Ad Lib Feeding Babies When They Are Hungry

Ad lib feeding refers to feeding babies "as desired," meaning when they're hungry, rather than on a schedule. It's also known as "feeding on demand."

The term ad lib feeding comes from the Latin phrase ad libitum, meaning at will.

Ad Lib Feeding Versus Feeding on a Schedule

For decades, moms were encouraged to put their babies on a schedule. But that's changed. The American Academy of Pediatrics, the American Dietetic Association, and the World Health Organization now recommend that healthy babies should be fed when they show signs of hunger rather than when a clock indicates "it's time."

The key here is for you to determine the difference between honest-to-goodness hunger cues and the typical fussiness that nearly all babies experience. You don't need to feed your baby at every whimper or hiccup but certainly, do feed her when it is clear to you that she is hungry. 

It's important to learn the signs of hunger and fullness in infants when feeding ad lib. Typical hunger cues may include:

• Your baby puts his hands near his mouth.
• Your baby turns his head from side to side.
• Your baby begins rooting as if to nurse.
• Your baby sucks on his hands or clothing.
• Your baby ramps up his fussy nature.
• Your baby is crying.

Premies might not always cry, but you might notice your premature baby fussing when he is hungry. Most premies get hungry every two-and-a-half to four hours. Some babies nurse or feed even more often, especially as they are hungrier. Newborn breastfed babies also tend to nurse more frequently: about every one-and-a-half to three hours.

How Do I Know If My Baby Is Eating Enough?

You can tell how much your baby is eating by how many wet diapers he is having per day. Your baby should have six to eight wet diapers each day.

If your baby is not getting enough milk, he or she will show signs of dehydration, including:

• Fewer than 6 wet diapers in a 24-hour period
• Sunken eyes
• Sunken fontanelles (soft spots)
• Crying with no tears

Regardless of whether you are breastfeeding or bottle-feeding with formula or breast milk, your baby will look healthy and will grow well if he or she is getting enough to eat. Take your baby in for regular pediatrician visits so your baby's doctor can weigh him and measure his length and head growth.

Ad Lib Feeding and Premature Infants

Premature babies are often not strong enough to take all of their nutrition from the bottle or breast. They get tired while nipple feeding and receive all or part of their feedings through a feeding tube as they grow.

Once premature babies are strong enough to take all of their feedings by the bottle, they will most likely be placed on an ad-lib feeding schedule. This means that the baby guides his or her own feeding schedule, waking up when hungry and taking as much breast milk or formula as he wishes. Before babies are discharged from the NICU, they usually will be taking enough milk on an ad lib feeding schedule to continue gaining weight.

Whether preterm babies should be fed ad lib versus on a schedule when transitioning from a feeding tube to the breast or bottle is still being studied. A 2015 literature review looked at nine randomized controlled studies that compared these two feeding methods in premies. The reviewers noted that some studies suggested that feeding on demand helped babies adapted to full oral feeding faster than premies fed on a schedule; however, they said the research was not strong enough to make a clear recommendation.