Early feeding success is dependent on the establishment of four things:

Feeding is a relationship, a strong two-way connection; the baby contributing as much as the mother to the experience.

• SELF-REGULATORY PROCESSES
  • The ability of the baby to be stable enough to feed
  • Awake and alert, breathing easily, calm, able to suck.

• CARETAKER RESPONSIVENESS
  • Able to read baby’s signals, calming and gentle approach.
  • Confidence in ability to feed and nurture the baby

• INFANT CAPACITY TO EMIT RANGE OF SIGNALS
  • Show clear signs of hunger, tiredness, strong cry, mouthing and sucking
  • Respond positively as feed starts; show clear signs of wanting a break, and clearly satisfied.

• CARETAKER IDENTIFICATION AND RESPONSE
  • These may be clouded by illness, depression, anxiety or not understanding hunger signals.

The babies most vulnerable to feeding difficulty, are those whose early days or weeks are a struggle to establish feeding or maintain good weight gain. For them, feeding may have felt out of their control, especially if on nasogastric feeds, when hunger is either not noticed or is ‘magically’ fixed by a tube feeding. Similarly, babies with many orally aversive events in the early days or months may be less than fully comfortable with feeding.

The baby may not ‘remember’ this but rather recognises the emotions associated, either negatively or positively with feeding.

This lays down a possible pathway for the baby’s reaction to future upsetting feeding experiences. However a variety of other situations and events can then lead to fussy feeding or an aversion to oral stimulation and feeding.