Around 32 weeks CGA, infants show cues they would like to be fed by mouth:
waking, fussing, sucking on hands/pacifiers, stable muscle tone & vital signs
An infant that needs to stop feeding shows disengagement cues, which are signs of stress:
Crying, arching, weak or absent suck, hands in “stop sign”, listless behavior, toneless posture, going to sleep
Attempts to continue feeding by unswadddling, prodding, twisting/pulling the nipple, or using a faster flow rate put infant at risk for unstable vital signs (hypoxia, apnea), increased energy expense, feeding aversion, and poor weight gain
Gavage rest of feed- undue stress sets infant up for safety issues and being unsuccessful on next feed
Mentor parents in how to recognize cues and stress behaviors
Use skin-to-skin contact when the infant is not cueing or needs to stop feeding to increase attachment, involvement, and satisfaction