Infant Driven Feeding
Feeding your baby for the first time is exciting! Your baby may have been born prematurely or was too sick at birth to start eating by mouth. Eating can be difficult to learn. Here at UC Davis, we use Infant-Driven Feeding®. This means we look at your baby’s behavior to decide when to begin and end feedings. We want to teach you how to understand your baby, so you can provide the support he or she needs to learn to eat successfully. By letting your baby lead the way, you will provide a safe and positive feeding experience.
When can my baby start eating?
Babies often learn how to suck and swallow while in the womb. However, they do not learn how to breathe while eating until about 34-36 weeks. Some babies do not eat well until they reach their due date or later. Every baby is a little different and develops on their own timeline. This is why we let your baby lead the way.
When is it time to start eating by mouth?
We have an easy number scale that will score how ready your baby is based on their behavior. The scores range from 1-5. At every care time we will score your baby using this scale. If they score a 1 or 2, a feeding may be attempted. If they score a 3, 4, or 5, we will let them rest and see if they are ready at the next feeding time. Based on your baby’s behavior, he/she may try to eat one to eight times in 24 hours. It all depends on how your baby is feeling at each care time.
Infant Driven Feeding Scale - Readiness
Score 1: I am awake before cares and looking hungry. I might have my hands to my mouth or be sucking on a pacifier.
Score 2: I wake up with cares and then accept my pacifier when offered.
Score 3: I briefly wake up with cares but I don’t show any rooting or interest in my pacifier.
Score 4: I am not waking up with cares.
Score 5: I am working on maintaining my stability. I might hold my breath or drop my hear rate or oxygen saturation when being card for.
How can I get my baby ready to eat?
- Swaddle baby with hands close to mouth
- Turn down the lights
- Offer pacifier first and work on sucking skills
- Limit sounds. Speak quietly and put away your cell phone
- Encourage baby to “root”. Place the nipple on baby’s lips and wait for baby to open his/her mouth.
How can I get my baby ready to eat?
When feeding is going well, your baby will:
- Look happy to be eating!
- Be able to comfortably breathe while eating
- Stay awake and finish the feeding in less than 30 minutes
If your baby still needs time to learn to eat you will see:
- Trouble taking breaths while eating
- Falling asleep, not sucking, and/or muscles getting tired
It is time to stop the feeding if your baby is showing any of these signs:
- Making sad or angry faces
- Pulling away or not sucking
- or heart rate levels have dropped
- Coughing, choking, or having a hard time breathing
- Has been eating for 30+ minutes
“Break for Breastfeeding”
The first days of eating by mouth are a great time to start breastfeeding! Babies often breathe better when next to mom’s skin. If you are able to be with your baby for at least 4 feedings a day, we would like you to try exclusively breastfeeding for three days before we give your baby a bottle. You and baby can bond and learn to breastfeed while he/she still gets nutrition from the NG (nasogastric) tube.
When bottle feeding, you might hear us talk about these techniques:
- Elevated side-lying position: This position is like breastfeeding and makes breathing and swallowing easier. Hold your baby with their ear toward the ground and with baby’s nose and toes pointing in the same direction. The baby’s head should be higher than his/her hips.
- Pacing: Babies often like to suck a lot and forget to breathe when first learning to eat. We need to teach them to suck, swallow, AND breathe. You can do this by tilting the bottle down (so the milk is out of the nipple) every couple of sucks to remind your baby to take a breath.
- Slow Flow Nipple: A slower flow nipples helps give the baby more time to control the flow of milk while they learn to eat. Talk to your nurse or speech therapist about which nipples are best for when your baby goes home.