Looking for cues - infant communication of hunger and satiation during milk feeding

Appetite. 2017 Jan 1:108:74-82. doi: 10.1016/j.appet.2016.09.020. Epub 2016 Sep 17.


It is known that duration of breastfeeding and responsive feeding are associated with decreased risk of obesity. It is however, not clear whether breastfed infants signal more to mothers to facilitate responsive feeding, compared to formula fed, nor what communication cues are important during the feeding interaction. The present study aimed to explore feeding cues in milk-fed infants and to examine if such cues vary by mode of feeding. Twenty-seven mothers and infants were filmed while breastfeeding or formula feeding. Infants' age ranged from 3 to 22 weeks. Feeding cues were identified using a validated list of communication cues (NCAST). The frequency of each cue during the beginning, middle, and end of the meal was recorded. There were 22 feeding cues identified during the feeds, with significantly more frequent disengagement cues expressed than engagement cues. Significantly more frequent feeding cues were observed at the beginning than at the end of the meal showing that cue frequency changes with satiation. Breastfeeding infants exhibited more engagement and disengagement cues than formula fed infants. Supporting mothers to identify engagement and disengagement cues during a milk feed may promote more responsive feeding-strategies that can be acquired by mothers using different modes of feeding.

Keywords: Breastfeeding; Formula feeding; Mealtime interactions; Obesity hunger; Responsive feeding; Satiety.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding / adverse effects
  • Breast Feeding / ethnology
  • Child Development*
  • Cohort Studies
  • Cues
  • Feeding Behavior* / ethnology
  • Female
  • Follow-Up Studies
  • Humans
  • Hunger* / ethnology
  • Infant
  • Infant Behavior* / ethnology
  • Infant Formula / adverse effects
  • Infant Nutritional Physiological Phenomena* / ethnology
  • Israel / epidemiology
  • Male
  • Mother-Child Relations* / ethnology
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / ethnology
  • Pediatric Obesity / etiology
  • Pediatric Obesity / prevention & control
  • Qualitative Research
  • Risk
  • Satiety Response*
  • United Kingdom / epidemiology
  • Video Recording