Hunger Cues
Co-authored by Sejal Fichaida | Kindred Mother Care
One of the most commonly asked questions from new parents is, "How do I know if my baby is hungry?".
Once parents learn how to identify how their baby communicates hunger, it seems like their baby is telling them they're hungry all the time! Seeing constant hunger signs often leads parents to worry and ask, "How do I know if my baby if full?"
It's almost torturous that, scientifically, parents are better at identifying hunger cues than they are at telling if their baby is full.
If you are here because you feel unsure about knowing how to tell if your baby is hungry (or full), you are not alone. I've teamed up with Sejal Fichadia, a fellow International Board Certified Lactation Consultant (IBCLC) and owner of Kindred Mother Care, to tackle this often confusing topic.
What are hunger cues?
The term 'hunger cues' describes a broad set of movements/behaviors meant to alert you to your baby's feeding needs. While that sounds super specific, essentially, these cues are signals that tell you to pay attention to your baby.
These cues are primitive reflexes and are a universal means of reflexive communication to ensure our survival. Cool right?
Though it may take time to learn how your baby communicates hunger based on the level of hunger they feel -"Oh, hey, I could eat" vs. "I'm super hungry. Feed me NOW!"- it usually becomes less of a struggle within the first few weeks after delivery.
Like any other skill, to master it, it requires frequent practice; thankfully, babies eat a minimum of 8-10 times a day, so there is no shortage of practice time to tune in and learn how your baby communicates.
Using your baby's hunger and satiety (fullness) signals to drive how and when you feed your baby is called responsive feeding. Responsive feeding has many benefits, which you can read later on in this post.
What are the signs that my baby is hungry?
Hunger cues are generally broken up into either two or three categories: early and late signals or early, mid, and late signs. In this post, we'll go the two category route.
Early hunger cues include:
moving their head side to side (where's the boob?)
moving their mouth towards a cheek that is touched (rooting reflex) (is that a boob?)
sticking their tongue out beyond their gums and lips (Can I find it with my tongue?)
licking or sucking their lips (Maybe my parents will notice I'm hungry)
bringing their hands to their mouth (Maybe I'll find it with my hands and my mouth)
an increase in movement, such as trying to stretch, moving their feet like bicycling, squirming, etc. (Okay.. I really need to find it)
an increase in their breathing (I've been searching for my food source, and I'm getting a bit hangry)
Late hunger cues:
Frantic head movements (aka Feed me right NOW)
Crying (aka It feels like I've been asking to eat all day and now I'm mad)
Suckling, vocalizing, and tactile stimulation- all of the early hunger cues- stimulate oxytocin and dopamine, which in combination, control your baby's stress hormone (cortisol) levels. When your baby's stress hormones are appropriately managed, it builds resilience and has a positive effect on long-term health.
Want to see the progression of the above steps in real time? Check out this video —>
How do hunger cues change as my baby gets older?
For a newborn, any movement and stirring between feeding sessions can be considered a feeding cue, especially for the first two weeks or until the baby reaches their birth weight.
It's important to note that babies born early (preterm or very preterm), or babies that have certain conditions (ex. low blood sugar, Jaundice, or any neurological impairment), may not signal hunger due to their nervous system not being developed fully (immaturity) or their energy status.
As babies get older, generally around the 8-12 week mark, signs that you once relied on, such as bringing hands to mouth, may become confusing.
A good rule of thumb at any age (if you're at the breast/chest feeding) is if you're unsure if your baby is hungry, offer. If your baby is actively hungry, they can choose to remove as much milk as they want, and if all they want is comfort, closeness, and a sucking stimulus, they get that too.
Win-Win.
What are the benefits of responsive feeding?
From a milk production standpoint, responsive feeding plays a significant role in maintaining an adequate supply. In the absence of any underlying health issues, milk production works on a 'demand and supply' basis.
Every time your baby communicates that they have a desire to eat (or suck) and you respond appropriately, your body receives the signals it requires to meet your baby's intake needs.
In regards to your baby, responsive feeding provides them with opportunities to learn to trust you.
It may seem odd that babies aren't born trusting their parents. However, it makes sense when you consider that birth signifies a new stage in you and your baby's relationship, one that requires active communication.
Every time you respond appropriately to their requests, they learn that they can depend on you.
Additionally, responding to early feeding cues means your baby spends fewer calories and is calm at the breast during important steps like latching.
What can interfere with seeing your baby's early hunger cues?
Things that may contribute to missed communication include:
Swaddling: Swaddling works well to calm babies down and make them feel in the womb again; however, it's this specific benefit that may lead to missed signals. Not only does swaddling recreate the womb-like experience where they had the luxury of a 24-hour buffet, but also, babies need the full range of movement in their arms and hands to cue. Considering the hands-to-mouth motion is the cue most parents pick up on, any limitation in your baby's ability to cue may lead to missed early signals.
Pacifiers: The act of sucking has a soothing effect on babies and releases Cholecystokinin. This hormone causes the feeling of being full. Additionally, paci use can interfere with a baby's ability to give hunger cues leading to missed communication. There are many recommendations for pacifiers use, which vary by circumstances: Some recommend avoiding any artificial nipple before the baby is 3-4 weeks old. Others suggest just to minimize its usage regardless of when it's introduced.
Baby's temperament: Up to this point, we've assumed that every baby gradually increases the intensity of their hunger cues, with crying being the very last communication method. Like nearly everything parenting related, however, there are outliers: You may be honored with a baby that bypasses the subtle signs of hunger and gets right into crying. In situations like these, it may be helpful to learn your baby's feeding rhythms and offer the breast/chest just before, and when they would typically cue to reduce crying and stress for both of you.
Medical conditions: Babies without medical issues usually have no problem waking up and cueing based on internal signals such as hunger. We expect babies to want to eat every 1-3 hours during the first week of life, followed by sooner than every 3-4 hours with maybe** one longer stretch of fewer than 6 hours. Babies' appetites and hunger are variable, but these are trends we expect.
Babies with blood sugar issues, Jaundice, neurological impairments, or other medical conditions may not cue each time they experience the internal stimuli of hunger. Additionally, they may not continue to cue to ensure a response. Many parents ask whether or not they should wake their baby up to eat, which I address in this post with the same title. In cases where there is a lack of sufficient signaling, the answer is a resounding yes.
Answered another way...
Will babies sleep through hunger?
Yes, they can! Usually, premature babies, jaundiced newborns, babies with birth trauma, who are neurologically compromised, or have low blood sugar (hypoglycemic) may not wake up when hungry. Common strategies for waking your baby up, in this case, may be helpful. However, a lactation professional (IBCLC) will be able to better guide you for the appropriate approach based on your baby's specific condition.
Strategies for waking a baby to eat include:
bringing baby skin to skin, chest to chest with you
putting them on their back without a swaddle,
gently tickling their cheek with your finger
doing the doll's eye maneuver
When a baby is suckling/eating their own hands, is that a feeding cue?
Whether hand sucking is a feeding cue depends on the age of your baby. For babies under the age of 8 weeks, hands to mouth is almost always a feeding signal. After 8-12 weeks, your baby grows and gains control over some motor movements. Eventually, they will find that their hands are a cool thing to explore; it no longer may be a hunger cue. This is very concerning to parents- no longer having a clear signal to know if their baby is hungry. A good strategy is to offer anytime you think* your baby may be hungry.
How do I know if my baby is crying because they are hungry?
Many parents report their baby has a distinct cry to signal hunger and describe it as having a "neh" sound. If you don't hear a difference in your baby's cries, that's perfectly okay.
Note: I didn't.
If you have a newborn, it may be best to assume that crying is a late hunger cue. If your baby is older than four weeks, crying may be a sign of a wide range of needs me, such as a diaper change, more or fewer clothes, or a snuggle.
Babies use multiple signals simultaneously, and there may be other signs to help you identify your baby's needs (i.e., skin changes if cold, sweating/red if hot, wet diaper, etc.). It may take some investigation work at times to get a clear picture of what your baby is trying to communicate, and that's okay.
One final note on this- you are your baby's environment and your baby crying when you put them down is both expected and normal. Though crying in this situation is not a hunger cue, offering the breast will have many benefits and is always a great idea.
Why does crying impede a baby's ability to latch efficiently?
Crying is the enemy of successful latching. One reason, outside of the obvious factor that crying babies are stressed, is that babies' tongue movements become very disorganized. Crying makes it difficult to latch your baby because the combination of stress and oral disorganization interrupts their ability to engage in any pre-feeding behaviors.
It’s important to calm your baby down before latching attempts. Here are a few strategies you can try:
For the first six weeks of life, skin to skin contact is a powerful tool in your toolbox as a new parent. Breastfeeding is a natural consequence of skin to skin contact and many parents find that their baby's latch without much direction.
For slightly older babies, sucking on a clean finger may help calm them down.
A slow-motion elevator movement- where you move the baby up and down slowly, while keeping the baby supported by your arms or holding baby skin to skin and doing gentle squats- may do the trick to calm an upset baby.
Rocking or singing are two tried-and-true calming methods.
Try to take a few deep breaths yourself so your baby can synchronize their breathing with you.