From the Guidelines
Hunger cues in infants include rooting, sucking on hands or fingers, smacking lips, opening and closing the mouth, sticking out the tongue, and turning the head toward the breast or bottle (rooting reflex), and parents should feed their baby when they notice these early hunger cues rather than waiting for crying, which can make feeding more difficult. These early signs also include increased alertness, activity, or hand-to-mouth movements 1. Crying is a late hunger sign, indicating the infant is already quite hungry. Recognizing and responding to these cues promptly helps establish healthy feeding patterns and supports the infant's natural ability to self-regulate food intake. Some key points to consider when identifying hunger cues in infants include:
- Infants typically need to eat every 2-3 hours, but following their hunger cues rather than strict schedules is recommended, especially in the early months 1.
- A responsive feeding approach, which involves recognizing and responding to an infant's hunger and satiety cues, promotes better feeding experiences and helps develop a healthy relationship with food 1.
- Breastfeeding mothers may be more likely to practice responsive feeding, as they are more attuned to their infant's cues and are less likely to use restrictive feeding practices 1. However, it is essential to note that the relationship between breastfeeding and responsive feeding is complex, and more research is needed to understand the optimal approaches for promoting responsive feeding during early childhood 1. Overall, parents should prioritize recognizing and responding to their infant's hunger cues, rather than relying on strict schedules, to promote healthy feeding patterns and a positive relationship with food.
From the Research
Hunger Cues in Infants
- Infants communicate their hunger and satiety through various cues, which can be identified and responded to by caregivers 2, 3.
- Research has shown that breastfed infants exhibit more engagement and disengagement cues than formula-fed infants, highlighting the importance of recognizing these cues to promote responsive feeding 3.
- The frequency of feeding cues changes with satiation, with more frequent cues observed at the beginning of a meal than at the end 3.
- Studies have identified 22 feeding cues in milk-fed infants, including engagement and disengagement cues, which can be used to guide responsive feeding practices 3.
Responsive Feeding
- Responsive feeding, which involves feeding in response to an infant's hunger and satiation cues, can enhance infants' and parents' experience and satisfaction, and may help establish independent oral feeding and increase nutrient intake and growth rates 4, 5.
- However, the evidence on the effectiveness of responsive feeding for preterm infants is limited and of low quality, with some studies suggesting that it may result in slightly slower rates of weight gain and earlier transition to oral feeding 4, 5.
- Mother-infant physical contact, such as co-sleeping and babywearing, has been shown to predict responsive feeding among breastfeeding mothers, highlighting the importance of social interaction and physical contact in shaping infant nutrition 6.
Identification of Hunger Cues
- Caregivers can identify hunger cues in infants by observing their behavior, including rooting, sucking, and swallowing, as well as changes in their facial expressions and body language 2, 3.
- The use of validated lists of communication cues, such as the NCAST, can help caregivers recognize and respond to infant hunger and satiation cues 3.
- Coaching and education on responsive feeding practices, such as the LEIFc intervention, can also help caregivers develop the skills and confidence to recognize and respond to infant hunger cues 2.