What are Cue-Based Feeds?
Feedings offered by mouth based on your baby’s cues (signs) that he/she is ready and interested in bottle feeding. It is infant driven, flexible, safe, and emphasizes quality over quantity. Feeding readiness is determined by your baby’s hunger and stress behavior and how your baby sucks on the nipple. The goal is to lessen and prevent your baby’s stress while PO feeding. Babies need to learn how to coordinate sucking, swallowing, and breathing, which takes a lot of practice and patience. This typically starts around 32-34 weeks gestation. Cue-based feedings follow the developmental progression of oral motor and sensory skills. Nurses and therapists will work with parents to learn their baby’s hunger signs, stress cues, and techniques to properly and safely feed their baby.
Common Hunger Signs:
Bringing their hand(s) to their mouth
Sucking on their fingers or pacifier
Being alert, crying and fussing
Rooting (turning head side-to-side to find the nipple)
Having good muscle tone
Opening their mouth (“ooh” face)
Common Stress Cues:
Crying during the feed
Yawning often
Gaze aversion (avoiding eye contact)
A change in muscle tone (limp and floppy)
Splayed fingers or “stop sign” hands
Arching or pulling away from the bottle
Apnea and/or bradycardia
Breathing too fast or too slow
Facial grimacing
Gagging/coughing/retching
Spitting out the milk excessively
Vomiting
A change in coordination
Falling asleep