The way we feed our babies today has evolved through centuries of medical advice, societal norms, and even economic interests. One controversial figure who shaped early ideas about infant care was Dr. William Cadogan, a man with a view that pediatrics should follow “man sense,” rejecting the natural instincts of mothers. To understand whether babies need to feed on a rigid two-hour schedule, we must delve into the history of feeding practices, Cadogan’s influence, and modern science’s take on baby-led feeding cues.
Traditional vs. Cue-Based Feeding
In traditional societies, mothers often breastfed their babies whenever the baby showed signs of hunger—what we now call feeding on demand. This approach allows infants to regulate their intake naturally, eating when hungry and stopping when full. In contrast, modern schedules, especially the two-hour rule, suggest feeding at regular intervals, regardless of the baby’s cues. The question arises: where did this idea come from, and is it beneficial?
The History of Infant Feeding Recommendations
Feeding practices have always reflected the medical understanding of the time. In early human history, mothers would breastfeed on cue, as this was the natural way to ensure an infant’s survival. However, as medicine and science advanced, so did the urge to control the most basic aspects of caregiving, including feeding.
Dr. William Cadogan’s Role in Infant Care
In the mid-18th century, Dr. William Cadogan emerged as a key figure in shaping pediatric medicine. A physician with strong opinions on how infants should be raised, Cadogan believed that the care of babies should be based on logic and science, or as he phrased it, “man sense.” This was in stark contrast to what he perceived as overly emotional and misguided maternal instincts. His views were published in his 1748 essay, An Essay Upon Nursing and the Management of Children.
Cadogan’s essay was influential because it was one of the earliest medical texts advocating for a standardized approach to infant care. But it also reflected the misogynistic attitudes of the time, where women, particularly mothers, were seen as ill-equipped to manage infant care without guidance from male doctors. By promoting the idea that pediatrics should be grounded in reason, he inadvertently pushed for regimented practices, like feeding schedules.
Dr. Cadogan’s 1748 Essay on Nursing and the Shift in Practices
Cadogan’s essay went beyond feeding advice. He believed that children should be raised in a highly structured manner, reflecting the Enlightenment-era belief in reason and order. He saw mothers’ natural instincts as chaotic, potentially harmful, and in need of reform through medical expertise. His recommendations encouraged mothers to adopt practices that were aligned with emerging scientific ideas rather than traditional, intuitive approaches.
Misogyny in Medicine: Marginalizing Maternal Instincts
Cadogan’s approach is a clear example of how the patriarchal attitudes of the 18th century shaped medical practices. His dismissal of maternal intuition wasn’t merely a medical opinion—it was a cultural statement that undervalued women’s roles in caregiving. Prior to his influence, women, often midwives or mothers themselves, were the primary sources of knowledge for infant care. The shift to male-dominated medical science led to a reliance on prescriptive care, often ignoring centuries of maternal experience.
By advocating that babies should be cared for based on “man sense” rather than maternal instinct, Cadogan helped shape an era of medical practice that sought to control even the most natural aspects of motherhood—feeding.
Scheduled Feeding: Where Did the Two-Hour Rule Come From?
The two-hour feeding schedule, while not directly from Cadogan, can be seen as a descendant of the structured approach he advocated. Early pediatricians and caretakers embraced feeding schedules as a way to regulate the baby’s life, much like how they imposed sleep schedules and other routines. The idea was that babies should be fed every two hours to ensure they received enough nutrition, especially in a time when formula feeding was becoming more common and breastfeeding rates declined in certain societies.
The Science of Baby’s Feeding Cues
Babies are born with an inherent ability to communicate their needs. Crying is often a late sign of hunger; more subtle cues include rooting (when a baby turns their head and opens their mouth when touched on the cheek), sucking on fingers, and making sucking motions. Feeding on demand respects these cues, allowing the baby to regulate their own intake based on hunger, which in turn supports healthy growth and development.
Modern research supports the idea that babies who are fed based on their cues tend to have better outcomes in terms of weight gain, emotional attachment, and overall health. Their bodies naturally tell them when they need to eat, and rigid schedules can disrupt this natural balance.
However, do note that, it is important to wake your baby every two to three hours during the first few weeks of life, especially if they are not waking on their own. This is crucial until they regain their birth weight. Most newborns lose some weight in the days following birth, and frequent feeding helps them recover this weight and supports the establishment of breastfeeding. After they reach their birth weight and demonstrate consistent growth, it’s usually safe to let them sleep longer between feedings, especially at night. Always consult your healthcare provider for personalized guidance, especially if your baby was born prematurely or has specific health concerns.
Comparing Scheduled vs. Cue-Based Feeding
When we compare the outcomes of babies fed on a schedule versus those fed based on their cues, the evidence increasingly favors the latter. Scheduled feeding, especially rigid schedules like every two hours, may not accommodate the baby’s changing hunger needs, which vary with growth spurts, activity levels, and individual metabolism. On the other hand, cue-based feeding allows for flexibility and responds to the baby’s immediate needs.
The Rise of Formula and the Reinforcement of Schedules
With the advent of commercial infant formula in the 20th century, feeding schedules became even more rigid. Formula feeding often required mothers to measure precise amounts, and the idea of feeding at specific intervals fit neatly with the formula’s marketing. Pediatricians, influenced by Cadogan-like ideals of medical control, advised mothers to adhere strictly to feeding schedules to avoid overfeeding or underfeeding.
Breastfeeding and Formula Feeding: Different Approaches to Scheduling
Breastfeeding naturally supports a more flexible feeding schedule because breastmilk is digested faster than formula, leading to more frequent hunger cues. Formula-fed babies may go longer between feedings, but even so, their individual cues should still guide feeding times. The idea that all babies should feed every two hours ignores the variations between individuals and feeding methods.
Impact on Infant Development: Physical and Emotional Outcomes
Feeding on demand is not just about nutrition—it’s about supporting emotional development as well. Babies who are fed based on their cues tend to form stronger attachments with their caregivers. This practice also fosters trust, as the baby learns that their needs will be met consistently and promptly. Over time, this approach can lead to healthier emotional regulation and social development.
Returning to Maternal Intuition: Embracing the Baby-Led Approach
As we step back from the rigid, schedule-based feeding practices of the past, there’s a growing movement toward respecting and reembracing maternal intuition—something that was dismissed under figures like Dr. William Cadogan. Today, science recognizes that a mother’s instincts, combined with careful observation of her baby’s behavior, are often the best guides for infant care, especially when it comes to feeding.
Feeding on demand—often called baby-led feeding—gives power back to the mother and baby, trusting their natural ability to manage hunger and satiety. This approach aligns with the infant’s biological rhythms, promoting not only better physical health outcomes but also stronger emotional bonds between parent and child. It acknowledges that babies, much like adults, have fluctuating hunger needs that should not be boxed into arbitrary schedules.
Conclusion: Moving Beyond Historical Biases
The history of infant feeding has been shaped by many influences, from economic forces to cultural biases, and even figures like Dr. William Cadogan, whose paternalistic views steered care away from maternal instinct toward structured medical control. His belief that infant care required “man sense” contributed to the dismissal of mothers’ intuition, leading to the imposition of feeding schedules that didn’t always align with an infant’s natural needs.
Today, we recognize the wisdom of baby-led feeding, which respects the cues babies naturally give when they’re hungry or full. Modern science supports this approach as the most beneficial for both physical and emotional development. By trusting a baby’s ability to communicate their needs, and a parent’s instinct to respond, we can ensure that infants receive the best care, free from the constraints of outdated medical advice.
