There is something so special about holding a newborn.
That baby smell, the feel of their tiny bodies nestled on your shoulder or in the crook of your arm, the joyful peace that immediately takes over. There are few pleasures in life that can compete.
While it soon becomes second nature, holding your newborn baby can be a little scary for first-time parents. It’s completely normal to be nervous. Babies seem so fragile and we all know how important it is to support a baby’s head and neck. In relation to the rest of their body, the head of an infant is disproportionately large and their neck muscles are simply too weak to hold it up.
Just like those neck muscles, a baby’s digestive system needs time to strengthen and develop in order to work properly. So after the baby nurses or takes a bottle, they need to be held upright in order to effectively dispel any air bubbles.
This upright positioning of your baby after they eat helps in digestion, and burping, and can help prevent hiccups. This time allows gravity to do its work as the stomach contents settle down through the digestive tract and the air bubbles rise up and out of their system.
And in case you’re wondering… no, holding your baby upright isn’t the same thing as tummy time! Babies need dedicated time on their tummies to help strengthen their neck muscles so they can gain better control. Holding your baby upright after feeding is all about healthy digestion.
When Can You Stop Holding Your Baby Upright After a Feeding?
There are many different ways to hold your baby safe while they nap, feed, and for extra cuddles, but after each feeding, newborns need to be held upright until they reach a certain age. Burping after breastfeeding or bottle feeding prevents the discomfort that comes from trapped gas bubbles, reduces spit-up, and helps prevent reflux.
Like so many other aspects of parenting, the answer to when you can stop holding your baby upright after feeding isn’t a clear-cut one. It depends on the individual situation, such as how often your baby is spitting up if they have reflux, and how quickly their system is developing.
The good news is that as your baby grows and develops, its system matures and it will require less time being held upright. Most babies will start having more control over their digestive muscles around four to six months of age.
Once your baby reaches six months and they’re spitting up less frequently or not at all, it’s a sign that you can start putting them down sooner after feeding sessions. After you put your little one down, watch for signs of discomfort, vomiting, or spitting up. If they settle in nicely with no issues, they are probably ready. If not, they might need more time.
It’s a process of trial and error and may require a little patience as your baby makes the transition. If you’re normally holding your baby upright for 30 minutes after a feeding, try holding them up for 15 minutes before putting them down in their crib.
Eventually, you can try putting them down without holding them upright at all. It’s best to start experimenting during daytime feeds so that you don’t interrupt nighttime sleep as much.
If your child has issues with gastroesophageal reflux, it might take longer for them to get there. In that case, you’ll just have to wait until they stop spitting up before they can skip being held upright after a feed, which might not be until they reach their first birthday.
Why It’s Suggested to Hold Your Baby Upright After Feeding Them
The lower esophageal sphincter is the muscle between the esophagus and the stomach that acts as a valve to keep swallowed food from coming back up. In newborns and babies, this is underdeveloped and it doesn’t close all the way. It can open at random times, allowing the contents of the stomach to come back up through the esophagus.
This spitting up is completely normal in newborns and young babies and often happens right after a feeding. Because a baby’s stomach is so small, they fill up quickly and that causes milk to come back up as well. Holding your baby upright helps the milk to continue moving down into the stomach and intestines, and can greatly decrease the amount and frequency of spit-up.
In some children, this sphincter can take even longer to close, causing even more episodes of reflux and spit-up. With these reflux babies, it’s even more important to hold them upright. When you’re noticing signs of reflux, be sure to hold them upright for at least thirty minutes after eating.
How Long You Should Typically Keep Your Baby Upright After a Feeding
Each baby is different, so how long they need to be held upright will vary. With newborns, try an upright position for at least 15-30 minutes after each feeding and longer if they have symptoms of reflux, spit up often, or are swallowing a lot of air during feeds.
Since spit-up usually happens right after a feed, be sure to hold your baby upright as soon as they’ve finished eating. You can hold them on your shoulder or sit them up on your lap with one hand under their chin, using the palm of your hand to gently tap or rub your baby’s back. Staying upright for 10-15 minutes should be enough time to allow the milk to settle into your baby’s belly.
If you notice that your baby is spitting up often, even after 15 minutes of being upright, try holding them up for 30 minutes. Some babies who have gastrointestinal issues like GERD or esophagitis may need to be held upright for an hour or more after each feeding.
Can You Use a Bouncer or a Swing to Keep Your Baby Upright?
Holding your baby for an hour or more after every feeding can take its toll. It can be physically exhausting, especially in the middle of the night, not to mention how much time it can take out of your day. If you have older children, need to get things done, or just need a break, it’s understandable that you might look for other ways to keep your baby upright after each feeding.
Using a bouncer or a swing can give you a break and keeps your baby in an upright position. As long as your child is supervised, it can be a helpful alternative. Wearing your baby in a harness is another great way to keep your baby close, in the right position, and hands-free.
It’s never advised to let your baby sleep in an upright position unsupervised unless you have been told otherwise by your pediatrician. If they do fall asleep in a sitting device, be sure to move them to a safe sleeping place as soon as possible. Never use blankets, pillows, or wedges to prop your baby up in its crib.
When to Call The Doctor
Holding your baby upright after feedings is done to help decrease spit-up and reflux. For most babies, spitting up one or two ounces of breastmilk or formula is normal, even with consistent burping and being upright. It’s nearly impossible to eliminate and is a regular part of infancy.
Sometimes spitting up can be a sign that more intervention is required. If you notice any of the following signs, contact your pediatrician:
- Poor weight gain
- Silent reflux (when the milk comes up the esophagus but sinks back down before it reaches the throat)
- Dehydration, or fewer wet diapers than normal
- Constipation
- Forceful or projectile spit up or vomit
- Loss of appetite
- Spitting up blood or anything that looks like coffee grounds
- Choking or trouble breathing
Contact your physician if you notice any of these symptoms. They may recommend acid-blocking medications, feeding smaller and more frequent meals, or using a liquid thickener for formula-feeding or pumped breastmilk.
