What's going on with my newborn?

[NewGiraffe]

I am a brand new first-time mum and completely clueless about pretty much everything! I have a gorgeous 2 1/2 week old who is behaving slightly differently this last few days - Hopefully all normal but just wanted to check. He has a number of different “symptoms” and I don’t know if they are related or not.

Also, just a couple of contextual things- he was underweight at his 5 day check and we have been doing a feeding plan to get his weight up. His weight was checked end of last week and he has gained loads, and has now been discharged from the midwife care in terms of the feeding plan. We’ve now been told to just feed as normal now, so on demand and every 4hrs at night.
He is combination fed EBF and formula.

Current behaviours / “symptoms”:

1.	He has been much harder to settle after his feeds than he was for the first fortnight. He took <strong>ages</strong> to settle the last two nights after his last feed and before bed and kept asking for more milk. He was getting really tired and frustrated but wouldnt settle without more milk. As he is combination feeding I am cautious about over feeding him, as by that time the breast milk had run out and it’s formula he’s having. I’m unclear about whether it’s possible to overfeed him as he’s combination fed. Midwife and health visitor seemed to offer conflicting / confusing advice on this point. However I’m still aware that he was underweight until recently so I don’t know what’s right. My elderly relative told me it’s fine and I should “fatten him up for winter”! 
2.	His appetite has <strong>majorly</strong> increased. I think this is normal and okay because of growth spurt? But he is really wanting to guzzle the milk I am trying to make sure he drinks slowly takes breaks and gets a good burping. He is drinking at least 120 ml each feed in the daytimes. (every 3hrs in the day). We would like to try and get him into more frequent slightly smaller feeds, if that’s sensible. 
3.	He has a stuffy nose which seems to be partially blocked and is causing him to breathe quite loudly at times
4.	He has been experiencing reflux with little bits of milk coming down his nose and out of his mouth after feeds. It’s a bit distressing to see but I think it’s common?
5.	He makes a grunting pant type noise when he is feeding sometimes- maybe to do with blocked nose and / or reflux? 

Hopefully someone can help? Thank you! X

This all sounds completely normal for a new born. They change rapidly, daily even. You think that they've settled into a routine, then it changes again. The snuffly nose is normal too, iirc.
Milk needs will increase quickly, too. Is there any reason why you need to give more formula rather than breast milk? Are you expressing, rather than feeding directly from the breast? The baby may be trying to increase your milk production by feeding more, but if the extra comes from formula, then your milk production won't increase. Nothing wrong with giving formula btw.
Congratulations on your baby x

Babies cluster feed at this stage, due to growth spurts and to increase your milk production. If you're able to, I would try and mainly breastfeed until he's settled into more of a pattern and so your milk doesn't decrease. Everything sounds very normal though.

Sorry should have clarified that. He's been unable to latch. Being investigated for posterior tongue tie. So I am bottle feeding mainly breast milk and pumping to boost supply

Mine did this. I found infacol worked well and lots of burping between feeds. It will get better.

Thanks @pinkblossomdreams I haven't heard of that before. Just looked it up. Would it be okay with the reflux he's getting too? X

I'm no expert but I found it really worked with my two and their reflux during feeds. The thing is you have to see the next 3 months as another trimester of the baby's development in terms of their developing digestive system. I found it very stressful the first time round as it was all so knew!

Things change regularly but if it doesn't then maybe you Might needs more support from the dr. This happened to a friend of mine and eventually they were diagnosed with lactose intolerance.

For all 3 of mine they started to get more "windy" from about the 2 to 3 weeks mark and taking longer to settle. All sounds really normal to me x

My DD is two weeks on Tuesday, and had her posterior tongue tie snipped last Weds. I was told that reflux can be related to tongue tie, and that it is a symptom of something else as opposed to being an issue of its own. She dribbles lots too. She is breast fed but we are using nipple shields 24/7 still at the moment. She is grunty during feeds and I've got a noise sucker thing for her boogers. I think a lot of hers are milk boogers!

We have another weigh in tomorrow (day 13) as we are still waiting to be discharged. Not much help really, but I can empathise.

" (every 3hrs in the day)."
Why be so strict? Feed him when he is hungry. Whatever is too much will come out - usually lands on your back, soaking your heels even. :)

Everything else seems totally fine for a newborn.

Ok, if you can, try pumping more frequently or for a bit longer each time to increase your milk supply. Strangely, this doesn't seem to make the process take too much longer, once it's built up a bit you can pump loads in the same amount of time. Keep trying to latch as well, I found two of mine suddenly got the hang of latching after a few weeks when they couldn't at first.