A variety of confusing FF issues

[PH123987]

Hi guys

This is my first time posting and I would really appreciate your advice.

My DS is 7 weeks and at the last weigh-in at 6 weeks he was 11lbs on the dot (from 8lbs 7oz at birth). At the 6 week weigh-in, my health visitor says he has dropped from the 75 percentile to the 50 percentile in respect of his weight gain and said "that's a bit concerning, keep an eye on that". (Words not to use when speaking to a first time mum prone to over thinking haha!)

He was BF for the first 3 weeks at which point I switched to FF completely.

Since he switched to FF he has only really taken 3oz to 4oz on average every 3 hours; for weeks I have tried my best to increase this mainly because I wanted him to sleep better and for longer however more so now to ensure he manages to put on good weight in light of the HV's comments ; I have tried regular burps, keeping him awake during feeds, taking a break during a feed, leaving longer than 3 hours between each feed etc but he won't take more. He doesn't start crying or anything but just pushes the bottle away with his hand and literally clamps his lips shut so that I can't get the teat in!
I have switched bottles (to MAM) which have been great for his wind and I have experimented with different teats too so I don't think the flow speed is a problem.

As he was windy to begin with, the Midwife recommended Aptamil Comfort; he was on that for 3 weeks but I have taken him off it as I felt that it wasn't really helping with his bowel movements, and I felt that the MAM bottles were helping sufficiently with his wind without needing any special Comfort milk. He is now on HIPP Organic which was recommended to me by some friends. This has been great so far as his bowel movements have been more regular and he winds fine, but once again still only takes about 4oz before refusing any more.

I was about to just to ignore the HV's weight gain comments and just accept that he's one of those babies that eats little and often. However I had my routine baby check up scheduled with the GP today who I mentioned all of the above to. He then put the concern straight back into me by saying "no he should be eating more than that for his age and weight " and then said that he thinks it might be reflux. I never really thought of this, largely because he's never been sick and whilst he does posset milk, it's not huge amounts and not at every feed, I just thought whatever he posseted was "normal".
Having said that, there have been some occasions where he's had his hands in his mouth and his fingers smell like sick, so I'm wondering if some has come back up is oesophagus but not made it quite so far. I really don't know!

He has prescribed Gaviscon for a week and to see how it goes. He is confident that it will sort the issue and thinks that my DS will miraculously start consuming more milk. I am sceptical of this because upon researching Gaviscon it says that it thickens the milk and keeps it down - so wouldn't that make him feel fuller on even less milk!?

1. has anybody been in a similar situation whereby their baby has been treated for reflux (particularly with Gaviscon) and it has had a positive after- effect on the amount of milk their baby consumes?
   
   
2. the instructions for using Gaviscon are quite confusing - I tend to make a bottle of 5oz at each feed in the hope he'll one day decide to drink it all. Should I add just the one sachet to this?
   
   
3. does anybody know if Gaviscon can also be added to the ready made bottle variety or is it just to formula mixed bottles?
   
   Any advice or comments would be massively appreciated

[Bessie111]

Hello, I might not be much help but wanted to offer support . I can't help on gaviscon but just wanted to say that my 10 week old still only has 4oz bottles every 3 hours, refuses any more except 1 x 5oz in middle of night as she's had her longer sleep. Also that's only increased to 5oz this last week. My HV says some just like little and often!! She also has silent reflux which I think is what your doc is suggesting your baby has (rather than projectile vomiting reflux) but we are on thickened Aptamil milk instead of gaviscon and it works wonderfully.
My health visitor said to multiply weight by 2.5 and that gives you the OZ per day roughly they need. But 11lb sounds like a really great weight. At our 6 week check they plotted DCs weight wrongly and told me we were underweight then I went to doc who reweighed and found nothing wrong the HV had plotted on wrong week!!! So maybe get reweighed?

All in all don't worry, sounds like you are doing great xxx

[Bessie111]

Sorry should say my DC weights about 12lb 6 so good sized baby despite little and often

[SpeakNoWords]

I'm surprised that the HV and the GP are concerned about a change of one centile, babies don't stick to the curves and can move up and down at various points. Crossing 2 centile lines I thought was an issue, not 1. So I'm not sure you need to be trying to increase quantities where your DS isn't keen to have it. Can you see a different HV for a second opinion?

Just for comparison, my DS2 is now 7 weeks old and fully breastfed having been mix-fed for the first couple of weeks. He has dropped down one centile or so, and neither the HV or his consultant at the hospital are in any way concerned despite the fact that he is still very titchy at 8lbs 9oz, having been 7lbs at birth.

[Heirhelp]

Babies should only be weighed once a month as it some weeks they might but on lots of weight and others none. It is perfectly normal.

My lo was bf until 6 weeks and then we moved to formula. We used gaviscon and then moved to ranitidine for silent reflux.

Comfort milk works in a similar way to infant gaviscon. It works by thickening the milk but it also thickens poo and causes constipation which it why we stopped using it. I would recommend offering cooled boiled water to help reduce the constipation.

We just put the sachet in the bottle and shook the bottle before feeding. It works for both powder and premade bottles. I would just use one sachet in a 5oz bottle. From your post I can't tell why you have been perscribed gaviscon.

As for weight gain just feed him when he is hungry. There is nothing else you can do.

[ItsAllGoingToBeFine]

It's not clear from your post, but have you tried feeding more often than every three hours as opposed to trying to get more in at each feed.

His stomach is very tiny, and little and often may work best - like breastfeeding, formula feeding should really be done on demand rather than certain amounts at certain times.

[dementedpixie]

I can't understand why he is being treated for reflux without any reflux symptoms. You can't force him to take more than he wants and 3 hourly feeding is about normal for that age. What weight is he and how much is he having in a 24 hour period?

[feesh]

My son's only symptom of cow's milk protein intolerance was pushing the bottle away (he was about 7 or 8 weeks at the time). And then he was hungry again a short time later. At first he was treated for reflux (we did Gaviscon and then omeprazole), but my gut instinct said it was something else. He never dropped any percentiles, but I just knew something wasn't right. The doc suggested it might be cow's milk.

NB his twin sister fed at the same time as him, and she always took less milk, because she was smaller, but she used to guzzle it down and then happily fall asleep. With him, it was different - he was a big boy and I knew that he wanted to be drinking more, but somehow he seemed uncomfortable and I knew there was something else wrong.

The only way to test for it is to do an exclusion diet and see if there is any improvement, and it took us a good 3 weeks or so to switch him to Neocate (because the taste is so foul, we had to gradually increase the percentage of it in his bottles). And at first he got worse, not better, but after a couple of weeks he was like a different baby, guzzling down 8oz bottles at every feed. And now he's a big strapping 3 year old. He still can't have any dairy, because it gives him horrific constipation, but looking back I think my instincts were very much right.

[SpeakNoWords]

But the only "symptom" is that the baby had dropped a centile, to the 50th, and even that isn't really a symptom of anything necessarily. And yet the GP is suggesting reflux and medicating, and someone here has suggested CMPI. But there doesn't seem to actually be anything wrong with the OPs baby!

[29redshoes]

Sounds like you've had some really strange advice from your HV and GP! As others have said, dropping one centile is not a big deal. Taking 3-4oz every three hours also sounds pretty normal at his age.

Don't try and force him to take more milk if he's pushing the bottle away with his hands, it sounds like you've been doing the right thing so far in terms of feeding on demand and listening to him when he's telling you he's had enough.

Overall it's very confusing - sounds to me like you were doing fine!

[bonzo77]

I would agree with lots of the above:

1. Percentile drop of one line not a concern. Monitor by weighing every 2-4 weeks. Babies often settle at a different percentile at some stage. All mine have shifted up at around 6-12 weeks and stayed up.
   
2. The behaviour you describe is normal not nec reflux. Gaviscon is not great for reflux and caused constipation in my babies.
   
3. You sound like you're recognising and responding to your baby's feeding cues. You cannot get them to take more than they want: that really does make them vomit! I found a lovely bit of writing about bottle feeding on the la Leche league website. Will find it and post.

[29redshoes]

I meant to say in my previous post - my DD also dropped from the 75th to the 50th and nobody ever raised any issues with it.

[bonzo77]

It's here. A bit of the way down under "understanding normal"

[PH123987]

Hi all

Sorry for the delay and thanks so much for your replies.

I completely agree in that it doesn't make much sense, and the more I research the more it seems that my LO's feeding patterns and quantities are completely normal. I'm going to stop focusing on his weight gain and avoid getting him weighed for a few weeks at least.

Thanks for the sense check, it's easy to get lost in your own head sometimes and convince yourself of something especially when it's inaccurately validated by professionals!!

Thanks again X

[PH123987]

Thanks for the link Bonzo, really good read x