Infant Feeding Cues During the Early Days of Life

#1 first period of reactivity

For 6 to 8 hours after birth, your newborn will be in his first period of reactivity. During the first 30 minutes after birth, your infant will be very alert, may cry vigorously, may suck greedily on his fist, and will appear very interested in his environment. Your infant's eyes will probably be open, making this an excellent opportunity for mom, dad, and baby to meet each other. Your baby will have a vigorous suck reflex at this time, creating a great opportunity for you to breastfeed. Your baby's doctor and/or nurse will be glad to allow you to breastfeed if your baby is adapting well to life outside of the womb. If mom or baby's condition doesn't allow breastfeeding at this time, don’t fret. Your safety and your baby's safety are most important at this time....breastfeeding will still be available.

However, research shows that if colostrum is not expressed within 6 hours of birth, it reabsorbs into the body and it takes longer for the colostrum to increase in volume. This means that if your baby is not medically able, or exhibits an inability to latch onto your breast during this timeframe, then it is very important to request the use of a hospital-grade electric breastpump to remove this valuable breastmilk from your breasts.

After your baby's initial stage of alertness, she will enter a second stage of the first reactive period, which generally lasts 2 to 4 hours. Your baby will enter a state of sleep and relative calmness. This is a difficult time to try breastfeeding. If your baby breastfed prior to this sleepy period, she has started the milk-producing functioning of your breasts and she is digesting colostrum, minimizing her chances of becoming dehydrated during this sleepy phase after delivery. This may be a good time for mom and baby alike to rest. Or, mom may like to hold her baby skin-to-skin on her chest to keep baby warm and to stimulate her milk-production. This is called .kangaroo care..

The second period of reactivity begins when your baby awakens from his deep sleep. This period lasts about 2 to 5 hours. Take this excellent opportunity to interact with your newborn by offering the breast. It is recommended that you keep your baby rooming-in with you to optimize your abilities to breastfeed. If your baby has to be in the nursery, make sure the nurses know you want to breastfeed your baby for feedings unless medical reasons exist.

For the next 2 to 3 days, your baby may sleep almost constantly to recover from the birthing process. Her sleep has 6 distinct states. Her quiet alert state is the optimum state of arousal. During this state, your baby may smile, coo, look around and at you, and may actually appear to respond to your words. This is the best time to feed your baby! Watch and listen to your baby and feed accordingly. She is a better indicator of feeding time than the clock.

In the active-alert state, your baby will have periods of fussiness, active arm & leg movements, and will appear to be staring. You may need to calm your baby by

swaddling him, talking soothingly to him, holding him, and/or offering a clean finger to suck on briefly. After calming him, offer the breast.  If he becomes fussy, console him by swaddling, talking, holding, & sucking on finger, and then offer the breast again. Repeat this process until he successfully latches onto the breast.

Many parents believe a baby is hungry and ready to feed when she cries. However, crying is a late hunger cue. By the time your baby is crying, she is probably ravenous and won’t be able to concentrate too well on learning to breastfeed. An analogy to this is when you were 8 months pregnant and ravenously hungry! You probably didn’t have the most patience with your loved one at that point. (Ha! Remember those days and nights?!)

When your baby is in a deep sleep state, it will be very difficult to feed him. Your baby will appear very relaxed and when you apply a cold washcloth to his face, he’ll still tend to drift off to sleep. But, this cycle only lasts 10 to 20 minutes, so relax and attempt to arouse your baby when you notice him entering the state of light sleep.

Light sleep is seen when your baby’s eyes are closed, yet fluttering under her eyelids. (This is called REM’s or rapid eye movements.) You may notice some irregular breaths taken by your baby and also some slight muscle twitching. Now the cold washcloth or unswaddling the blanket and changing your baby’s diaper will arouse your baby. You should offer the breast at this time. This period can be short-lived and your baby may indeed fall back into a deep sleep. Your prompt attention to her needs, though, will alert you to take this opportunity as a time to successfully latch baby onto the breast.

Your baby enters a period of drowsiness when he opens & closes his eyes, moves his arms & legs, and breathes irregularly.  This is a great time to pick-up your baby and feed, rather than leaving him in the crib. 

Feeding your baby according to his aforementioned feeding cues will grant him the opportunity to learn to breastfeed and will keep him adequately hydrated. Your drops of colostrum are like drops of gold! Save each drop and feed it to your baby. You can expect to feed your infant 8-12 times in 24 hours in the first days of life. And, remember, sore nipples is not expected, but a sign of poor or shallow latching to the breast. 

© Copyright: Carol Chamblin, RN, MS, IBCLC  1/25/2007

#2- second stage of the first period of reactivity

#3 - quiet-alert state

#4 - active-alert state-first period of reactivity

#5 -crying

#6 - deep sleep state

#7- light sleep

#8 - drowsiness