Responsive Feeding Tool for Home Visitors

Responsive feeding divides the responsibility for meals and snacks between adult and child. Adults give a safe and nurturing feeding environment that responds to the child’s signs of hunger and fullness. Adults offer healthy meals and snacks in serving sizes that are right for the child’s age. The child decides whether to eat, which foods, and how much to eat. Every child is unique and has their own way of helping adults understand their hunger and fullness signs.

Home visitors and others who work with families can use this resource to share information about responsive feeding, help families set up a positive eating environment, and look for responsive feeding behaviors.

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Cultural Considerations

Food, meals, and feeding practices for babies and young children can be emotional topics that are rooted in a family’s culture, values, history, and experiences. Each person in a family may have different perspectives on child feeding. Families often are anxious when deciding how best or how much to feed their child. They may use food to show love, give comfort, or manage behavior. Taking time to understand the family’s culture and traditions related to food can help build lasting and trusting relationships. During visits and conversations with families, you can help them set up a positive, social environment at mealtime and make meals a chance for children to learn new skills.

Tips for Discussing Responsive Feeding with a Family

• Respect the family’s needs and goals for their child’s nutrition and feeding experiences.
• Guide them with the best information and help them make the best choice for their family — which may be different from what is best for other families.
• Let the family lead the conversation.
• Help them learn to read their children’s signs of hunger and fullness and to learn about foods and serving sizes that are right for their child’s age.
• Explore and acknowledge your own opinions about food and mealtimes and how they might affect your conversations with families.
• Do you have an image of an ideal or healthy weight for a baby or young child? Where do you think this image comes from? Do you think the families you work with have a similar image?
• How do you feel about breastfeeding/chestfeeding? Do you feel you have the knowledge to talk to families about breastfeeding/chestfeeding?
• What were mealtimes like when you were growing up? Did you have family meal routines?
• Were you expected to eat all the food on your plate? How do you think this affected your relationship with food?
• How have you used food as a learning tool in lesson plans?
• How do you make mealtime enjoyable and introduce new food with your family?
• What words do you use to describe the foods you serve?

Talking Points with Families

Use these conversation starters and talking points to guide your conversation about responsive feeding with families. If you are working with new parents or expectant families, you may want to share Healthy Feeding from the Start for Expectant Families.

Infants (0 to 12 months)

How does your baby tell you when they are hungry and when they are full?

Talking Points: It is great that you can recognize how your baby is communicating to you. While each baby is different, they often give early signs they are getting hungry or full, such as turning their head, putting their hands in their mouth, and stretching. Do you ever notice any of these? Recognizing these signs can make feeding babies less stressful and teach babies that their family understands them.

Can you name some ways you interact with your baby while feeding?

Talking Points: Feeding your baby is a great way to bond and connect. They learn so much from what you do even if they can’t copy your words yet. You can make silly faces, introduce new words by naming the type of food you are eating, show how you like the foods you are eating by smiling, or introduce new colors and textures.

Do you think your baby is a healthy weight? Why?

Talking Points: Babies come in different shapes and sizes. Every baby is different, and you know your baby best. By listening to and watching for your baby’s signs of hunger and fullness, you can support a healthy weight. If you feel your baby isn’t a healthy weight, you might want to talk to their doctor about how much and what they are eating. The pediatrician can help you look at your baby’s growth pattern and see what your baby needs.

Do you have questions about whether they are getting enough or too much to eat?

Talking Points: Every parent wonders at some point whether their baby is getting enough food or eating too much. How much they eat may be different every day, but understanding how your baby tells you they are hungry or full can help you feel confident they are getting enough to eat.

How do you feed your baby?

Talking Points: Feeding your baby can be an important time to bond with each other. Try to find a calm, quiet place to feed them. It may seem too early, but they are already building language skills by listening and interacting with you.

How will you know when your baby is ready to try solids?

Talking Points: All babies are not ready to try solids at the same time. Some signs they may be ready to try are when they can sit up alone or with support, control their head and neck, and move solid foods from the front to the back of their tongue to swallow. If they gag or spit the food back out, they may not be ready yet.

How does your baby feed themself?

Talking Points: I’m so glad to hear they are practicing fine motor skills during meals. Letting them grab the spoon can allow them to show you when they are still hungry. They probably love exploring food, but if they play with food but do not feed themself, they may be full.

Toddlers and Preschoolers

What does a meal at your home look like? Where do you sit? Do you eat together? How do you talk with your child?

Talking Points: It seems you are starting to build some mealtime routines. This is a great idea! Routines help children know what to expect when it is time for meals and snacks, and how meals can be a fun time together. You can set routines such as eating at similar times each day, eating as a family as often as possible, and giving your child tasks to help prepare or clean up. You can use mealtimes to talk about colors, shapes, and textures. Make mealtimes fun. Tell your child stories from your day or your childhood, or just make up a silly story! They will love to hear your voice and laugh with you. What are some things you might want to add to your meals together?

How does your child tell you when they are hungry and when they are full?

Talking Points: I’m so glad you can recognize these signs. As their language develops, children can tell you clearly when they are hungry or full. But it is important to let them decide when they want more or are done eating. Letting them listen to their body for hunger and fullness sets up a lifelong good habit. You might try asking at mealtime, “What does your tummy feel like? Does it have enough food, or would you like more?”

How do you encourage your child to try new foods?

Talking Points: Choosy eating is very normal at this age. Your child is trying to find a balance between independence and their need for direction from you. This can be frustrating, especially since you may have to offer a new food 10-15 times before they will try it. It might help to serve a new food when you eat together as a family so they can see others eating it too, or offer a new food with a familiar food. Or we can try to pick an activity for our next visit that uses this new food. For example, we could plan an activity where we find green things, and you could serve a new green vegetable at your meals that week.

How does your child help with mealtime?

Talking Points: It may seem a little early to ask your child to help with mealtime, but it helps them feel a part of your family habits. It can also be an alternative to using the TV or your phone as entertainment while you prepare food. Let your child help you prepare meals. This can be as simple as setting the table, mixing, or adding ingredients. They are more likely to try new foods they helped prepare.

Does your child eat a variety of foods? What do they seem to like best?

Talking Points: Every child has favorite foods, and new foods are simply favorite foods they haven’t tried yet. It’s important to introduce them to a wide variety of fruits, vegetables, proteins like beans or meat, and dairy like cheeses and milk. This gives them time to learn how each food tastes and build healthier habits. When you introduce many different foods now, they may be healthier and less choosy as they get older. Are there some new foods you might let them try?

Looking for Responsive Feeding Behaviors in the Home

When visiting with families, look for these responsive feeding behaviors. You can share what you notice with the families to let them know what they are doing well and to find opportunities for new strategies for responsive feeding and healthy mealtime practices.

Does the family:

• Offer a feeding environment that is pleasant, with few distractions?
• Make sure the child is seated comfortably, ideally facing other family members?
• Avoid screen use during mealtimes?
• Talk about food, and encourage the child verbally during mealtimes?
• Serve food that is healthy, tasty, and developmentally appropriate?
• Offer food on a predictable schedule?
• Watch for the child’s signals for hunger and fullness?
• Respond to the child’s feeding needs in a prompt, emotionally supportive, and developmentally proper way?
• Experiment with different food combinations, tastes, and textures?
• Allow the child to decide whether to eat or finish the food served to them?
• Avoid all efforts to force a child to eat, such as force-feeding, holding the child’s head, and threatening or shaking the child?

Specific behaviors to observe include:

Birth to 6 months

Adult Behavior

• Breastfeeds, chestfeeds, or bottle-feeds on demand
• Watches for and notices the baby’s hunger and fullness signs
• Prepares to feed when the baby signals hunger
• Responds to the baby’s cues by feeding or stopping the feeding

Child Behavior

• Signals hunger and fullness through voice, facial expressions, and actions.
• Uses hunger cues: Moves hands or puts things in mouth, displays rooting reflex, makes sucking noises or motions, or clenches fist over chest and tummy, etc.
• Uses fullness cues: Moves into intermittent pattern of sucking (i.e., stopping and starting), unlatches often while breastfeeding, slows pace of feeding, becomes drowsy or falls asleep, fidgets or gets distracted easily, closes mouth or turns away when offered the breast or bottle, extends or relaxes fingers, etc.

6 to 12 months

Adult Behavior

• Responds to the child’s signs of hunger or fullness
• Introduces new foods, with increased variety, texture, and tastes
• Introduces a variety of fruits and vegetables
• Responds positively to the child’s attempts to self-feed (if this is a family goal)

Child Behavior

• Signals hunger and fullness through voice, facial expressions, and actions.
• Sits with good head control.
• Uses hunger cues: Leans toward food and opens mouth, gets excited when seeing food, focuses on and follows food with eyes, etc.
• Uses fullness cues: Spits out or pushes food away, fidgets or gets distracted easily, closes mouth when offered food, turns head away from food, plays with food, etc.
• Chews and swallows semi-solid foods.
• Self-feeds by hand (if this is a family goal).

1 to 3 years

Adult Behavior

• Offers three to four healthy meal choices each day.
• Offers two to three healthy snacks each day.
• Offers food that the child can safely pick up, chew, and swallow.
• Responds to the child’s signals for hunger and fullness.
• Respects the child’s fullness cues (e.g., allows the child to stop eating when child signals “all done”).
• Feeds child slowly and patiently.
• Responds positively to the child’s attempts to self-feed. For example, adult helps the child with eating skills while allowing child to pick up foods with their fingers and self-feed.
• Makes the child’s meals part of family meals as much as possible.
• Avoids practices such as making the child eat all the food on their plate or bribing children to finish a healthy food in exchange for dessert.
• Anticipates mealtimes and has food ready before the child is over-hungry, tired, or crying.

Child Behavior

• Self-feeds many different foods.
• Uses child-safe utensils.
• Uses words to ask for food.
• May start having strong preferences for certain foods.
• May use mealtime to show independence in food choices, self-feeding, etc.

Last Updated: April 9, 2024