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Thread: 3-mo-old doesn't like eating

  1. #1

    Default 3-mo-old doesn't like eating

    I have ongoing concerns about my 3-month-old daughter’s weight.

    She was born full term at 8 lb 7, 20 in, which is something like 85th percentile for both weight and height. Her height and head circumference have stayed at around 85th percentile, but she’s been steadily losing ground on the weight percentile. At 12 weeks she’s 11 lb 6 oz, around 30th percentile.

    The pediatrician was worried at first and had us come in for a million weight checks in the first two months. He says he’s no longer worried and that if she had some kind of metabolic disorder, it would most likely be obvious by now.

    We’ve seen two different lactation consultants; one said she has a posterior tongue tie (went to an ENT who said he didn’t see anything that should be affecting her feeding.) The second one said she had a high palate. One recommended laid-back feeding; the second recommended cross-cradle hold. These days we mostly nurse lying down.

    Except for the first few days, nursing has not been painful. Latch seems okay. We did a pre-and-post feed weigh at eight weeks and she took 2.5 oz in 20 minutes.

    We started pumping at two weeks. She’s gone through times when she preferred the bottle, times when she preferred the breast, and times when she didn’t seem to want either.

    We supplemented with formula for a little while, but never in significant quantities (currently making maybe two bottles a week of formula if I’m asleep and husband runs out of pumped milk). At this point my supply is fine - I pump off more than she drinks because we throw away so many half-finished bottles. She’ll pull off even if I’m still squirting milk, so I don’t think supply is the issue.

    She seems generally well. She’s meeting milestones, and she has a decent amount of time during the day when she is alert, smiling or just lying and looking around. She’s always had plenty of wet and dirty diapers. Stool is yellow with curds in it, sometimes pretty wet. She’s never been sick except for a head cold once. She rarely spits up.

    She has never been a great eater - early on she would fall asleep all the time during nursing, and now she doesn’t fall asleep but will rarely nurse for more than about 15 minutes. She will take at most 3.5 oz from a bottle. We probably attempt around 10 feedings a day, but she refuses a lot.

    Mostly she refuses bottles and cries if you offer it to her. She’ll often drink 1-3 oz from a bottle if she’s just woken up. At night she nurses well without fussing (she sleeps in a cosleeper beside me and wakes every 1-3 hours for 5-15 minute feedings). But during the day she fusses maybe half the time I offer her the breast. She doesn’t want to be horizontal, only to be held upright.

    Her father and I are both slim and were slim children, so I wouldn’t expect her to be chunky. But I worry that 85% for height and 30% for weight is too slim. If she were getting plenty of food I would just figure she has a fast metabolism and is burning it off, but I don’t actually think she’s getting that much.

    We’ll be traveling for three weeks soon (planned before we knew the realities of life with baby!) and I’m scared that with everything disrupted she won’t eat much. Most of our feeds are side-lying on a bed or couch at this point, and when we’re out she’ll take some from breast or bottle but not enough to satisfy her, so she ends up hungry and crying, at which point I get her to sleep and go home so we can feed lying down.

    I feel like my life revolves around coaxing her to eat. I’m afraid that she’s not getting enough. And I do also hope to someday sleep more than 3 hours at a stretch, which won’t happen if she’s always talking such small feeds.

    I don’t know how concerned to be about any of this.

  2. #2
    Join Date
    Jun 2009

    Default Re: 3-mo-old doesn't like eating

    Hi. I would suggest a couple things.
    Healthy babies are compelled to eat by hunger as well as a need to suckle. So if a baby is truly not wanting to eat, that might indicate baby's appetite is suppressed. If a baby is full, they are not going to be hungry. So one reason a baby won't eat is baby is being expected to eat more than they actually need.

    But sometimes a nutritional deficiency or illness causes a lack of appetite. I am not a doctor and I do not know what tests were done on your child, but if your instincts suggest that your baby is not wanting to eat even enough to be healthy, then I would suggest seeking more medical advice.

    I am confused why bottles were introduced, or formula. Was this deemed medically necessary, or was there another reason? At this point, how often does baby get a bottle? While some babies can do combo feeding without issue, Bottle use will often discourage nursing/lead to breast refusal over time. Do you wish to continue with bottles, or exclusively nurse? What is your goal there?

    These days we mostly nurse lying down.
    Baby refuses to nurse in any other position?

    We did a pre-and-post feed weigh at eight weeks and she took 2.5 oz in 20 minutes
    That is normal intake.

    She has never been a great eater - early on she would fall asleep all the time during nursing, and now she doesn’t fall asleep but will rarely nurse for more than about 15 minutes. She will take at most 3.5 oz from a bottle. We probably attempt around 10 feedings a day, but she refuses a lot.
    15 minutes is a perfectly long nursing session for a 3 month old. IN fact, many babies nurse for a shorter time than that. Longer is fine too, of course. Usually, it varies, because babies nurse for food and comfort. How long do you think baby should nurse? 3.5 ounces is on the large side of normal for a feeding. How much are you expecting baby to take from the bottle?

    If you attempt to feed the baby 10 times, but she refuses 'alot' how often is baby actually nursing and how much is baby getting in bottles?
    But I worry that 85% for height and 30% for weight is too slim.
    But doctor says its fine, right? Percentiles & growth charts get us really worked up. But that is because they are misused. Weight gain is measured in order to give one piece of info so that hcp can know when to keep an eye on a particular baby's health. Your doctor did this, and found nothing wrong. As far as I know, there is nothing inherently wrong with these percentiles.

    Your baby is GROWING because her height and head circ have stayed right at the same % as at birth. A malnourished baby would not grow normally. Also, Birth weights are often inflated by several ounces. Basically, birth weight % is meaningless.
    Baby has gained (from birth weight) 3 lbs in three months. Yes, this is slow overall gain. But has gain been relatively steady? I am not talking about % I am talking the actual gain. birth weight was likely inflated-do you know what the lowest known weight was?
    Has baby ever not gained or lost weight between weight checks?

    Anyway, one way or the other, I think you need to find peace that this is who your baby is, or continue to search for a medical answer if you think there really is something wrong. Because weight gain typically SLOWS after 3 months, so a normal slowing in weight gain may only become more alarming to you if you are unsure that your baby is eating enough.

    I suggest the excellent book My Child Won't Eat by Carlos Gonzalez. Yes he mostly concentrates on slightly older children but there is info about young babies as well, and a very good explanation of growth charts, what they mean, and what they don't, and reasons why a baby would appear to not want to eat, plus some discussion of what medical issues actual might cause poor appetite.
    Last edited by @llli*lllmeg; June 22nd, 2014 at 10:34 AM.

  3. #3

    Default Re: 3-mo-old doesn't like eating


    I introduced pumping and then formula as a way to potentially get her to drink more (and at times, she's had a week or so when she was doing really well with bottles). Also as a way for me to get some rest while family feeds her for a couple of hours.

    I don't have a strong preference about bottle vs. breastfeeding. I'm willing to do whatever combination works. In about two months I'll be going back to work, so I do hope she can take a bottle well then.

    The worst week she had was gaining half an oz over 6 days. Other than that it has been a slow gain.

    15 minutes is a long feed for her - more typical is 3 to 7 minutes at a time. She does usually refuse to feed in any position except sidelying. If she will feed in something like a cradle hold, it's only for about 2 minutes and then she fusses and pulls off.

    I don't think birth weight was inflated, as I didn't get any fluids or anything during the birth. Lowest weight was 7'14 at 3 days.

    If I offer the breast 10 times, she might accept 5 times. If we offer the bottle she will refuse 90% of the time unless she's just woken up. She probably ends up taking anywhere from 5 to 15 oz a day from the bottle and breastfeeding maybe four to eight times.

  4. #4
    Join Date
    Jun 2009

    Default Re: 3-mo-old doesn't like eating

    Ok, I probably should not have said birth weight is 'inflated.' What I meant was, for various reasons, it is not reliable. 1) because it is taken on a scale that is usually never used again for that baby, usually minutes after baby was born when there is lots going on and 2) it is normal for a baby to lose several ounces in the first 2-3 days after birth because a healthy full term baby is born well fed and it normally takes a couple days for mothers milk to start being enough to stop loss and start gain 3) babies are typically born with lots of poop inside, are weighed with that poop onboard, and often do poop quite a bit the first day or so. Due to all this, it is usually clearer for measuring if gain is measured from lowest known weight (usually about day 3 or so, depends on baby) basically, even with a birth with no fluids, it can be misleading to measure gain from birth weight. If lots of fluids are on board, for example, mom had an epidural, then yes, birth weight may also be inflated.

    Normal average daily intake for a breastfed (or breastmilk fed) baby is about 25-30 ounces per day, give or take. I do not know if or how this might change with formula in the mix. Some babies can easily get this much nursing 8 times, others need to nurse more often, and eating more like 10-12 or more times in 24 hours is entirely normal. Some babies prefer to snack, and like small frequent meals, and others eat less frequently for longer, and some (most probably) do some combination.

    So, if the days baby takes 5 ounces are the same days baby nurses about 8 times, and the days baby takes 15 ounces are when baby nurses 4 times, that may be plenty of feedings for baby to be taking in the right amount overall? Or do you mean there are days baby only takes 5 ounces from the bottle and then only nurses 4 times? That would strike me as infrequent eating.

    Since you are happy to stay with combo feeding and don't mind if baby begins to refuse to nurse, there is no reason to change anything there. I do wonder if choosing one method of feeding and going with that for a while might simplify things, as the combination feeding is clearly not bringing the gain you are hoping to see. But of course I would suggest trying exclusive breastfeeding (until you return to work) and could not suggest going over to exclusive bottle feeding, as there is no indication that is needed. plus, (I imagine) pumping on top of all the coaxing baby to eat is tiring. Since baby has taken a bottle on multiple occasions with no issue, I would suggest that when your child is balking at the BOTTLE, that is probably not due to breastfeeding, but due to some other issue. But the opposite can and often does occur (more bottles leading to less nursing.)

    Here are some ideas for helping baby get more milk:

    Breast compressions? Ever try these? Helps keeps flow more interesting for baby.
    Switching sides? Same thing- keeps baby more interested
    paced bottle feeding-makes bottle feeding more like breastfeeding by using pauses and positioning that allow baby to have more control over the flow of the feeding
    As far as positioning, what other positions have you tried? In op you mentioned trying laid back breastfeeding. This is a position that usually makes nursing much more comfortable for mom and baby. It is not really just one position, all it means is mom is tilted back more or less, according to her comfort, and supported. It can be done on a chair or couch or bed or sitting on the floor, as long as there is support for moms back. Baby can be in any position, and the position lends itself to easy adjustments to baby's position as baby likes.

    again I recommend my child won't eat. It's not only about breastfed children FYI.

  5. #5
    Join Date
    Jun 2009

    Default Re: 3-mo-old doesn't like eating

    laid back nursing position: See vid clip on this page. This little clip advertises the DVD. You do not need the DVD! That is for lactation consultants. The clip alone shows many varieties of positioning 'laid back." http://www.geddesproduction.com/brea...-laid-back.php

    laid back nursing explanation: http://www.llli.org/docs/00000000000...astfeeding.pdf

    paced bottle feeding: http://www.llli.org/docs/00000000000...astfedbaby.pdf and video: https://www.youtube.com/watch?v=UH4T70OSzGs

    breast compressions: http://www.breastfeedinginc.ca/conte...agename=doc-BC

  6. #6
    Join Date
    May 2006

    Default Re: 3-mo-old doesn't like eating

    with LLLMeg.

    There's a well-known phenomenon which may explain your child's growth trajectory. It's called catch up/catch down growth. Basically, babies often follow one growth trajectory inside the womb and another one outside. So a baby might be born small and then grow very rapidly after birth, or be born large and then grow at a much slower rate after birth. What's important is that the baby keep growing and developing normally.

    FTR, there's no such thing as a breastfed baby being too fat/too slim for her height. Babies come in all shapes and sizes! There are apple-shaped babies, pear-shaped babies, and banana-shaped babies. It sounds like you have a long, lean, banana baby on your hands!

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