Responsive Feeding Explained

Responsive Feeding is an approach to feeding that focuses on recognizing, and responding to, the child’s hunger and fullness cues. Feeding that prioritizes the relationship between caregiver and child is central to responsive parenting.  Parents learn to trust that the child is capable of deciding how much and whether to eat.  This begins during infancy, whether the baby is breastfed or bottle fed, and sets a foundation for implementing the Division of Responsibility.  Responsive feeding is important in establishing a positive relationship with food that carries over into adulthood. 

Trusting the child’s ability to self-regulate intake

Babies are born with the innate ability to self-regulate intake. Their bodies tell them when they are hungry and when they’ve had enough to eat.  The child’s ability to recognize their internal feelings of hunger and satiety can be compromised when parents force their children to finish their meal, praise them for eating, or restrict the amount of food that they eat. Children learn that eating “enough” or not eating “too much” is admirable. This can lead to emotional eating, or eating to please an adult.  On the other hand, they may develop anxiety around eating, which can be expressed through challenging or aggressive behaviors at mealtime.

Discovering The Child’s Unique Needs

Understanding the infant’s behavior and what they are communicating takes time and patience.  Each child is unique with different needs, different experiences (even at birth), and different behaviors that they use to communicated their needs.  New and seasoned parents need time to get to know their child. Unfortunately there is no magic formula for feeding. The amount and types of foods that infants and children need will vary depending on a number of factors.  Age, sensory differences, oral motor skills, taste preferences, size and metabolism, all play a role in determining the nutritional requirements of each child.  Responsive feeding is a journey of discovery.  What works best for the child and family can evolve at every new developmental stage.

The Responsive Feeding Approach Helps Build Secure Attachment

Eating not only provides the nutrients that the body needs for growth and development, but it also provides the opportunity to build connection between parent and child.  Eating together is an attachment related activity.  Trust is built when the environment allows for positive mealtime experiences that include the child and caregiver.  It is an intimate time where the child and caregiver are physically close to each other, and able to make eye contact. Verbal and nonverbal communication happens when meals are eaten together. Parents can foster an environment of either safety and security, or of stress and shame.

Parents using the responsive feeding approach learn to recognize cues that signal hunger and fullness.  As they develop a pattern of responding appropriately to the baby’s feeding cues, the infant learns to trust the parent as a comforting, reliable provider.  They develop reassurance in their caregiver to meet their physical and emotional needs. Secure attachment is formed when the child recognizes that they can trust others to meet their needs.

Non-Responsive Approaches To Feeding

Non-responsive feeding approaches can be effective in getting a child to eat more or less.  Usually such approaches focus on changes in behaviors.  However, in the long run, focusing on behavioral change without acknowledging the issues behind the behavior can also lead to trauma, poor self image, and food aversions.  Parents tend to ignore hunger cues when they are concerned about their child eating too much or not enough. They may push the child to eat more than the child needs, even if the child doesn’t feel hungry. On the other hand, parents might try to limit their child’s intake if they’ve been told that the child is overweight.  It’s not a surprise that some of these practices can lead to stressful and challenging behaviors at mealtime, and complex issues down the road.

How The Responsive Feeding Approach Works For Different Stages

Breastfed or Bottle Fed Infants

Parents can use the responsive feeding approach starting from infancy, whether the baby is breastfeeding or bottle feeding. Being present during feedings allows parents to observe the baby’s signs of hunger and signs of fullness.

Some non-verbal signals that the infant is hungry and ready to eat might include:  

    • Sucking on hands
    • Turning his head towards the breast or bottle
    • Opening her mouth 
    • Licking lips
    • Grasping hands
    • Bright wide eyes and facial expression
    • Smiling

Some non-verbal signals that the infant is full might include:

    • Spitting, coughing, gagging
    • Turning away when offered the breast or bottle
    • Yawning or hiccupping
    • Lips pressed tightly together
    • Fingers splaying and extention
    • Pushing or pulling away from bottle/breast or caregiver
    • Frowning, gimacing or crying
    • Falling asleep

Feeding the baby by propping up the bottle or feeding them in a baby carrier while multitasking and focusing elsewhere can be tempting. Not only is this risky, but it makes it harder to learn and recognize the baby’s cues.  They miss out on opportunities for developing attachment through eye contact in these early stages. Ideally, feeding opportunities are moments designed for connection.  Crying is usually the last sign that a baby uses to indicate they are hungry. When parents learn to catch the earlier signs of hunger, they’re able to give the child opportunities to eat while she is still calm.

Babies Who Are Starting Solid

Solid food can be introduced when babies are able to sit up, hold their head up, and when they begin to show interest in food by reaching for, or pointing at, food.  This usually occurs around 6 months of age.  It’s important to pay attention to how the child responds as she is introduced to a growing variety of food.  Allowing them to play with their food, visually inspect it, and and become familiar with the way it smells, increases their comfort with new eating experiences.

Parents are responsible for adapting the environment so that children can experience felt safety at mealtimes. Internal motivation can produce long term progress in children when parents allow them to set the pace for progression in eating. Developmental abilities and eating skills vary from child to child.  Parents should follow the child’s cues rather than pushing them to meet age related milestones that are beyond their abilities.

Some signs that a baby is ready and able to eat when they’re starting solids:

    • Reaching out to grab food
    • Following food with their eyes
    • Showing excitement around food
    • Opening mouth

Some signs that a baby is full and not wanting to eat when they’re starting solids:

    • Pushes food away
    • Closes mouth when offered food
    • Spits out food
    • Throwing food
    • Seems distracted or uninterested

The Older Child

Toddlers and young children are generally easier to read when it comes to hunger and fullness cues. As children begin to talk, they also develop a sense of independence and desire for predictability.  It’s normal for children to refuse different foods at this stage.  Most kids will outgrow their rigid or selective preferences. Those who continue to struggle with eating may need feeding therapy to address concerns that could lead to impaired growth and development. Parents of children with speech delays should look at body language, gestures, and facial expressions for signs of hunger and fullness.

Hunger cues for toddlers and young children:

    • Reaching for food
    • Using words or gestures to indicate the desire to eat
    • Crying, business or tantrums

Fullness cues for toddlers and young children:

    • Covering their mouth or turning away
    • Using words or gestures to indicate they are done eating
    • Spits out food
    • Throwing food
    • Seems distracted or uninterested

Responsive Feeding For Children With Feeding Challenges

Different feeding challenges can emerge as the child begins eating solid food and progresses in development.  Children have a desire for more independence, and may begin to refuse certain foods or overeat at times. These behaviors can be part of normal development.  When they start to impact other parts of daily life, then it may be a sign of more concerning underlying issues.  Pediatric feeding disorders- whether its avoidant, restrictive eating, hoarding or food preoccupation, can be addressed using a responsive feeding approach.

Avoidant or Restrictive Eaters

Children with Avoidant/Restrictive Food Intake Disorders (ARFID), sensory processing differences, oral aversions, food intolerances, or other issues impacting eating may have impaired growth and slower weight gain. This is concerning for many parents who are often bombarded with suggestions on how to get their child to eat more. A professional trained in feeding therapy can work with your family to uncover underlying issues that may be affecting your child’s nutritional status.  Creating safe eating environments allows parents to nourish their children without causing harm or adding trauma to their feeding experiences. Parent’s anxiety over a child’s growth and development can create unnecessary stress at the dinner table. Responsive feeding supports an environment where trust can be formed, and children can learn to eat, guided by their own intrinsic motivation.

Food Preoccupation, Hoarding, or Food Maintenance Syndrome

Food preoccupation, hoarding, or Food Maintenance Syndrome are characteristics found more commonly in foster and adopted children. Trauma and stress are major contributing factors. A history of food insecurity often leads to developing a scarcity mindset. Even when living in homes where food is plentiful, children can feel inclined to steal, hide, or hoard food. This gives them reassurance that they will not go hungry.  Restricting access to food reinforces their belief that food is limited.  A responsive feeding approach addresses the underlying fear of not having enough, and creates room to foster trust in the feeding relationship.

When Your Doctors Says Your Child Is Overweight Or Underweight

Healthcare professionals often use BMI or growth trends to assess a child’s health status.  This can create stress for many families whose children get categorized as either underweight or overweight.  Parents and health professionals should keep in mind that the BMI calculation does not take into consideration genetics, neurodivergence, trauma, past medical history, or access to food and healthcare. Growth also varies over time, and is not always linear.  When addressing feeding challenges or weight concerns, a responsive approach focuses on building trust within the feeding relationship and creating safe environments for the child to eat well. Minimizing stress and trauma around eating can be more effective in addressing health concerns than focusing on the BMI or pressuring a child to eat more or less. Contact us if you’d like to learn more about implementing responsive feeding in your home.