Step Number 8

Encourage feeding on cue

Teach mothers how to respond to their baby’s hunger cues in order to ensure milk supply and breast comfort.

Teach mom to recognize hunger cues like when baby brings her hands to her mouth.

Why Step 8?

Demand or ‘‘cue-based” feeding involves feeding an infant when they signal hunger or satiety. Infants typically feed eight to twelve times or more in a 24-hour period.  Feedings may occur at irregular intervals.  
Using length of time as a marker of feeding offers no measureable information on breastmilk intake. Unless indicated by a medical condition, the length of infant feeding should not be limited or prescribed. 

Mothers and their families should receive education about infant feeding cues and normal infant transitional behavior. Patterns of feeding that are frequent and closely spaced, known as cluster feedings, occur routinely in the first few days of breastfeeding and are often mistaken for breastfeeding problems.  Information on sleep patterns and crying can provide valuable guidance for parents. Families should be supported throughout their stay to provide unlimited opportunities to respond to their infant’s needs (Step 7). 

Teach mom about cue-based feeding.
Quote from an Expert

“The most common cause of low milk supply is ineffective suckling and/or infrequent feeding routines that do not adequately stimulate milk production and milk removal.”

Source: Wellstart International. 2009. Lactation Management Self-Study Modules, Level I. 

Primary Goals of Step 8

  1. Educate families to understand the importance of baby’s cues for feeding readiness, satiety and physical contact.
  2. Educate families on principles of breastmilk supply as it relates to infant feeding demand.
  3. Empower mothers to establish infant-feeding rhythms and patterns driven by their own needs and the needs of their infant.
  4. Provide unrestricted, 24-hour opportunities for babies to learn to suckle at the breast effectively. Teach all mothers cue-based feeding regardless of feeding method.

Ten Step Self-Assessment

Use the Ten Step Self-Assessment to help you evaluate your progress for this step. This self- assessment document does not have to be submitted with application.

New Applicants

  • Use document checklist (PDF) to ensure appropriate support documentation is included with application.
  • If your current practice does not meet these criteria, review the Ten Step Self-Assessment to assess how your facility might fully implement this step.

View Application and Support Documents

Re-Designation Applicants

  • Review your individual Ten Step Scorecard from the last designation for change recommendations.
  • Use the Ten Step Self-Assessment Tool to help plan for step-by-step improvement in any areas needed.
  • Review the Baby Friendly USA, Inc. Guidelines and Evaluation Criteria to view full standard for this step.

Download Baby Friendly Guidelines