Re: "Could it be normal for babies to go back and forth?" i.e., from nutritive to non-nutritive suckling? It's my understanding that the healthy infant displays nutritive suckling during active milk release, so it only makes sense that when one milk release ends, a lighter, non-nutritive sucking pattern is naturally and normally displayed until the next milk release occurs, and this includes colostrum feeds (there are multiple MERs during a feed, much like separate courses served during a meal). There's a great clinical education to be had by observing entire feeds all the way through to satiety. Effective suckling does indeed cycle back and forth during a feed at the breast from non-nutritive to nutritive, and is ALWAYS non-nutritive as the healthy term baby approaches satiety. In contrast, feeding by bottle is nutritive throughout the feed due to the immediate and constant gravity flow of the milk.
Test weights for babies beyond Day 3 are part of a routine newborn feeding assessment, and performing test weights is also educational for the clinician, meaning we can observe what appears to be an effective feed, while a test weight/transfer weight may show inadequate transfer. Similarly, a feed may not appear to be extraordinary, but a test weight can reveal a superb transfer by a baby.
The notion that non-nutritive sucking is somehow related to colostrum is a mistaken notion.
We IBCLCs and other infant feeding specialists often provide guidance to babies who display solely or much non-nutritive sucking during an entire feed. Our guidance is often in the form of providing an increase in flow to the infant by using a supplementer at the breast, and this increase in flow helps the infant to learn effective nutritive suckling by doing. Sensory-perceptual-motor learning and procedural learning are, in essence, on-the-job training or learning by doing. Mothers can learn how to position their babies to feed, and can learn how to guide their babies to the breast by watching others in real time or on film, such as in a prenatal or postpartum class, and by receiving verbal and manual guidance from clinicians. Mothers can also read books and online literature with images of nursing mothers positioning their babies in various ways (mirror neurons are activated in the brain when we observe someone doing something), but babies can only learn by doing. That we are assisted in infancy with reflexive movements for learning how to feed is such a marvel of nature.
In procedural learning/motor learning, the repetition of effective practice leads to more skilled movement, as movements gradually become more smooth and controlled and eventually effortless - - a state of motor control termed automaticity. Hence the older baby gradually becomes a faster feeder, able to transfer far greater volumes in much shorter periods of time. Older children and adults also show a similar learning curve when learning how to drink from a cup or from a new style of water bottle - - there is naturally very little motor control during early learning, but with the repetition of practice, motor memory gradually becomes more robust.
Could say more but it's 4:35am EDT & am headed for sleep. Sleep is important, because we consolidate (or strengthen) our memories, including motor memories, during time between practice sessions and during sleep. Interestingly, when we're sleep deprived to a certain extent, we can exhibit clumsiness, but with adequate sleep, we wake up with our usual motor control. One hypothesis is that various reflexes are recalibrated during sleep.
Also of note: The older baby who is more skilled in milk-feeding requires much less sleep than the newborn who is just beginning to learn and consolidate motor memory for milk-feeding skills.
For more information on consolidating memory during sleep:
Feld GB, Diekelmann S. Sleep smart – optimizing sleep for declarative learning and memory. Frontiers in Psychology 2015 May 12. DOI: 10.3389/fpsyg.2015.00622
Fifer WP, Byrd DL, Kaku M, Eigsti I, Isler JR, Grose-Fifer J, Tarullo AR, Balsam PD. Newborn infants learn during sleep. PNAS 2010 June 1;107(22):10320-10323.
Fischer S, Born J. Anticipated reward enhances offline learning during sleep. Journal of Experimental Psychology: Learning, Memory, and Cognition 2009 November;1586-1593. DOI:10.1037/a0017256
Korman M, Doyon J, Doljansky D, Carrier J, Dagan Y, Karni A. Daytime sleep condenses the time course of motor memory consolidation. Nature Neuroscience 2007 Sep;10(9):1206-1213. Epub 2007 August 12. DOI:10.1038/nn1959
Kuriyama K, Stickgold R, Walker MP. Sleep-dependent learning and motor-skill complexity. Learning and Memory 2004;11:705-713.
Lahl O, Wispel C, Willigens B, Pietrowsky R. An ultra short episode of sleep is sufficient to promote declarative memory performance. Journal of Sleep Research 2008;17(1):3-10.
Nguyen ND, Tucker MA, Stickgold R, Wamsley EJ. Overnight sleep enhances hippocampus-dependent aspects of spatial memory. SLEEP 2013;36(7):1051-1057.
Wishing all compatriots ample opportunities to consolidate many good memories (sleep well and long enough!) - -
Debra Swank, RN BSN IBCLC
Ocala, Florida USA
More Than Reflexes Education
http://www.MoreThanReflexes.org
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