Why lists of feeding cues can make breastfeeding go worse, not better
Cues that your baby wants milk
Have you been given a list of your baby's feeding cues, or lists of behaviours which are meant to signal their baby wants to feed? In the Possums programs, we don't give parents lists of baby behaviours and what they mean, because these lists can be both misleading and disempowering.
You are the expert on your baby, and the only way any of us work out what a baby is cueing for at any particular time is through experimentation. Experimentation is the key to your resilience as a parent! You can find out about experimentation here.
You'll hear that the oral seeking (or rooting) reflex signals hunger - but babies are hardwired to root when their cheek touches your skin. Quite often baby might be searching with her mouth because of hunger, and it doesn't hurt to offer.
But some parents worry a lot that the baby is hungry because they've seen rooting and bobbing behaviour or the baby sucking on his or her little hand, but then baby won't take the breast! "What's wrong?" you might think, and it can be tempting to pressure the baby to take the breast a little, if you think the baby is always hungry when he or she bobs her head around against your body.
The main communication or cue from your baby that he or she wants to feed is the dialing up. Really there are just two responses to experiment with: your two tools of either milk or sensory motor nourishment. We activate a baby’s breastfeeding reflexes when the lower half of the little one’s face has contact with our breast and body. Since this is a reflex, some babies will begin their oral seeking and bobbling behaviours anytime they are in contact, but then signal when they come onto the breast that this isn’t what they really want at all. The concept of the two tools to experiment with to make the days as easy and as manageable as possible is very helpful here. When your baby dials up, you can offer milk, and you can offer rich and changing sensory nourishment, and see what works.
In the early days you can't go wrong with offering milk, but our baby's sensory motor needs are powerful, and often misunderstood. Sometimes you might go outside for a little walk and look at the world, rather than breastfeed, even if the baby is rooting or sucking on his or her hand, and see what happens.
The newborn who doesn't cue for feeds
This is a particular problem for some babies in the first couple of weeks after birth, especially when baby has some jaundice and be quite sleepy. The baby doesn’t wake and cue for breastfeeds very often, and the lack of calories and poor weight gain causes the baby to sleep more and cue less, until suddenly you might find you're in a crisis situation, of continued weight loss and failure to regain birth weight.
This is why, in the first couple of weeks, parents might be told to wake their baby to feed every three hours day and night: the baby needs calories to move out of the newborn sleepiness and poor intake cycle.
Outright crying is often a late sign of hunger, and it is best to respond before the baby’s dial has turned up high. You can certainly try offering the breast when the baby is crying hard, but often the little one is too disorganised and distressed to take it, and a change of sensory environment (such as stepping outside the home, if you don’t live in an extreme climate) can reset the dial.
| Bottle-feeding baby's cues | Popular misinterpretations | Typical cause | Possums or NDC strategies |
|---|---|---|---|
| Back-arching and fussing | Oral ties, oesophagitis, reflux, wind pain or gas, colic, allergy or intolerance, cranial nerve dysfunctions, weak suck, torticollis | Positional instability | Paced bottle-feeding |
| Back-arching and fussing | Oral ties, oesophagitis, reflux, wind pain or gas, colic, allergy or intolerance, cranial nerve dysfunctions, weak suck, torticollis | Does not want more milk; pressure on feeds due to spacing | Paced bottle-feeding - cease offering bottle for a time |
| Back-arching and fussing | Oral ties, oesophagitis, reflux, wind pain or gas, colic, allergy or intolerance, cranial nerve dysfunctions, weak suck, torticollis | Conditioned hyperarousal of sympathetic nervous system | Paced bottle-feeding, health professional support to build enjoyable feeding associations |