Parents are often advised to burp their babies after feeding them. Some people think burping after feeding is important to reduce or prevent discomfort crying, or to reduce how much a baby regurgitates milk after a feed.

It is true babies, like adults, swallow air when they eat. Burping releases this air from the top part of our digestive tracts. So when a baby cries after a feed, many assume it’s because the child needs to “be burped”. However, this is not necessarily true.

Why do babies cry or ‘spit up’ after a feed?

Babies cry for a whole host of reasons that have nothing to do with “trapped air”.

They cry when they are hungry, cold, hot, scared, tired, lonely, overwhelmed, needing adult help to calm, in discomfort or pain, or for no identifiable reason. In fact, we have a name for crying with no known cause; it’s called “colic”.

“Spitting up” – where a baby gently regurgitates a bit of milk after a feed – is common because the muscle at the top of a newborn baby’s stomach is not fully mature. This means what goes down can all too easily go back up.

Spitting up frequently happens when a baby’s stomach is very full, there is pressure on their tummy or they are picked up after lying down.

Spitting up after feeding decreases as babies get older. Three-quarters of babies one month old spit up after feeding at least once a day. Only half of babies still spit up at five months and almost all (96%) stop by their first birthdays.

Does burping help reduce crying or spitting up?

Despite parents being advised to burp their babies, there’s not much research evidence on the topic.

One study conducted in India encouraged caregivers of 35 newborns to burp their babies, while caregivers of 36 newborns were not given any information about burping.

For the next three months, mothers and caregivers recorded whether their baby would spit up after feeding and whether they showed signs of intense crying.

This study found burping did not reduce crying and actually increased spitting up.

When should I be concerned about spitting up or crying?

Most crying and spitting up is normal. However, these behaviours are not:

• refusing to feed
• vomiting so much milk weight gain is slow
• coughing or wheezing distress while feeding
• bloody vomit.

If your baby has any of these symptoms, see a doctor or child health nurse.

If your baby seems unbothered by vomiting and does not have any other symptoms it is a laundry problem rather than something that needs medical attention.

It is also normal for babies to cry and fuss quite a lot; two hours a day, for about the first six weeks is the average.

This has usually reduced to about one hour a day by the time they are three months of age.

Crying more than this doesn’t necessarily mean there is something wrong. The intense, inconsolable crying of colic is experienced by up to one-quarter of young babies but goes away with time on its own .

If your baby is crying more than average or if you are worried there might be something wrong, you should see your doctor or child health nurse.

Not everyone burps their baby

Burping babies seems to be traditional practice in some parts of the world and not in others.

For example, research in Indonesia found most breastfeeding mothers rarely or never burped their babies after feeding.

One factor that may influence whether a culture encourages burping babies may be related to another aspect of infant care: how much babies are carried.

Carrying a baby in a sling or baby carrier can reduce the amount of time babies cry.

Babies who are carried upright on their mother or another caregiver’s front undoubtedly find comfort in that closeness and movement.

Babies in slings are also being held firmly and upright, which would help any swallowed air to rise up and escape via a burp if needed.

Using slings can make caring for a baby easier. Studies (including randomised controlled trials) have also shown women have lower rates of post-natal depression and breastfeed for longer when they use a baby sling.

It is important baby carriers and slings are used safely, so make sure you’re up to date on the latest advice on how to do it.

So, should I burp my baby?

The bottom line is: it’s up to you.

Gently burping a baby is not harmful. If you feel burping is helpful to your baby, then keep doing what you’re doing.

If trying to burp your baby after every feed is stressing you or your baby out, then you don’t have to keep doing it.

Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A recent study has suggested Shingrix, a relatively new vaccine given to protect older adults against shingles, may delay the onset of dementia.

This might seem like a bizarre link, but actually, research has previously shown an older version of the shingles vaccine, Zostavax, reduced the risk of dementia.

In this new study, published last week in the journal Nature Medicine, researchers from the United Kingdom found Shingrix delayed dementia onset by 17% compared with Zostavax.

So how did the researchers work this out, and how could a shingles vaccine affect dementia risk?

From Zostavax to Shingrix

Shingles is a viral infection caused by the varicella-zoster virus. It causes painful rashes, and affects older people in particular.

Previously, Zostavax was used to vaccinate against shingles. It was administered as a single shot and provided good protection for about five years.

Shingrix has been developed based on a newer vaccine technology, and is thought to offer stronger and longer-lasting protection. Given in two doses, it’s now the preferred option for shingles vaccination in Australia and elsewhere.

In November 2023, Shingrix replaced Zostavax on the National Immunisation Program, making it available for free to those at highest risk of complications from shingles. This includes all adults aged 65 and over, First Nations people aged 50 and older, and younger adults with certain medical conditions that affect their immune systems.

What the study found

Shingrix was approved by the US Food and Drugs Administration in October 2017. The researchers in the new study used the transition from Zostavax to Shingrix in the United States as an opportunity for research.

They selected 103,837 people who received Zostavax (between October 2014 and September 2017) and compared them with 103,837 people who received Shingrix (between November 2017 and October 2020).

By analysing data from electronic health records, they found people who received Shingrix had a 17% increase in “diagnosis-free time” during the follow-up period (up to six years after vaccination) compared with those who received Zostavax. This was equivalent to an average of 164 extra days without a dementia diagnosis.

The researchers also compared the shingles vaccines to other vaccines: influenza, and a combined vaccine for tetanus, diphtheria and pertussis. Shingrix and Zostavax performed around 14–27% better in lowering the risk of a dementia diagnosis, with Shingrix associated with a greater improvement.

The benefits of Shingrix in terms of dementia risk were significant for both sexes, but more pronounced for women. This is not entirely surprising, because we know women have a higher risk of developing dementia due to interplay of biological factors. These include being more sensitive to certain genetic mutations associated with dementia and hormonal differences.

Why the link?

The idea that vaccination against viral infection can lower the risk of dementia has been around for more than two decades. Associations have been observed between vaccines, such as those for diphtheria, tetanus, polio and influenza, and subsequent dementia risk.

Research has shown Zostavax vaccination can reduce the risk of developing dementia by 20% compared with people who are unvaccinated.

But it may not be that the vaccines themselves protect against dementia. Rather, it may be the resulting lack of viral infection creating this effect. Research indicates bacterial infections in the gut, as well as viral infections, are associated with a higher risk of dementia.

Notably, untreated infections with herpes simplex (herpes) virus – closely related to the varicella-zoster virus that causes shingles – can significantly increase the risk of developing dementia. Research has also shown shingles increases the risk of a later dementia diagnosis.

The mechanism is not entirely clear. But there are two potential pathways which may help us understand why infections could increase the risk of dementia.

First, certain molecules are produced when a baby is developing in the womb to help with the body’s development. These molecules have the potential to cause inflammation and accelerate ageing, so the production of these molecules is silenced around birth. However, viral infections such as shingles can reactivate the production of these molecules in adult life which could hypothetically lead to dementia.

Second, in Alzheimer’s disease, a specific protein called Amyloid-β go rogue and kill brain cells. Certain proteins produced by viruses such as COVID and bad gut bacteria have the potential to support Amyloid-β in its toxic form. In laboratory conditions, these proteins have been shown to accelerate the onset of dementia.

What does this all mean?

With an ageing population, the burden of dementia is only likely to become greater in the years to come. There’s a lot more we have to learn about the causes of the disease and what we can potentially do to prevent and treat it.

This new study has some limitations. For example, time without a diagnosis doesn’t necessarily mean time without disease. Some people may have underlying disease with delayed diagnosis.

This research indicates Shingrix could have a silent benefit, but it’s too early to suggest we can use antiviral vaccines to prevent dementia.

Overall, we need more research exploring in greater detail how infections are linked with dementia. This will help us understand the root causes of dementia and design potential therapies.

Ibrahim Javed, Enterprise and NHMRC Emerging Leadership Fellow, UniSA Clinical & Health Sciences, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.