Mary Catherine Bolton, BS and Cathy Snyder, RN, BSN, IBCLC
For years, women have been told that feeding “on demand” is best for breastfeeding newborns. However, demand feeding implies the mistaken notion that baby needs to cry to be fed. Recent research suggests that parents should be alert for feeding “cues”, which are instinctive behaviors an infant displays before crying.
Babies may cry for many reasons – overtiredness, overstimulation, discomfort, or loneliness, to name a few. On the other hand, sometimes babies who are very hungry do not cry. Newborns who have jaundice, who are small or born prematurely, or affected by labor medications during birth may be groggy or sleepy. Even a baby who has a calm temperament may not cry very often. A baby in any of these situations may be undernourished if fed only when he cries.
The best approach is to respond to a baby’s feeding cues. These behaviors, although more subtle than crying, are distinctive and can be easily recognized by watchful parents or caregivers. Even a very sleepy newborn is likely to display feeding cues during periods of light sleep, and will be easier to wake at such times. The American Academy of Pediatrics recommends, “Newborns should be nursed whenever they show signs of hunger such as increased alertness or activity, mouthing or rooting. Crying is a late indicator of hunger.”
Feeding on cue offers many advantages. Mother and child are more in tune with one another, which fosters bonding and trust. Mother respects her infant’s individual and changing needs. Baby learns to cry less, making the home more peaceful and parenting more pleasurable. Baby is likely to latch on more easily and nurse more calmly. Mother is more likely to develop a milk supply that matches baby’s biological needs and baby is more likely to have his comforting needs met.
Research has shown that cue-based feeding works. In one study, premature babies who were fed on cue were discharged sooner than those fed on a schedule. Since parents had learned feeding cues, these babies were also less likely to have problems with weight gain once home.
These behaviors, although more subtle than crying, are distinctive and can easily be recognized by watchful parents or caregivers. Very sleepy newborns, who may be difficult to wake for feedings, are likely to display feeding cues during periods of lighter sleep and will be easier to wake at such times.
Feeding cues are one of the many ways in which your newborn communicates with you and attempts to control his environment. When you recognize and respond to his preverbal “voice,” you reinforce his efforts to interact with the world around him. Perhaps even more importantly, you show respect for him as a unique person capable of expressing his needs and entitled to have those needs met.