Newborns' First Feed: How Much And Why Sucking Matters

Newborns have a natural urge to suckle, which is one of the many reflexes that help them survive and thrive in their first few weeks and months of life. The sucking reflex is involuntary and develops in the womb, usually between 32 and 36 weeks of pregnancy. This reflex is triggered when something touches the roof of the baby's mouth, such as a breast, bottle, or finger, and helps them feed and soothe themselves. The rooting reflex is another reflex that goes along with sucking, where babies will instinctually turn their heads and open their mouths to search for the breast or nipple. In the first hour after birth, newborns go through distinct stages of behaviour that facilitate their adaptation to the outside world and the initiation of breastfeeding. This includes periods of rest, activity, familiarization, and finally, suckling.

The rooting reflex

The persistence of the rooting reflex beyond the typical resolution period of four to six months may indicate an underlying condition, such as congenital cerebral palsy or autism. In such cases, infants may experience excessive drooling, difficulty swallowing and chewing due to a dysfunctional tongue, and other developmental delays. Therefore, it is important for parents and healthcare providers to monitor the disappearance of the rooting reflex and seek medical advice if it persists beyond the expected timeframe.

The importance of skin-to-skin contact

Skin-to-skin contact with a newborn is important for several reasons. Research has shown that babies who are kept skin-to-skin with their mother immediately after birth have a steadier heart rate and body temperature, better respiration, normal blood sugar levels, and cry less. This type of contact also facilitates the initiation of breastfeeding and helps the baby adapt to the outside world.

Skin-to-skin contact, also known as kangaroo care, is beneficial for both the baby and the mother. For the baby, it provides warmth and comfort, similar to what they experienced in the womb. It also helps to regulate their breathing, heart rate, and body temperature. Additionally, skin-to-skin contact stimulates the baby's sucking reflex, which is important for feeding and growth.

For the mother, skin-to-skin contact can help with milk supply and promote bonding with the baby. It also allows the mother to observe the baby's natural behaviours and reflexes, such as rooting and suckling. This early bonding experience can have long-lasting positive effects on the baby's development and well-being.

According to Widström and colleagues, there are nine stages that a baby typically goes through when placed skin-to-skin with the mother after birth:

• Birth Cry: Immediately after birth, the baby's lungs expand, and they let out their first cry.
• Relaxation: The baby quickly relaxes and reorients themselves, with brief stillness and no mouth or hand movements.
• Awakening: About three minutes after birth, the baby starts to move their head and shoulders, opens their eyes, and makes small mouth movements.
• Activity: Around eight minutes after birth, the baby increases their mouth and suckling movements, including a more pronounced rooting reflex. They may visually search for the breast and make cheek and tongue movements.
• Rest: Periods of activity are followed by periods of rest throughout the first hour.
• Crawling: About 35 minutes after birth, the baby may use their arms and legs to move towards the breast, including leaping, sliding, or crawling motions.
• Familiarization: Around 45 minutes after birth, the baby may lick the nipple, touch or massage the breast, look at the mother, or move their hands between their mouth and the breast.
• Suckling: About an hour after birth, the baby self-attaches and starts to suckle at the breast.
• Sleep: Finally, the baby enters a recovery stage and falls asleep, which may start about 1.5 to 2 hours after birth.

It's important to note that babies will go through these stages at their own pace and should not be forced or rushed. The mother may need to provide support to prevent the baby from flopping and can guide them towards the breast when they are ready to suckle.

The baby's suckling technique

The sucking reflex is one of the many involuntary survival reflexes that develop in the womb, usually between 32 and 36 weeks of pregnancy. It is triggered when something touches the roof of the baby's mouth, such as a breast, bottle or finger, and helps the baby feed and soothe themselves.

The Rooting Reflex

The rooting reflex is when the baby turns their head to look for food, triggered by something stroking their mouth or cheek. Once they find the nipple, their suck reflex is triggered, and they use their jaw, lips and tongue to extract milk.

The Sucking Reflex in Action

When the nipple is correctly positioned in the baby's mouth, feeding occurs by peristalsis, a wave-like motion caused by muscle contractions. The baby draws the nipple and breast tissue into their mouth, and the lower jaw is raised to constrict the base of the nipple. The front tip of the tongue then wells up to compress the breast against the roof of the mouth. Waves of compression by the tongue push the milk towards the back of the baby's mouth for swallowing.

Testing the Reflex

You can test a baby's sucking reflex by placing a nipple, finger or pacifier inside their mouth. If the reflex has fully developed, the baby will place their lips around the item and then rhythmically squeeze it between their tongue and palate.

Strengthening the Reflex

If a baby has a weak sucking reflex, there are exercises you can do to strengthen it. For example, you can allow the baby to suck on your finger, stroking the roof of their mouth to trigger the reflex, and pressing down on their tongue so they have to work harder to maintain suction.

The Benefits of the Reflex

The sucking reflex is important for a baby's development, particularly for the development of their mouth, oral cavity structure and teeth. It also helps them to self-soothe, and can be combined with breastfeeding to calm and relax the baby.

How to test the sucking reflex

How to Test a Newborn's Sucking Reflex

The sucking reflex is a survival reflex that develops in the womb, usually between 32 and 36 weeks of pregnancy. It is triggered when something touches the roof of a baby's mouth, such as a breast, bottle, finger, or pacifier, and is essential for feeding and soothing newborns.

To test a baby's sucking reflex, you can use the following steps:

• Place a clean finger, pacifier, or nipple inside the baby's mouth: Stimulate the roof of the baby's mouth with a clean pinky finger, pad side up. You can also use a pacifier or nipple, either from a bottle or breast.
• Observe the baby's response: If the reflex is fully developed, the baby will instinctively place their lips around the object and begin to suck rhythmically. This is a sign of a strong sucking reflex.
• Evaluate the quality and strength of the suck: A weak or uncoordinated sucking reflex may indicate prematurity or other issues. Observe if the baby is able to maintain suction and coordinate their sucking, swallowing, and breathing.
• Consult a pediatrician if you suspect any issues: If you notice any deviations from a typical sucking response, it is important to consult a pediatrician. A weak or absent sucking reflex can lead to malnutrition and may indicate underlying neurological problems.

Additional Tips:

• It is normal for some babies, especially preterm infants, to have a weaker sucking reflex or to take time to coordinate sucking, swallowing, and breathing.
• If your baby is born prematurely, they may require assistance with feeding through a feeding tube or spoon until they develop a stronger sucking reflex.
• Skin-to-skin contact, also known as kangaroo care, can help stimulate your baby's sucking reflex and improve your milk supply.
• If you are breastfeeding, ensure your baby has a proper latch by positioning them correctly and seeking help from a lactation consultant if needed.

By testing and supporting the development of their sucking reflex, you can ensure your newborn is getting the nourishment and comfort they need.

How to improve the sucking reflex

The sucking reflex is an involuntary survival reflex that develops in the womb, usually between 32 and 36 weeks of pregnancy. It is triggered when something touches the roof of the baby's mouth, such as a breast, bottle or finger, and is essential for feeding.

• Figure out the cause of a weak sucking reflex. This could be due to prematurity, a tongue tie, birth trauma or other factors. Consult a trained professional, such as a speech and language pathologist (SLP) or international board-certified lactation consultant (IBCLC), for an accurate assessment.
• Allow the baby to suck on your finger, with the finger pad against the roof of their mouth. Gently stroke the roof of their mouth to stimulate the sucking reflex, and press down slightly on their tongue to encourage stronger suction.
• If the baby's finger sucking becomes tiring, allow them to suck your finger back in. Gradually, move your finger further back on their tongue without triggering the gag reflex.
• Practice this exercise for a count of three, repeating the process of pressing down on the tongue. The goal is to improve suction strength and tongue strength so that the baby can suck continuously for 10 minutes without tiring.
• Provide skin-to-skin contact, also known as kangaroo care. This helps regulate the baby's temperature and promotes bonding.
• Wake the baby for feedings every 2 to 3 hours. Consult a healthcare provider for guidance on when to stop waking the baby for feedings.
• Experiment with different feeding positions, such as the "twin" or "football hold", where the baby is tucked under your arm with their body supported by a pillow.
• Increase your let-down reflex, which is the reflex that causes milk to flow. This can be done through massage, hand expression, or applying a warm heat pack to your breasts.

Remember, it is normal for newborns to take some time to master the coordination of sucking, swallowing and breathing. If you have concerns about your baby's sucking reflex or feeding, consult a healthcare professional for personalised advice and support.

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