State regulation occurs during the first three months of life, often referred to as the fourth trimester. During this time your baby is primarily learning to stabilize his or her biologic and neurologic functioning. State regulation means that your baby is learning and responding to his or her body and new routine out of the womb. Your baby adjusts by learning to eat, sleep and process all the new information in his or her new world. Now that your baby is no longer inside of you, your baby is learning where his or her body is in space and how it interacts with the world around them.

In order to have a successful feeding, your baby needs its body and mind to be calm, regulated and alert. Too many distractions, such as, noises, smells, bright lights and sounds can over stimulate your baby, leaving him or her too uncoordinated for successful feedings or too fatigued. Additionally, your baby needs to feel boundaries and support for his or her body.

If your baby is held or swaddled too tightly, it will cause your baby discomfort and will discourage adequate volume intake during feeding. On the contrary, if your baby is held too loosely with flailing arms, your baby will not feel secure or stable enough for good coordination of the muscles that are required for the suck-swallow-breathing pattern needed for successful feedings.

You can facilitate successful feedings during the first three months by keeping your environment positive, calm and relaxed. Your baby will benefit and adjust to a schedule more rapidly if you change your environment to provide a non-verbal, mealtime signal. You can reduce environmental distractions by dimming the lights, shutting off the television and devices and removing toys. You can create a predictable routine for your baby by using a familiar blanket while holding your baby comfortably and securely to give their body boundaries.

Your baby should be held or swaddled comfortably with their head in a gently tucked, forward position. Your baby’s arms should be kept close to their body and your baby should feel warm, comfortable and dry to begin your feedings. A baby that is calm, comfortable and has physical support to help them stabilize their bodies will always have successful mealtimes!

Cindy is a Medical Speech Language Pathologist in the NICU, and a Certified Lactation Counselor. She has advanced clinical experiences in pediatric dysphagia (feeding & swallowing disorders). To help parents with her expertise, she founded Chew Chew Mama, LLC where she provides individualized therapy services for behavioral feeding disorders of newborns and young children.