Breast-feeding is a baby-led activity, where the baby dictates his own feeding pattern. Babies have an amazing ability to tell parents when they need to eat and even when they are finished. It is very important to follow the baby's signs and not try to follow rigid schedules. Parent-led patterns may interfere with the infant receiving the right balance of foremilk (beginning of feeding) and hindmilk (end of feeding).
Babies have their own schedules. Throughout the day, a baby passes many times through six states or physical conditions:
- Deep sleep: The baby lies very still while sleeping and does not wake easily.
- Light or active sleep: The baby has rapid eye movement and sucking or mouthing activity. He is easier to wake.
- Drowsy: The baby is very easily awoken. His eyes may open and close, and he may yawn and stretch.
- Quiet alert: The baby looks around, interacts and responds to people and things. He is still but watchful. This is the best time to nurse.
- Active alert: The baby may be attentive; he moves his hands and feet and is wide-eyed. He may become fussy.
- Crying: The baby is agitated and needs attention quickly.
To know when to feed your baby, it is important to understand these states and also, how babies communicate. Babies express their needs through crying and body language. The signs that the baby gives to express hunger are called feeding cues.
Early signs of hunger occur during the light sleep state, drowsy state or quiet alert state. When a baby is getting hungry, he may suck or chew on his fingers and hands, open his mouth and stick out the tongue, turn his head toward the breast with an open mouth (called rooting), suck his tongue or lips, move his eyes under the lids when in light sleep, stroke his own cheek with his hand, and squirm and move when held. Crying is a late sign, and the infant usually will need to be comforted before going to breast, as it can be difficult for a crying baby to latch on to the breast.
When the baby begins to nurse, his hands will be in very tight fists and his body will be tense. He may even look as though he is frowning. Then as the baby is being nourished by the milk, his body will start to relax and his hands will open. Eventually the baby's body will be limp. The baby will have a dreamy look in his eyes and his mouth will become slack and milk may drip from the lips. This is sometimes called "milk drunk."
The baby ends the feeding by "popping" off the breast on his own. However, some babies will stay latched on the breast and even may fall asleep at the breast. In this case, mothers may need to gently take them off. If the baby does not suck and swallow when taken off the breast, then he is finished with that feeding.