A child is born with strong attunement to cues of appetite, hunger and fullness, and can thus naturally eat well if raised in a supportive food environment. A mother’s role is to nurture this inborn ability by creating the right environment. Beginning with infancy, emotional development evolves in stages; understanding these stages can help a mother relate to her child in a helpful way, so her child can thrive in all areas. In this series, we describe a healthy parent-child relationship as it applies to an ideal feeding dynamic, so that the mother can support her child’s natural ability to eat and grow well. This wholesome approach is meant to enhance a child’s nutritional and emotional well-being.
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Esty is utterly exhausted and depleted. Baby Gitty, all of four weeks old, isn’t giving her mother a moment’s rest. When Esty nurses her infant, Gitty is calm and sleeps, but shortly after she puts her down in the crib, Gitty wakes up and cries. At first, Esty tries rocking her and singing to her, but nothing quiets Gitty the way nursing does. So Esty keeps nursing her, until one night her husband gives her a funny look and asks, “Are you sure this is normal? Didn’t the nurse say a baby’s stomach is as big as a marble? How can she nurse around the clock like this?” As if to take her father’s side, Gitty gags and spits up. Esty sighs – she knows she is over-feeding her baby, but it is the only way she and her infant can relax.
Leah, a new mother and a busy office manager, is determined to get her baby onto a schedule before she heads back to work, and a quick survey from neighbors, friends and aunts has her reading the latest and greatest train-your-baby-book on the market. Leah obediently follows the author’s instructions and feeds her baby Chaya specific amounts of foods at specific intervals ONLY. Sometimes, Leah’s heart aches to see her baby searching for food with her little mouth. More often, her infant loses interest in her bottle halfway through a feeding, and Leah has to force it back in her mouth several times before the baby gives in and finishes the whole thing. Leah realizes that Chaya must not be too hungry, yet she persists feeding her because she wants her baby to learn to eat enough food to carry her through to the next scheduled feeding. Eventually, Chaya becomes more compliant with finishing up her bottles.
Baby Chaya and Baby Gitty are infants who naturally work to achieve the developmental task of homeostasis, a state where the infant feels comfortable within herself and with her environment. A baby who achieves homeostasis can remain calm and alert – and when she gets upset, she is relatively easy to understand and settle down. A parent who is able to figure out what her infant needs is helping her infant achieve homeostasis. One of the ways homeostasis can be achieved is when the feeding goals at this stage are met, by the mother learning to identify when her infant is hungry, feeding her in response to those hunger cues, and ending the feeding when the infant signals she is full. This supports the infant’s ability to feel settled and achieve homeostasis.
Once her basic needs are met, an older infant (two months old) will feel loved and important as the parent continues to respect and respond to her cues. This creates a calmer interaction around feeding which leads to enhanced bonding and attachment between the parent and infant. When an infant’s needs are properly met, she will naturally continue to develop healthy attachment with the parent, a significant emotional component to infant development.
Both new mothers mentioned earlier are prone to the common pitfalls of feeding during the earliest stages of childhood development. Esty is constantly misusing feeding to calm an upset baby instead of understanding and tending to cues indicating tiredness, overstimulation, or stomach upset. Leah, on the other hand, is following a strict feeding schedule, which is out of sync with her baby’s hunger and fullness cues. These mistakes impact the baby from both feeding and emotional standpoints.
From a feeding standpoint, both parents aren’t respecting their infant’s hunger and fullness cues. Since Esty is only connecting with her infant through feeding, her baby is inadvertently forced to ignore the fact that she isn’t always hungry. An infant naturally wants to bond with the mother, so she will nurse even when she isn’t hungry if that’s the only way her mother will connect with her. Since Leah is hyper-focused on putting her infant on a rigid schedule, her infant is coerced into finishing a bottle although she is full. As they grow, these infants will be at risk for overeating, since they had been taught to disconnect from their natural cues while eating.
From an emotional standpoint, both well-meaning mothers are in disharmony with their babies, since they are having difficulty recognizing and meeting some of their baby’s basic needs. It is unlikely for an infant to connect with her mother while she is rattled from being uncomfortable, overfed, or overtired – pair that infant with a mother who is tired and anxious, and bonding is even less likely to happen. Disrupted bonding in infancy is a golden opportunity lost. Mother-infant bonding looks simplistic, but it runs deep. This bonding infuses the infant with a sense of security that can fuel her with inner confidence for years to come. Studies have found the quality of infant-parent attachment to be a powerful predictor of a child’s later social and emotional outcome[1].
The good news is that both mothers mentioned above can correct their feeding errors and enjoy an enriched bonding experience with their babies. This is because although an infant’s food regulating cues may get buried when they are ignored, these cues are never fully lost.
Esty can correct her feeding errors and have a more pleasant bonding experience with her baby. Esty is feeding her baby too frequently – she needs to learn how to differentiate between her baby’s many cues, and respond to each one uniquely. Most of us can empathize with Esty, and know that this is a lot easier said than done! When Esty’s baby is crying out of tiredness or discomfort, her mother interprets it as cries of hunger. Additionally, there are times when Esty knows her infant is not hungry, but doesn’t see any problem with feeding her to calm her down.
While a mother and an infant should enjoy the lovely bonding and calming effect of the feeding experience, it should be limited primarily to address real hunger. Occasionally nursing an infant who isn’t hungry, to help her fall asleep or relax, won’t cause harm. However, Esty is doing this continuously, which is abusing and overusing feeding. Since the infant craves connection with her mother, she is forced to ignore herself to connect in the way the mother is offering to connect, i.e. through eating and overeating. Esty needs to learn to recognize when her baby is hungry as opposed to when her baby is tired or uncomfortable.
Additionally, she needs to learn other ways to calm her baby and ease her discomfort. To achieve this, Esty will have to pay close attention to her baby and expand her toolbox of methods to connect with and calm her; this may take trial and error as she explores various ideas. She might reach out for support from a sleep coach or lactation consultant who can help her understand her baby’s patterns. (Some helpful pointers can be found at the end of this article.)
Leah needs to put her feeding agenda aside and trust her baby to let her know when she is hungry and full. No book and no guru can dictate to a parent exactly when or how much their baby needs to eat. Leah should discover her infant’s usual spacing between meals and build a flexible schedule based on that.
For example, she might observe that her infant shows signs of hunger between three and four hours after the start of the previous feeding. She might then begin feeding her at 8:00 a.m. and instruct the babysitter to prepare a bottle at 11:00 a.m. to be given to the baby when she indicates that she is hungry. The feeding should end when the baby turns her head away from the bottle.
Leah should then be prepared for the unpredictable. One day, her baby might surprise her and show signs of hunger only two hours after her last feeding, and another day she might take a long five-hour nap. One day, she might only drink half her bottle, or finish it all and want more on a different day. These patterns should be accepted as normal child feeding patterns; as long as the child is growing consistently over time, day-to-day fluctuations in eating should not be concerning.
If you can identify with any of the feeding patterns described above, you’re in good company. These mistakes are common and there is no need to feel guilty about it. Since children have strong resilience and an inborn tendency to self-regulate eating, feeding errors need to be strong and continuous to disrupt the child’s inborn ability enough to result in disrupted growth. However, continuously disregarding a baby’s hunger and fullness cues can lead to growth and/or eating problems, particularly if feeding tactics remain poor into toddlerhood.
Proper feeding entails feeding in response to a baby’s hunger cues, trusting the baby to know how much to eat, and not forcing a baby to eat. Feeding this way will give your infant a good foundation for eating according to her inner cues. Furthermore, the infant feels loved and important when the parent respects and responds to her cues. As a result, her nutrition thrives, as well as her emotional well-being.
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Tips for Infant Feeding
Wait until your child is fully awake before beginning a feeding. This gives your infant a better chance to have a strong suck until she is full. If the infant is sleepy during the feeding, she may fall asleep before she is full and ask for another feeding very shortly afterwards. You can help your infant awaken by changing her first, turning on the light, or washing her face.
Keep an eye on your watch and pay attention to spacing between feedings and duration of feedings. This will help you become aware of your baby’s usual feeding patterns.
Most infants will go about three hours from the start of one feeding to the start of the next feeding. This gives their stomach sufficient time to empty out and feel real hunger cues. She will then approach the next feeding with an appetite and a strong suck. If your infant fusses and it hasn’t been three hours from the start of the last feeding, try comforting her first or putting her to sleep. If the infant persists or shows obvious hunger, try feeding her.
Be familiar with your baby’s hunger signals. Commonly, a hungry baby will open her mouth and turn her head from side to side as if she is searching for food.
Look out for signs that your baby is getting enough food. If your baby is having plenty of wet and dirty diapers daily, that is a good sign she is getting enough food. If her lips are dry and/or she has few wet/dirty diapers, she may not be getting enough food.
Brochi Stauber is a Registered Dietitian Nutritionist whose goal is to make healthy living a lifestyle reality for individuals and families. She combines clinical nutritional knowledge with an understanding of the behavioral science of food, enabling clients to sustain healthy habits. 732-731-9340; satisfinutrition@gmail.com.
Shira Francis is a Licensed Marriage and Family Therapist in private practice in Chicago, IL. She provides guidance and counseling in relationships and self-development. 773-971-3388; shirafrancis@gmail.com.
[1] Benoit D. (2004). Infant-parent attachment: Definition, types, antecedents, measurement and outcome. Paediatrics & child health, 9 (8), 541–545. doi:10.1093/pch/9.8.541
