by Donna Walls, RN, BSN, ICCE, IBCLC, ANLC
New information from UNICEF has been released supporting responsive feeding strategies for breastfeeding and for formula feeding, including breastfeeding mothers who bottle feed expressed milk exclusively or for return to work or school. UNICEF defines responsive breastfeeding as “ a mother responding to her baby’s cues, as well as her own desire to feed her baby. Crucially, feeding responsively recognizes that feeds are not just for nutrition, but also for love, comfort and reassurance between baby and mother.” They also stress that responsive feeding makes breastfeeding and early parenting easier, less stressful and that breastfeeding will not spoil a baby nor can you overfeed a breastfed infant. Responsive breastfeeding is generally regarded as instinctive for mothers but societal views and cultural attitudes can often hamper a mother’s natural instincts such as fear of breastfeeding in public. Misinformation persists regarding scheduling of feeds and the need to train newborns to sleep longer are persistent and can have a negative effect breastfeeding and milk supply. Responsive bottle feeding is defined as “encouraging mothers to tune in to feeding cues and to hold their babies close during feeds. Offering the bottle in response to feeding cues, gently inviting the baby to take the teat, pacing the feeds and avoiding forcing the baby to finish the feed can all help to make the experience as acceptable and stress-free for the baby as possible, as well as reducing the risk of overfeeding.” Other tips for responsive bottle feeding include keeping the bottle horizontal during the feeding to minimize gulping and overfeeding and allowing for frequent pauses that occur naturally during breastfeeding. Responsive feeding allows the baby to be “in control” of the feeding and is related to better self-regulation of food impacting the later possibility of obesity. Beginning with smaller amounts of formula and gradually increasing the amounts slowly over the first weeks is also a more physiologic way of mimicking the normal pattern of feeding and may help to avoid stomach upsets, fussiness and unnecessary formula switching. Encouraging cuddling time before, during and after feedings creates an opportunity for supporting the parent/child relationship and consider feeding while skin to skin to comfort and soothe infants during feedings,
Resources
https://www.ajol.info/index.php/sajcn/article/viewFile/97829/87130 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040905/ Responsive-feeding-infosheet-UNICEF-UK-Baby Friendly Initiative.pdf https://jn.nutrition.org/content/141/3/508.full
