What is Breastfeeding on Cue?

Did you know that babies breastfeed for a wide variety of reasons—with hunger being just one of them?

This is an idea that can be confusing as a new parent. Our culture understands bottle feeding and use of artificial baby milks as the normal standard of infant feeding. Our family, friends, and healthcare providers are familiar and therefore comfortable with these methods of feeding, and we may be, too. Prior to welcoming our babies, we must decide how we will feed them. Once our babies arrive, regardless of which choice we make, our healthcare providers typically ask questions like, “How often is she eating?” and “How many minutes is he feeding?” Additionally, many mothers quickly begin to encounter (often well-meaning) comments from family and friends like, “Is she really hungry again?” or “He won’t need to eat again for x number of hours.” Whether we choose bottle-feeding or breastfeeding, consumption is often emphasized, rather than the act of nursing itself. Therefore, when we’re then given the information that our breastfed baby should be fed on cue, it can be difficult to understand what this really looks like.

So, what is breastfeeding on cue? Simply put, it is following your baby’s lead: nursing when your baby cues you to do so, as opposed to following a set, parent-led schedule.

What is a baby cue for nursing? It may be a rooting motion where he turns his head to the side or swings his head from side to side looking for the nipple, perhaps opening and closing his mouth at the same time. It may just be little whimpers. Or maybe she has been quiet and content for a while, but now is getting restless and no amount of rocking or soothing will make her happy. In the end, if all early cues are missed, she may begin to cry.

--Sharon Knorr

Breastfeeding on cue allows our babies to not only feed when they are truly hungry, but also gives our babies the opportunity to nurse in order to meet a whole host of other normal needs. Babies nurse not only to meet hunger and thirst, but also for comfort. They nurse for pain relief, and when overtired or overstimulated. They nurse for immune support during times of illness and to boost the mother’s milk supply during growth spurts. They nurse to reconnect after a lengthy separation. Breastfeeding meets their inherent biological sucking instinct and skin-to-skin needs and allows babies to engage in eye contact and communication with their mothers. As our babies grow older, they nurse to soothe big emotions and to calm themselves during times of transition and vulnerability. They nurse to nod off peacefully for a nap. When mothers allow this normal biological behavior to happen, breastfeeding can easily become one of the most important tools in the mothering tool kit during the early years. So much so, that many use the term coined by La Leche League ‘mothering through breastfeeding’ to articulate the enormity of the role that nursing can play in the dynamic between a mother and her child.

Additionally, even though cultural perception is often that both breastfeeding and bottle feeding accomplish the same task, and while they do both fulfill hunger and thirst, the two are actually entirely different mechanisms. When a baby is nursing at the breast, he has the ability to control the flow of milk and can suck both nutritively (to fill a hungry tummy), and non-nutritively (to soothe and to satisfy sucking needs). When a baby is feeding from a bottle however, she has little control of the milk flow, and over-feeding becomes a possibility. For this reason, bottle fed babies often use a pacifier to meet additional sucking needs, and it becomes important to schedule and measure feeds. On the contrary, as long as a breastfed baby is thriving and the nursing relationship is going smoothly, there is no need to time, measure, schedule, or attempt to quantify, nursing sessions.

What can become challenging for many breastfeeding mothers is the disconnect between cultural expectations and norms. How does one make the leap from “How many times are you feeding him each day?” and “Does he really need to eat again?!” to ‘mothering through breastfeeding’? There is not one answer to this question or one path that all mothers and their nurslings take. Each nursing dyad is unique, and each embarks on its own journey. However, here are helpful rules of thumb: ‘watch the baby, not the clock’ and ‘follow a routine, not a schedule.’

First, work towards following baby’s lead and allowing baby to set the tone and the pace. Breastfeed on cue by getting familiar with your baby’s cues and respecting them, and allow room for growth, change, and the overall imperfection and messiness of babyhood.
He went three hours between his last two breastfeeds but then nursed twice in the last hour? Normal.
One day she nursed every hour all night long and the next she slept a four hour stretch? Normal.
Sometimes she nurses on both sides and other times just one side?
Normal, normal, normal!

Next, give yourself permission to forgo a strict schedule. While this can feel disconcerting, especially for those of us used to a tight schedule each day, it’s important to remember that you can still have routines, even if you don’t hold baby to a rigid timetable. These routines will change many times as baby grows and develops, but small pieces of routine and predictability are possible and helpful. Perhaps baby wakes up in the morning, plays, nurses, and rests, before it’s time to head out for errands together. Maybe you find yourself reading a book and nursing in the rocking chair before bedtime each night. Maybe baby likes to nap in a sling or stroller while Mom goes about her day and is always ready to nurse upon waking up. Often, as baby gets older, mothers will begin to notice additional patterns emerging and routines naturally take shape, giving more of a sense of stability to both. As much as we would sometimes like our babies to operate by the clock, unfortunately no one experiences hunger, thirst, sleepiness, sickness, happiness, boredom, or curiosity at set times each day. Baby seems fussier than usual? Offer the breast! Even if he’s “eaten” recently, he may want to snuggle, may be thirsty because of warm weather, or may have just gotten vaccinations or a ‘boo boo.’ Allowing for some flexibility can actually make it more manageable to fit in all of the other demands and responsibilities of life. Releasing expectations and just ‘going with the flow’ can make the experience of motherhood much more joyful.

Trust your gut. Give yourself permission to let go of cultural expectations and judgements and follow your own intuition as a mother.
Your baby is not ‘treating you like a pacifier;’ she is behaving biologically normally by seeking the breast as her place of solace in a world that can feel quite overwhelming after nine months of incubation in the womb. You are not ‘creating bad habits’ or ‘a rod for your own back’ by allowing (and maybe even enjoying!) comfort nursing. You are not required to break your baby of “associations.”
Listen to your heart and to your baby’s communications, and reach out for support when you need it.

Recommended articles for further reading on this topic:
The Clock and Early Breastfeeding
Can I Overfeed My Breastfed Baby?
The Dangerous Game of the Feeding Interval Obsession
What Does It Mean to 'Use Your Breast as a Pacifier?'
Does Breastfeeding on Demand Spoil Children?
Breastfeeding in the Land of Genghis Khan
Importance of Responsive Feeding
Are You Watching The Clock Or Watching Your Baby? Sleep Training Books And Schedules…
Hunger Cues – When do I feed baby?
Why “Feed, Play, Sleep” routines make no sense for a breastfed baby…