Newborn Feeding Cues
Learning When to Breastfeed
“The day after the birth of Shellie’s baby, Nicky was very sleepy. Shellie was sleepy too, but she was worried that her baby wasn’t getting enough to eat. The nurses had told her to feed her baby every 2 to 3 hours, but Nicky was so sleepy she was having trouble getting him to take her breast. By 11 pm, the baby had only had a few successful feeds and Shellie was feeling exhausted.
Happily, the next day Nicky seemed much more alert. He practically attacked her breast with a need to suckle. As she attended to Shellie’s needs, the day nurse casually observed a feeding. “You’ve got a little barracuda there,” she said with a smile. Shellie’s nipples were beginning to hurt. She did her best to ignore the pain, it was more important that her baby eats, but Shellie was dreading each feeding. Feeling desperate after two weeks of living with their little ‘barracuda’, Shellie and her husband, Rick, finally decided to call a Lactation Consultant and ask for a home visit.
When I appeared at their door, I was handed a notebook they had been keeping. In it they had jotted down the time of each feeding, how long it lasted, which side, etc. To be polite, I looked at the notebook for a moment, and then I looked at the baby—his fists were clenched by the sides of his mouth. I knew he was hungry but when I suggested that it was time to feed both Shellie and Rick insisted that it wasn’t time yet. According to their notes he had fed just an hour and a half ago. It would be at least another hour before the baby would be ready to feed again they told me.”
Watching the clock instead of watching the baby is one of the most common mistakes that new parents make with a breastfed baby. In their efforts to be good parents they try to follow all instructions to the letter. What they don’t realize is that the ‘rule of thumb’ about babies eating every 2 to 3 hours is merely a guideline. The reality is that babies don’t know anything about clocks. The size of the newborn stomach is so small (it is no bigger than their tiny hand!) that it empties very quickly. An empty stomach is the trigger that wakes a baby up. Rather than watching the clock or waiting until the baby cries, a newborn should be offered the breast as soon as he shows signs of rousing. And just like their mothers, many babies are sleepy the day following the birth. Starting on the second day many babies like to cluster feed, meaning they like to hang out on their mother’s chest and graze for a couple of hours with quick cat naps in between suckles.
Babies who are fed on a schedule tend to get hungry, and the hungrier a baby gets the more likely he will start to act like a ‘barracuda’. It is almost impossible to get a comfortable latch when a baby is crying or agitated; the baby (and the mother!) needs to be calm. Unfortunately a mother with sore nipples is also less likely to feed frequently, and the longer she stretches out the time between feeds the hungrier her baby will be which increases the risk of further damage to her nipples. The longer this cycle continues the more likely she is to simply give up.
Although they were reluctant at first, Shellie and Rick finally agreed to give up their breastfeeding notebook and to stop watching the clock. We worked together on learning the feeding cues and catching feeds as early as possible. They could then see how much easier it was to get a comfortable latch with a baby who wasn’t frantic with hunger. Feeding more frequently finally made sense to them.
Feeding Cues
- R.E.M. (Rapid eye movement when a baby is sleeping means your baby will wake up soon. This is not the time to take that long shower!)
- Hands tightly clenched
- Fists drawn up to the mouth
- Head turning from side to side
- Rooting (Lips pouted, sucking on hands)
- Face begins to crinkle
- Crying (this is the sign that means you waited too long! Calm the baby down before
trying to feed)!
By the time I left, instead of dreading their little ‘barracuda’ Shellie and Rick had thrown their notebook into the trash and had settled down for an evening on the couch cuddling and adoring their beautiful baby.