more time to perfect their technique. Though it is very tempting to start changing bottles and teats and trying to ‘fix’ things, the best thing you can do is give your baby plenty of time and opportunity to practise with one bottle.
Remember, they are as new to feeding as you are, but they have instinct on their side and will usually figure it out eventually.
Apart from air that gets into the baby’s mouth via their nose, the other main reason air is swallowed is that baby stops sucking, releases the vacuum they have built up and then goes back to feeding again.
This can happen because they are getting full, because they are uncomfortable with wind, are not really hungry or are getting distracted, but it can also be because the milk is flowing too fast for them to be able to cope. They need to settle to a nice, easy breathe-suck-swallow rhythm, and this can become interrupted by fast-flowing milk pooling or hitting the back of their throat. If you think this might be the case, it is worth trying a slower-flow teat for a while until they become more practised at feeding, or expressing from the breast a little before a feed.
Bearing this in mind, don’t stop feeding to wind baby every ounce or 30mls as is sometimes advised, especially for bottle feeding. The more times the seal is broken the more opportunity there is for baby to swallow wind. Leave them to stop naturally unless they are prone to being sick or you suspect reflux.
Anatomy of a baby’s stomach
The baby’s stomach is traditionally referred to as being the size of an almond/cherry and is said to have a 5ml to 7ml (less than one fluid ounce) quoted as its capacity, however, more recent and accurate studies have now shown capacity to be much higher, around 20mls but remember, even this an average. Some babies will take more than that, and some will need less. I have seen many newborns quite happily polish off a 90ml (3oz) bottle!
What it might help you to know for winding is that the stomach is not central, it is off set to the side, just under the left side of their ribcage, and the oesophagus does not join the stomach at the top, it joins a little way down on baby’s right hand side. It is also very useful to know that the lining of the stomach is not smooth.
The stomach is very elastic, allowing it to expand as it fills with food, but this means that for most of the time it is in its relaxed, more shrivelled state, leaving the stomach lining ridged and pleated. Most of the ridges run from the top to the bottom of the stomach, but they are not straight: there are a lot of folds, bends and ‘S’ shapes, all of which means that there are lots of nooks and crannies where little bubbles of wind can get stuck.
Bubbles in the stomach behave the same way as bubbles anywhere else: they always try to rise. Imagine a bottle of carbonated water, in which the bubbles are rising. If you pat the bottle, more bubbles are dislodged and rise faster, and with some babies (though rarely, in my experience) this is all that is required to release bubbles of wind.
This is the simplified version of winding, but the physiology of your baby’s stomach makes it much more likely that you will have to try a bit harder if you are going to get to those bubbles trapped in awkward places.
The winding process can be further complicated by the fact that your baby could be wriggling, you may be inexperienced, and, if your baby is crying or screaming, their stomach and abdomen are tensed up to the point where it is virtually impossible to get any wind to come up.
Winding Positions And Techniques
I find it helpful to think of winding methods as being either active or passive.
The more active methods can be used on a happy, calm baby who isn’t stressed by being handled and is not prone to being sick. These methods are also useful for keeping a sleepy baby awake.
The more passive methods can be useful for an overtired baby, or one who is upset, ill or suffers from reflux, or simply when you don’t want to do anything to stimulate your baby, such as during a night feed.
Most of the following techniques can be modified to be either more active or more passive by changing the speed or smoothness of your movements and by adjusting noise, light and activity levels in the environment.
Tips To Remember
● You are always aiming to elongate your baby’s body, which will help to straighten the kinks in the stomach lining and in turn help to free bubbles
● Try to keep your baby’s head lifted so that they look straight ahead, not down. This opens the airways and helps straighten the oesophagus and take pressure off the stomach valve.
● Do not apply anything other than the gentlest pressure (like the weight of your hand or their own body weight) to baby’s stomach.
● If a technique or position is not producing results after two minutes, it probably isn’t working, so stop and try something else.
● As much as possible, try to wind in a position that allows you to see your baby’s face so that you can see if they burp, even if you can’t hear it.
● Remember that bubbles rise, so after each different position you try, always return baby to the starting position for at least thirty seconds to allow any bubbles you have released to rise to the top of the stomach where they can be burped up.
● There is a pattern to a baby’s burps. The first one is usually the biggest and is often almost instantly followed by smaller ‘aftershocks’. There will usually then be a few or many other smaller burps, so don’t assume your baby has no more wind just because they have done two big burps.
It will take time to get to know your own baby’s unique wind pattern, so observe and learn.
When I watch inexperienced parents trying to wind, I frequently see baby being sat on their lap and held in a round-shouldered, slumping position.
This can actually prevent wind from coming up, and can also place pressure on the stomach and make it much more likely that baby will be sick, especially if they suffer from reflux.
The trick is to get baby sitting up straight so have your baby sitting on your lap facing whichever way feels comfortable, gently supporting their head by holding the cheek bones in front of their ears.
I call this the start position, and it is the very first thing I do when winding any baby and I always return them to this after I have tried a different position or movement.
Patting – A quick word about patting. Everyone pats their baby’s back, including me. Truthfully, I have no idea if it actually does anything useful. Maybe it does sometimes dislodge bubbles. I know it can be calming for babies; it certainly doesn’t do any harm so pat if you want to and don’t if you don’t, but certainly don’t worry about it.
Up-rub – Hold baby in the starting position, then rub your hand from the base of the spine up to the top. This is not a ‘rub up and down’ motion – you are just rubbing upward, and the aim is to press firmly enough to straighten baby’s spine a little, like a gentle Mexican wave of straightness.
I usually count slowly to three for each rub, wait for another count of three and repeat five to ten times. The wait in between rubs allows wind to come up, so remember to watch their face in case they burp quietly.
Tilting – As you hold baby securely in the starting position, very slowly tilt them away from you, sideways, keeping the head supported and the body straight. It may feel a little insecure, but remember that you can hold baby quite firmly with the cheekbone grip without hurting them.
Think of it as a slow, flowing, t’ai chi movement. You can tilt them a little way or all the way over until they are horizontal (wherever you are comfortable), then hold them there for two or three seconds. Then, just as slowly, bring them back up to the centre. You can repeat the movement, but this time tilt baby towards your body. It can help to gently anchor baby’s legs between your own for more stability.
Tipping – The same tilt can be done backward and forward, with the difference being that you need to move your hand slightly to support the head as you tip them backward.
Remember to keep their body straight, especially when tipping them forward, because if you allow their body to collapse and their spine to curl, you will be compressing their stomach and risking them being sick.
If your baby suffers from reflux, it is best to avoid winding positions that place direct pressure on the stomach or that fold them at the waist as this is much more likely to make them sick.
Once you have mastered both tilting and tipping, you can amalgamate the two moves to create a slow, smooth, continuous circular sequence – forward, side, back, side – which can be very calming for babies.
Remember that the aim is to elongate baby’s body to straighten out any kinks, and using the shoulder can be a good way of doing this.
In this position, their body is being gently stretched by gravity, especially if their head and arms are slightly over the shoulder and dangling down your back. The pressure placed on their stomach is being created by their own body weight, so you know it won’t hurt them. Simply leave them in this position for thirty seconds.
Sometimes this is enough to bring up wind without doing anything further, but if nothing happens, then you can try the up-rub movement but with hardly any pressure (remember, there is already pressure on their stomach from your shoulder, and any more could result in vomiting).
The aim of this position is not to try to squeeze air out of the stomach; it is simply a change of position which might cause a trapped bubble to be released.
There are two ways of doing this, depending on how your baby is reacting and how full they are.
To start with, place baby lying face down over your knees, with arms extended forwards on either side of the head (like a diver) and the head supported on your leg. Now stop and look at the position of their stomach in relation to your legs.
Is their stomach resting on your thigh, or is it over the gap between your thighs?
Now think about what is going on with your baby.
Are they prone to being sick? Is their tummy very full? Have they not managed to burp yet? Are they in pain from the wind, and upset or tense? If this is the case, then you should be aiming to have baby’s stomach in the gap between your thighs so that there is no direct pressure at all on the stomach that might cause pain or regurgitation.
The up-rub is useful here, as it is very calming. The aim is just to leave baby in this position from thirty seconds up to five minutes. Then sit them up into the starting position and see if any wind comes up.
If baby is not prone to being sick, not in pain and not overfull, or has already done one burp, you can try moving baby so that their stomach is gently resting on part of your thigh. This added pressure can help dislodge bubbles, and up-rub or patting may also help. Leave them there for up to five minutes before returning them to the starting position.
Put down/pick up.
This is so simple yet so effective, and really can work miracles with stubborn wind. I have found myself in a situation many times where I am trying and failing to get a baby to burp, I have tried everything and am rubbing and patting and getting frustrated, then I remember this.
Quite simply, put baby down on their back and leave them for five minutes, then return them to the starting position and see if anything comes up.
Again, this is not for when baby is very full or suffers from reflux, but in most other situations it is fine – just keep an eye on them and pick them up quickly if they look as if they may be sick or are uncomfortable.
Remember that a baby’s body needs to be relaxed in order for wind to come up, but when you are working on trying to get them to burp and it isn’t succeeding, baby can get tired of being handled, so they often enjoy a bit of peace and quiet, and while they are lying down, bubbles are being dislodged and moving to new positions. Then when you sit baby up again they are more likely to burp for you.
I put babies down like this on my lap, on a sofa, on the floor, in a moses basket, in a pram or in a cot under a mobile.
This is also a very good way to wind baby if the parent or carer is tired or getting stressed for whatever reason, because it requires no effort or frustrating movements such as rubbing and patting and gives you the chance to calm down in between winding bouts.
You can repeat this action as many times as you like, and can use it between other winding positions or techniques.
Not usually thought of as a winding technique, but it does work for some babies. If you have been trying to wind and are getting nowhere, you can try a good firm swaddle, even if you never use one at any other time. All it does is straighten out baby’s body beautifully, applies a little safe pressure to the whole torso and helps baby relax.
Use a muslin, cot sheet or cotton swaddle (not stretchy) to wrap baby snugly in a straight position with their arms by their sides, aiming to cover the body, not the legs (so hips are free). Once baby is wrapped, pick them up and hold them upright against your own chest or shoulder, keeping them as upright and straight as possible for a few minutes, and try the up-rub. You can also walk around with them like this, or go up and down stairs to see if any bubbles are dislodged.
Dislodging difficult wind
Although some rare babies are very easy to wind, most are not and most parents will, at some point, come up against the really tricky burps that just won’t come up. This is where you need to become more proactive and inventive.
Have you ever tried for ages to get baby to burp and then, when you hand them over to someone else, they burp immediately ? It feels like a conspiracy, and can lead the other person to claim, smugly, that ‘they have the knack’, but in reality, it is just the movement involved in passing the baby dislodging a hidden or trapped bubble.
Frustrating though this is, we can use it to our advantage by incorporating it into our own winding strategies by getting up and moving around.
The simplest method is just to walk around.
The over-the-shoulder position is good for this because it is very secure so you can pace up and down, dance around to music, go up and down stairs or potter around the house doing things one-handed. I know from experience that the burps often come up once you stop trying so hard, so walking around is definitely worth a go.
A good tip is to try even more movement by sitting on the edge of your bed or on a gym ball, holding baby securely upright (with head supported), and bouncing. This is remarkably therapeutic if you yourself are stressed or tense, and babies seem to love it too
A more passive version is to sit in a rocking chair if you have one. Hold baby over your shoulder or upright on your knee and rock. You are still introducing more movement to the winding, but it is much less stimulating if baby is over tired. If you are trying to wind a baby that is distressed by pain, hunger or overtiredness, then sometimes a change of scene can be a very helpful distraction.
Remember, baby has to be calm for their wind to come up, so anything that takes their mind off whatever is upsetting them will help immensely.
Kitchens with bright downlights and shiny utensils and pans can be good, as are windows, especially those near trees or bushes that might move in the wind.
Bathrooms are often excellent distractions, because baby spends little time there so everything is new and interesting. There are shiny taps and towel rails, sparkly mirrors and tiles, and you can run the taps for extra distraction.
Going to find other people or a television can be a good distraction for baby, and can also be a great de-stressing activity for a stressed parent.
Once you are confident that you can hold baby securely, you can go and wind anywhere, even outside.
As well as positions and techniques, there are a few other things that can help bring up wind.
Gripe Water – The first thing most people think of to help with trapped wind is gripe water. This is a very old-fashioned remedy, and used to contain alcohol which acted as a relaxant and did, according to my own mother, work quite well. Nowadays the alcohol has been removed and in my experience does little to help, but if it works for you then use it.
It helps to know that wind is a physical problem. Bubbles are stuck and need help to be released, so herbs will not make no more difference than cooled boiled water.
The only winding remedy I use is one which contains a chemical called simethicone. It is inert, so it cannot be absorbed into baby’s body, making it very safe. It acts on the surface tension of bubbles and makes small bubbles join together to form big ones, which are then easier to dislodge and be released. In the UK the product name is Infacol, (often known as Gas Drops in the USA) and it is one of the few things I make sure I take to every job because it is so useful. It is not a miracle cure for every baby, and on some seems to make little difference, but on others it can bring amazing results.
The act of swallowing anything can help wind come up, so sometimes giving the baby a pacifier to suck on can help, especially as it usually relaxes baby – which is always the goal in winding. You can pop in a pacifier and then either leave baby in one position for a while, or continue winding with it in. Not always successful, but definitely worth a try.
The other thing you can use to help with winding is any sling or baby carrier that holds the baby upright (not wrapped around your body at an angle). I use this when baby is very upset, as they almost always find it calming, and I can use movement to try to dislodge bubbles without over-handling baby.
How to become an efficient winder
Winding can be the most frustrating aspect of baby care, and I have known many people dread feeding because of the accompanying winding, but it doesn’t have to be that way.
I have given you a starting point and some techniques that are very effective, but it may help you to know that I was not born knowing how to wind, nor did anyone teach me. I learnt exactly the same way as any parent would – through experience. The fact that I have been ‘experiencing’ winding babies for my whole adult working life has just given me more time to think about it.
The fastest and best way to become a good parent is to educate yourself and then use that knowledge, and your instincts, to try different ways of doing things. In any aspect of parenting the process of trial and error is your biggest and best friend, and this goes for winding too.
Don’t be afraid of winding, turn it into a game.
Partners are particularly good at this when I present winding as a challenge, and very quickly start coming up with their own ideas, and there are plenty of families I know where the partner is the one who can get the stubborn burps up and gives the feeder a welcome break.
Use my tips as a starting point and go on from there.
Invent your own positions and techniques, discover your own distractions, find out what suits you and works best for your baby.
To very new parents it can seem impossible, but I promise you that with thought and practice, you will quickly become a competent winder.
I hope this helps you, and would love to hear your favourite winding tips and techniques so please share them with us in the Comments section xx
Sarah Norris is one of the UK’s most accomplished maternity nurses, with over 25 years experience caring for hundreds of babies and families in the UK and internationally.
She treats all babies and families as individuals, and respects all forms of parenting and feeding, aiming to help and empower new parents with sensible, practical tips and advice that is always non judgemental and non biased.
She is the author of ‘The Baby Detective’ with Orion Books, out now.