Homeostasis

Homeostasis is the ability to maintain internal regulation in the face of increasing challenges and demands.

Learning Theory

Learning Theory: Each feeding experience teaches a baby that eating is either a positive or negative experience.

A word to parents from Dr. Ross…

Most people think that we’re born knowing how to eat, and that we all love to eat. But that’s not entirely true. If your baby was born prematurely, you already know that sometimes babies are born before they have the skills to eat. So let’s begin breaking this process down.

There are two important concepts involved in an infant learning how to eat: Homeostasis and Learning Theory.

When babies are born healthy and on time, there are primitive motor patterns that are in place. These patterns include the ability to root/search for a breast or bottle, suck on the breast or bottle, and swallow. There are also protective reflexes in place, such as gagging and coughing. These protective reflexes help us swallow safely. When babies are born before their due date, they may be born before these primitive motor patterns or protective reflexes are fully developed. Most research indicates that that primitive motor patterns are usually present by 32 weeks post-menstrual age,  or 6 to 8 weeks prior to your due date. However, these patterns continue to develop until close to the due date. New research suggests that even the protective reflexes to help us swallow safely continue to develop until close to due date as well, which is why many preterm babies aren’t able to eat when they are born.

But there’s another part to this equation: some babies are born near or by their due date but aren’t totally healthy. Babies who have respiratory problems, cardiac conditions, genetic problems, traumatic

births, neurologic disorders, motor disorders, or infants who have stomach or digestive problems all may have difficulty eating. This is because each of these organ systems are involved in eating. And, problems in any of these areas affect the baseline stability, otherwise known as “internal regulation”.  In order to learn new things, your baby needs to have both a level of internal regulation from which to work, and the ability to tolerate the challenge of eating without losing their internal regulation.  This is known as Homeostasis (the ability to maintain internal regulation in the face of increasing challenges and demands.)

So how does Homeostasis relate to feeding? Well, the first thing a baby needs to be able to do is to reach a stable level of internal regulation. This means after birth they need to begin breathing on their own, digesting on their own, maintaining their heart rate, and adjusting to the outside world. Infants born with medical problems struggle to reach a stable level of internal regulation. Without this level of internal regulation, rising to the demand of eating is more challenging.

The second concept, Learning Theory (Each feeding experience teaches a baby that eating is either a positive or negative experience.) is equally important. Most babies learn that eating makes them feel better and is a time of pleasure and comfort. Unfortunately, some babies learn that eating is not a pleasurable experience. They may cough, choke, turn blue, or stop breathing when they eat. And your baby doesn’t understand that eating is necessary for survival. For the babies, negative feeding experiences sometimes lead to them learn not to eat.

Now, let’s put these ideas together. Most healthy babies born at term are born with a level of internal regulation to rise to the challenge of eating. They’re also born with the primitive and protective reflexes that allow them to eat safely. These supports are in place to provide the infant enough basic skill to eat “reflexively”, so they can have enough experiences to learn about eating voluntarily. Research now suggests that these primitive motor patterns will disappear around the two-month age. For babies born prematurely, motor patterns disappear around two months after their original due date. Once these primitive motor patterns have disappeared, eating is completely voluntary. The learning that the baby has had during feeding experiences now takes over. This is why some babies will be eating okay in the beginning but then show more and more resistance to eating. They literally learn that eating is unpleasant so they choose to stop. My good friend Kay Toomey, Ph.D., author of the SOS approach to Feeding materials is fond of saying, “They learn to eat, learn to not eat, or kinda-sorta learn to eat.” Her approach is for children who are older and are beginning to eat solid food.