Newborn Sleep Cues vs Hunger Cues: How to Tell Them Apart

Hunger cues can be difficult to differentiate from sleep cues when you have a new baby - but your sweet little baby might have unique ways of telling you whether he/she is hungry or exhausted, and learning to tell the difference can make a huge impact on how well your baby sleeps!

Telling the difference is an important skill for parents to learn, because within the first weeks of their baby's life, caregivers will quickly realize that tired babies tend not to eat well, and hungry babies tend not to sleep well. This never-ending cycle can cause frustration for both parents and their little ones, so learning to understand your baby's unique hunger cues and sleep cues is important especially during the newborn stage.

Newborn hunger cues vs sleep cues at a glance

Hunger cues mostly look like your baby is hunting for milk. Sleepy cues look more like they're tuning out.

Early hunger cues:

• Bringing hands to the mouth, or sucking on hands
• Turning the head toward the breast or bottle with an open mouth (rooting)
  
• Smacking, licking or puckering the lips, or sticking the tongue out
  
• Clenched hands and growing fussiness

Sleepy cues:

• Yawning and droopy eyelids
  
• Staring into the distance or looking away
  
• Frowning, grimacing or a furrowed brow
  
• Rubbing eyes or pulling on ears
  
• Arching the back, whining or fussing

A few cues show up on both lists, like sucking on fingers, clenched fists and fussing. When you can't tell which one it is, look at the clock. Newborns eat often: breastfed newborns usually nurse about every 2 hours, and bottle-fed newborns usually eat every 2 to 3 hours. If it's been a while since the last feed, start with hunger. If your baby ate recently, has been awake for a while and turns away after a few sucks, tiredness is more likely.

Crying is often a late sign of hunger. But an overtired baby may also cry as if they want food and then refuse to eat.

The 3 Phases of Hunger Cues

Hunger cues can vary among infants, but they usually occur in three phases: early, active, and late. The more quickly parents can respond to a baby's hunger, the easier it will be to get their little one to eat!

Early hunger: 

The early hunger stage is the best time to respond to a baby's cues. Signs that a baby is getting hungry include the baby sucking on his/her lips or hands, smacking his/her lips, licking his/her lips, and opening and closing his/her mouth repeatedly.

If the baby is being held, the baby might turn his/her head toward the person's chest or try to maneuver his/her body in that direction, toward the caregiver's body. If the baby has been playing, he/she might suddenly turn and make eye contact with the caregiver.

Active hunger: 

Active hunger cues include stretching, moving more and bringing the hands to the mouth more often. Rooting, when your baby turns their head with an open mouth to search for the breast or bottle, often starts in the early phase and gets more insistent now. The baby might also fidget or make movements to try to get in position to nurse or drink a bottle. The baby might be flailing or kicking his/her arms and legs or become irritable and fussy all of a sudden. This is the stage where your baby is hungry and ready to eat right away.

Late hunger: 

New parents might not know how to recognize baby cues right away, so their little one might move through the early and active stages without getting the parents to respond to her cues. Caregivers may have been distracted and missed the earlier signs that the baby is getting hungry.

A baby in this phase might thrash his or her head from side to side, begin turning away from the caregiver, turn red in the face, or become inconsolable and start crying. At this stage, the baby wants to eat immediately, but might become so overtired and overworked from the parents missing the cues that he/she refuses to feed or seems uninterested in feeding after a few sips.

It is much easier to console a baby when the cues are recognized early on. The baby will be more likely to feed calmly and eat to satiety instead of becoming frustrated and tired. Whether you are breastfeeding or formula feeding, the hunger cues are similar.

If your baby has already reached the crying stage, calm them first and then feed. A cuddle or skin-to-skin contact on your chest can settle them enough to latch or take the bottle. A red face is one of the classic late signs, but it's harder to see on babies with brown or black skin, so watch for crying and agitated movements too.

The 2 Phases of Sleep Cues

A baby's sleep cues can also occur in stages: early signs of sleepiness and late signs of sleepiness.

Early tired signs: 

Early sleep cues include things like tugging on the ears, staring, frowning, and red eyebrows. Physical signs of drowsiness include closing fists, yawning, making jerky movements, and sucking on fingers.

It can be easy to confuse some of these signs with hunger. After all, a baby sucking on his or her fingers might seem like he/she is hungry, when really he or she is just seeking sensory input to help calm and lull to sleep. Your baby might arch his/her back, which may seem like the baby is in pain or uncomfortable from eating, but he or she could also be fidgeting because he/she's ready to sleep.

Late tired signs: 

Late sleep cues include crying, whining, and fussing. Your baby might be so upset that it's impossible to console him/her and get him/her to fall asleep. Your little one might look like he or she is having a hard time trying to settle, and may move the body with jerky arm and leg movements.

If nursing or bottle-feeding is part of the sleep routine, an overtired baby might have trouble eating properly. Your baby might cry and turn his/her head away from the breast or bottle, or want to take a break during the feeding. Worse, the baby might reject the milk altogether because she is too tired to suck. It is much easier to feed a baby that is alert and awake than a baby who is crying and overstimulated.

It is optimal to respond to your baby's early sleep cues, rather than late sleep signs, in order to make nap time and nighttime easier for both parents and their infants.

What to do when you spot sleepy cues

Try to put your baby to bed when they look drowsy, before they get overtired. Every time, lay them on their back in their own crib, bassinet or play yard, on a firm, flat mattress with only a fitted sheet. Keep pillows, blankets, bumpers and toys out of the sleep space. The AAP recommends sharing a room with your baby, but not a bed, for at least the first 6 months.

During night feeds and diaper changes, try not to stimulate your baby. Keep things calm and quiet, and if you talk, talk softly.

Newborn babies and sleep:

Newborns are very sensitive to sleep and need plenty of rest throughout the day and night. Going long periods of being awake can make it difficult for a newborn to settle down and fall asleep when you want him/her to. Newborns don't necessarily need to be on a rigid schedule, but it is important to pay attention to your baby's wake windows and begin to notice sleep patterns.

Over time, parents will learn to recognize their baby's unique sleep cues and respond quickly, before the infant becomes overtired and cranky.

How can a parent tell the difference?

Many behaviors overlap for both sleep cues and hunger signs, making it difficult to differentiate between the two. For example, an infant might cry because he/she's hungry and wants to eat, or he/she might cry because of exhaustion from a long day of play and wants to sleep.

Learning how to communicate with a newborn can be overwhelming to new parents! The early months and years of parenting are not easy by any standards. As much as possible, try to remain proactive instead of reactive.

Do not fret when your little one starts to fuss or get tired; instead, pay attention to the volume, sound, and tone of your baby's cries. Babies will make different sounds and have different cries to communicate a wide variety of needs. The difference might be subtle, but a calm, observant mom or dad will soon learn to tell the difference between these noises.

It might be helpful for the parent to keep a food and sleep log for the first several months of the infant's life. Pay attention to what the baby does when he or she is starting to get tired, keep track of how long it takes to fall asleep, observe how much play impacts sleep and hunger, and watch the effects of giving the baby a break between activities.

All babies are different.

Regardless of what you read about baby cues, all infants are different. What is true for one baby might not be true for another. What helps with falling asleep for one infant might not work for another. The cues that one baby gives when he or she is hungry might not be the same for another baby.

Not all fussing means that a baby is sleepy or wants to be fed. Not all tongue movements indicate that your little one is hungry. A baby might be fussy for a variety of reasons besides hunger and drowsiness.

It is important for caregivers to figure out their little one's sleep and hunger cues. Over time, it becomes much easier to recognize your baby's unique cue for different needs. Notice the small clues that your little one gives you to indicate his/her needs, and soon mom and dad will have no problem at all understanding what their baby needs.

When a sleepy baby needs a doctor

Newborns sleep a lot, and they can be hard to rouse at times. Call your pediatrician right away if you notice a change in feeding, such as a baby who now has to be woken for feeds or can't finish them, or if your baby is sleeping more than usual. Call too for any fever in a baby under 12 weeks old, and don't give fever medicine before your baby is seen.

Go to the ER if your baby has a weak suck or can't suck for very long. Call 911 if you can't wake your baby.

Wet diapers are another useful check. After the first 4 to 5 days, your baby should have at least 5 to 6 wet diapers a day. If you see fewer, or you're worried your baby isn't getting enough milk, call your pediatrician.