Thanks to all for your various posts, under this subject line and
variations on it.
I've always felt it is at least as pressing to find the cause of the
restlessness, spitting up, etc, as it is to get the baby to burp.
After seeing the kinds of things that go along with increased
turbulence in the oral cavity, like tongue tie, oversupply, and more
complex forms of dysfunctional suckling, I think it's a red flag when
a baby is always squirming around and struggling at the breast,
instead of relaxing and drinking.

Susan B - the technique of burping a drowsy baby to wake it and
continue feeding is described as 'burp and switch' in the first
editions of The Breastfeeding Triage Tool from the King County Health
Department, written by Sandra Jolley (or Jolly?) in the 1980's, as a
method for improving both intake and supply in cases of low weight
gain / low supply. I'd forgotten all about it until I saw your post,
and this is a technique I do use, though I've started calling it
'windshield wiper breastfeeding', (and I dropped the advice on
burping) to illustrate to mothers the frequency with which you can
switch sides to keep a baby transferring milk more of the time during
a feed. Since they only swallow when milk is flowing, you give each
breast frequent short breaks while you feed on the other one. We
always emphasize that this is a *temporary intervention* for a
specific purpose and not a good way to breastfeed if everything is
going normally.

I guess my point is that in my experience there are usually good ways
of dealing with the underlying cause of whatever condition you are
trying to relieve with 'burp breaks'.  The underlying factor is
usually poor attachment at the breast and that will point the way to
finding the root cause.  For some reason it bothers me to see mothers
practicing a technique that ought to have been a stop-gap thing while
they fixed the real problem. Instead, we're accepting that
breastfeeding is generally difficult and worky, not something you can
do while sleeping, reading a book to another child or to yourself, or
just absentmindedly sitting still, lactating. When it works,
breastfeeding doesn't really require conscious effort.

Rachel Myr
Kristiansand, Norway

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