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Deborah Howell (Host): Welcome, if you’re a new mom or know someone who is, it can be tricky to understand your baby’s cues that tell a mom when her baby is hungry. I personally think this is a fascinating topic that we don’t hear a lot about, so I’m really excited to talk to our guest today. She is Sabrina Williams, an occupational therapist at High Point Therapy at Deaconess The Women’s Hospital. Hi, Sabrina.

Sabrina Williams (Guest): Hello, thanks for having me.

Host: Oh, such a pleasure. What are some of the most common cues that will tell a mom when her baby’s hungry? And are there early and late signs?

Sabrina: There are, so some common early feeding cues that we see in newborns are they start to kind of move around and stretch in their sleep. They may open their eyes a little bit and that just tells us that they’re transitioning from a deeper sleep state to a more – to a light sleep or a drowsy state. We also look for the baby to start to do some mouth movements. They may bring their hands up to their mouths a little bit, they may feel their clothing on their cheek and kind of turn to it, and that’s what we call rooting, but if the baby is crying or fussing to indicate that they’re hungry, that’s what we would consider to be a late feeding cue, and sometimes babies don’t eat as well if they’re in that state.

Host: Oh interesting, I didn’t know that. So why is it so important to understand your baby’s feeding cues?

Sabrina: It’s important for parents to be able to recognize and respond to their baby’s feeding cues because just like you and I, babies don’t always eat the exact same amount at the exact same time every day. We know that babies will tend to get the same volume in throughout the whole 24 hours at the end of the day, they just may divvy it up differently and ideally we like for the baby to be able to let us know when they’re hungry, when they’re full, when they may want more. Sometimes this is something we do have to help the family and help the baby with, but it also gives the parents the confidence to know what their baby wants and that the baby is communicating to them their needs.

Host: So, this is sort of just a no brainer, but you want to get them during those early signs rather than the late signs, right?

Sabrina: You do because if a baby has already indicated that they’re hungry and those cues have been missed and then they have to cry or fuss to indicate they’re hungry, it may not be as good of a feeding as if those cues had been caught earlier on.

Host: Understood and what kind of cues may indicate that your baby is having difficulties while feeding?

Sabrina: Some of those, the bigger red flags that we see is that the baby may have poor or slow weight gain and they also may have coughing or choking when they’re eating, but there is also some more subtle difficulties that we see and that could be if the baby is having a hard time waking up to eat or if the baby’s having a hard time staying awake in order to participate in the feeding. It could also take the baby a long time to finish the bottle, and that would just kind of cue us that the baby’s having a hard time being efficient with the feeding, and that would be something we would want to look into closer. Some parents describe their babies as being messy eaters or that they’re just refusing the bottle or the breast, and again those are things we want to look at a little bit closer. There are also subtle signs of distress that the baby may show that their bottle is either too fast for them or that they’re having difficulty coordinating their sucking and swallowing with their breathing.

Host: Wow, it’s very – much more complex than you think it might be, just a simple give the baby the bottle. So are these infant feeding difficulties common?

Sabrina: I think they are common in babies of certain diagnoses and also of babies that spend time in the NICU or who were born prematurely, but they’re also just common in healthy term babies. I know even from my own experience with my own children, I worked with a lactation consultant with my first child that I had and she picked up on some difficulties that my baby was having and she actually talked to me about referring me for an OT eval and talking with my pediatrician. So sometimes I think it just takes the right person to see it and to know that there’s something that can be done to help it too.

Host: Speaking a bit about evaluation, so how can evaluation and treatment by a therapist help with feeding disorders and difficulties?

Sabrina: Our goal is that we want to be able to work with the family and to educate them on to how best help their baby. Babies eat frequently throughout the day, sometimes it’s 12 times in a 24 hour span and if the baby’s having a hard time eating, that can become stressful on the family. So we want to provide the education to the parents or the caregivers the baby’s cue so that they feel more confident and more comfortable when they’re feeding their baby at home and our goal is for the baby and the parent, who’s feeding the baby to both feel comfortable because eating, it’s a big time of social interaction for the baby and we don’t want that to get overshadowed by being nervous or scared that something’s going to happen during that feeding.

Host: Exactly and what should someone do if they suspect their child is having issues related to feeding?

Sabrina: The first step that the family would need to do would be to talk with their pediatrician about the concerns that they’ve noticed at home, and then if the pediatrician felt like it’s something that needs to be looked at a little bit closer, they can make a referral for further evaluation to help the baby and the family.

Host: And in your evaluation, did you come away with more knowledge than you had before?

Sabrina: That’s our goal. It would allow the therapist to kind of get a set of eyes on the baby to see what’s going on. We want to see replicated during our evaluation, what the parents see at home and that’s going to give us a lens to kind of look closer at some issues and to try some things to help that baby or to help that family.

Host: Excellent information. To learn more about High Point Therapy, visit their website at deaconess.com/highpoint. If you have questions about your baby’s feeding, you should talk with your child’s doctor. An evaluation with Deaconess may be necessary. Sabrina thank you so much for being with us today to talk about feeding issues with our babies and what you can do for your patients at High Point Therapy at The Women’s Hospital. I know I learned a lot.

Sabrina: Thanks so much. It was a pleasure.

Host: This is Deaconess The Women’s Hospital, a place for all your life and I’m Deborah Howell. Thanks for listening and have yourself a great day.