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What feeding therapists & pediatricians are getting wrong when it comes to "responsive feeding"

Updated: May 15, 2020

We want to tell you a story of a baby that had some struggles with responsive feeding and then explore why and what could have been done differently. We want to talk about what this tells us about responsive feeding in general, and what both feeding specialists and pediatricians are getting wrong when it comes to responsive feeding...But before we get into that, let's quickly start with some foundational stuff- like what is "responsive feeding." As we described in our last post on this topic:

Responsive feeding is the practice of listening to a baby's communication about hunger or being full, then responding warmly and consistently by offering food or stopping the feeding. This includes offering food when baby "tells" you he or she is hungry (even if it's not "feeding time") and also stopping the meal when baby indicates he or she is full (even if the bottle is not empty or baby "usually" eats more).

For the record, we love this concept. As feeding specialists we strongly agree that infants should be listened to and respected (especially when it comes to feeding) and we would guess you do too. Having practiced in a wide variety of settings for over a decade each, we’ve also witnessed hundreds of babies over the years who were fed in a forceful or prescriptive manner early on and we’ve seen the impact on later feeding (picky eating, poor weight gain and really challenging mealtime behaviors to name a few...) We know feeding responsively is ideal and important, right? But we admit that we thought this was a relatively simple and easy idea when we first learned of it.

Yet we have seen many parents and medical professionals get tripped up with implementing responsive feeding. In fact, feeding therapists (old and new) struggle with this...we all seem to be at risk for getting things wrong when it comes to responsive feeding, which is why we wanted to explore it a bit more.

Let's jump into that story we mentioned. It's about a newborn admitted to the hospital a few days after birth and the journey to practicing responsive feeding.

Meet baby Ella

Ella (not her real name) was born at 37 weeks, 5 days via c-section for maternal preeclampsia. She was discharged home on day of life two, learning to breastfeed, but mostly taking formula from a bottle. Her mother was unfortunately readmitted to the hospital for severe postpartum preeclampsia, and all baby-related tasks were turned over to dad as mom was hospitalized—including bottle feeding.