My baby won't eat

[NoIDontWatchLoveIsland]

DD is 8m old (6.5m corrected). She was IUGR and is very very tiny.

She has no appetite. For milk or food. The doctors don't seem concerned because she's just about scraping along the 0.4% line, but it just can't be right that we have to spend all our time and energy desperately trying to coax milk or food into her. She will be hungry for a feed, drink 1.5 ounces then push the bottle away (she is on expressed milk). She picks enthusuastically at solids but swallows sod all, calorie wise. She will not take a spoon.

I'm just so tired of all the coaxing.

If we leave her to self regulate, she does not drink enough in a day and we have to wake her at night to give her more.

She has been like this for about 3 weeks and it's just getting worse. She used to eat a respectable amount for her size, without much trouble.

Any tips on either what could be wrong or shared experiences if you've had a child like this?

Could she be teething? That has always massively affected my DC's appetite badly.

For weeks and weeks though? I'm not sure, she is sleeping ok (waking early though). I can't see anything in her mouth at all. She's just not interested. She's reasonably happy the rest of the time, no temperature, no red cheeks.

I sympathise as my own has always been tiny. Honestly it’s just all hit and miss at this age. You say she picks at food. Have you ever tried to feed her with your own hands? Honestly this is the only thing that worked with DS at that age.

Sometimes mine would eat fine for 2 weeks then be off food for another 2.

We might try a dose of Calpol 30 mins before her next feed, try and eliminate any source of pain though, thanks

Yes mamathebest, we've tried that. She's of the stubborn "I'll do it MYSELF" variety.

She will have a good go at finger foods, but with no teeth and the motor skills of a 6.5m old, I'm certain she is not getting the calories she's dropped from milk, from food.

That sounds really tough :( Does she eat enough solids that you could boost calories with the foods she eats- double cream in a pasta sauce, mash with lots of butter and cheese etc? Is she getting distracted during bottle feeds? DD is a monkey for pushing her bottle away to nosey at everything going on around her and feeds better in a very quiet calm room, darkened even better.

Has she ever eaten or drank ?
Does she seem dehydrated?

Trashkitten

We were doing this where possible (v hard to add double cream etc for finger foods) but felt it was almost reducing her appetite even more. We focus a lot on offering calorific nutrient dense foods - egg, cheese, meat etc.

Booboodisney
She was much keener on milk a month ago and was eaten a bit more of the food too. She isn't dehydrated I don't think, however I think if i stopped dreamfeeding extra milk in over night, she would be nearer dehydration within a couple of days.

I also have an IUGR baby who has had severe issues around feeding (although it was never a problem with milk). If you are in the UK there is an IUGR support group on Facebook that you can request to join and there is also an international (mainly US) one. I would recommend posting on these groups for advice from people who have been through similar situations. All the best

Thanks WorriedFTM1

I'll look it up. I wouldn't worry about how she's doing on solids, I think it's reasonable for her age, it's the big drop in milk that stresses me :(

My DS was like this and it was silent reflux. Try some infacol and see if this improves her appetite. I have reflux now and its made me so much more understanding of how ds must have felt as a tiny baby unable to articulate the discomfort it causes. he always liked really cold drinks as this was more soothing that warm milk. we discovered this when we accidently just gave him the bottle from the fridge and he drank it all.

How does she look? Is she pale? Dark circles under her eyes? DS2 was like that, barely ate and just scraping along the 2nd centile. He had a B12 deficiency, the health visitors picked it up. A week or so after drops with B12 in he was a different baby.

To add- he was EBF and wouldn’t touch formula. Breast milk can be low in B12, if your DD is on expressed milk it could be that

Iloveplacentas this is interesting. I will ask the GP if this can be checked as she has had anaemia before & had to have a blood transfusion.

Yep she is on breast milk only.

Mummymeister she does have silent reflux but is on omeprazole (has been for ages) and I don't think it's that, before she was treated there was SO much screaming and it's not like that now. We do also use infacol as she is rubbish at burping (her brother was too, never affected him troughing up everything though).

Iloveplacentas, are you veggie out of interest? Were you b12 deficient too when your DS was? Internet seems to think b12 deficiency in BF baby usually starts with mum being deficient....

Fat, while very important is highly satiating and she will feel full very quickly.

Starch/sugar/carbs will stimulate appetite, trigger insulin (which will store fat) and trigger the growth hormone.

Does she like Fruit? Carbs?

Morningstar

This was one of the reasons we stopped adding cream - we felt it was overfilling her.

I try to get fruit & carbs in as much as possible. The challenge is she just isn't actually consuming enough of any of it.

Have you seen a dietician? My tiny prem baby who practically dropped off the charts was prescribed something called infatrini. Was a very high calorie milk, it really helped (9 years later he’s still very skinny but tall enough and thriving). It’s so worrying though I remember charting all food/milk.

my son was on omeprazole and other drugs but even now (older teens) he still suffers really badly with reflux and I can tell when its bad almost before he can because he starts being picky with food. it doesnt give the classic heartburn symptoms but disturbs his sleep and he loses his appetite. often as with him its a combination of things and you just have to get a number of experts involved and try lots of different strategies. he wasnt prem but he lost huge amounts of weight, dropped off the scale and was in hospital tube fed for a while. good luck its very worrying.

Thanks mummymeister

We were hoping the reflux was getting better now she's sitting, she been sleeping through etc, I'm really still desperately hoping this is just a real rotter bout of teething.

It doesn't help that my son ate everything, I don't have a useful benchmark!

Hippofrog

Waiting on appt with dietician. We've had a fortifier called duocal before but I felt like it just means she drinks less. I wish there was a way to truly increase her actual appetite, rather than find ever creative ways to get the same calories in via different routes

I have tiny one who hardly eats. At almost two, he is still in clothes of a 9 month old. He has never in his life finished 200ml of milk in a day. Finishing a 150ml bottle? May be 5 times. Been to GPs, dietitian etc. I have now relaxed. He is a happy boy who talks our ears off. I was told someone has to be on the last percentile and another on the top. As long as they follow it and not plateau. The worry never stops but am now 99% less worried than before.

Is she otherwise happy and active? As for cream, don't worry about over filling her. If she eats very little this will boost the calorie intake which matters more than filling full iykwim.
The suggestion to join iugr FB page is good. I joined a failure to thrive group and though the experiences were very different, it was comforting

Good luck

My DD was like this (still can be) she and her twin brother were prem, he’s always been a tank, she ate like a bird (it’s just and I mean just started improving at 2.5yo).

If your DD has no teeth yet, it could be that they’re starting to shift under the gums, my twins only rooted and did so for a few weeks before anything started to show.

As for milk, have you tried switching her onto the next teat size up? I found Mam teats (number 2) were the best for my DD from 6 months corrected onwards. She moved onto an X teat at roughly 15 months.

If you’re worried about getting the right nutrients in (as I was) would she be tempted by a sweet smoothie? I started making mixed fruit milkshakes (with formula to begin with as DD was on Infatrini) when appetites dropped (and even managed to sneak in some veggies like peppers, toms and such).

I hope your dietician can help more - my twins are now decent in size (just starting to wear 18-24mo clothes) we did have to rely on high calorie formula to get them there but now they have fairly decent appetites so it can get better 😊

Thanks ginger

We are wary of overdoing it on cream etc as if she doesn't get enough liquid in she could get constipated.... make her even less hungry