Should I be worried about formula intake?

[JD180785]

Hi guys

My daughter has a CMPA so she takes Nutramigen formula and she also has reflux which she takes carobel for. The carobel stops her from vomiting but some still comes up her throat and obviously this is painful/uncomfortable. We’ve tried all the other available options.. omeprazole, lansoprazole, gaviscon and rantandine. We even tried a more hydrolysed formula, no change.

So I took matters in to my own hands and bought a cot wedge from a company called the Wedgehog. They supply the NHS so I figured it would be safe. I also cut he bottle size down to 150ml/ 5oz max per feeding so as to not overload her tummy.

Problem is that I can only get on average 700-740ml per day in to her. She should be on more than this at 5 months? She’s definitely growing because she’s already too tall for her 3-6mth clothes but she’s not chunky, not even a lot bit.

Can’t get a HV to come see me because of covid 19 and my GP surgery doesn’t have baby scales. So there’s no way of me checking if she’s gaining weight.

Did anyone else’s baby just never up their intake at a certain age or should I be worried?

I don't know what a cot wedge is in this context. Does it raise the mattress so baby sleeps on their back on a gentle slope? (We used to put the legs on a yellow pages when mine were little)

How much was baby taking each feed before you cut down their intake to 5oz? And when did you cut down, two days ago, a fortnight?

Yes it props her up so she’s sleeping at a slight incline to stop acid sitting in her throat as she sleeps. From 3 months old she was offered 6oz at every feed, rarely took more than 5oz and if she did, she threw it back up. She’s been back on 5oz bottles now for at least a month

Ah okay. I am wondering if you can pull feeds forward, closer together, still 5oz but more throughout the day?

Finally a loose gauge would be you weigh yourself then weigh yourself plus baby in arms.

Do ring your HV again. You can't do face to face but you can get direct input from a RL person.

I’ve tried feeding her Like this

2.30am
6.30am
10.30am
2.30/3pm depending on naps
7pm just before bed

I don’t wake her up before 2.30am because I want her to sleep.

Do u think I should do a dream feed around 11am even if it’s 100ml?

5x 5oz bottles isnt bad going. I think carobel also has a few calories in it... if she is growing that's good. Is she generally content? Sleeping well??

If you do manage to weigh her and it turns out she is not putting on as much as you might expect then you could always sneak a sleepy bottle in. For lots of babies with CMPI/ reflux, this is the only way... at least at 5 months you can introduce solids soon. Lots of nice fatty things like avocado etc..

I'm mostly breastfeeding so no idea about oz which is a blessing in some ways! Best way to check is wet and dirty nappies and that's what I focus on - how many do you get per day and has it changed much since you went to 5oz bottles? Babies are stressful things so from me!

if I were you I would go three hourly in the day which would give you another bottle of 5oz and I would dream feed too.

Not overloading makes sense but to get the calories in feeds need to come closer together if baby will take them, and most will. See how it goes and call for input from your hv online/over the phone. Looking at a baby will usually tell you about their gain, it sounds like yours is longer but quite lean too?

Sometimes reflux babies can have a bit of feeding aversion but ordinarily the amount needed would be increasing. If it isn’t and your baby seems a bit lean then offering more will often mean more is taken. Your hv will take you through this- it’s hard when you aren’t sure and your baby has reflux.

I just rang the HV again and she said if I was really worried I could bring Lily to a clinic and have her weighed. She sleeps very contently but does start to smack her lips and eat her hands (still asleep) at 2am which is why I get her up and fed her.

She’s a very happy content baby. Gets a bit bad tempered when I won’t let her down to play because I have to hold her up for at least 30mins after every feed. So she’s thriving in every other way. Maybe she’ll just be tall and slim (doesn’t take after me in that respect)

She’s doing at least 6 wet nappies a day and at least 1 dirty nappy. There’s been no change to that since reducing the bottle size, obvs just not quite as full as when she was taking 6oz a time

Thanks @QualityFeet I tried to do 3 hourly but she just throws up more so it’s actually counter productive. Honestly I’ve tried everything.

I’ll going to start weaning her in a week or 2 anyway but I’ve been told whilst it helps reflux babies she could still be this way up to 12months so I need more support from HV

Those nappies sound fine to me - same as my almost 6 month old. Keep talking to the HV for advice and for your own peace of mind, and maybe try increasing the amount or frequency of feeds every so often to see if she'll take it but try not to stress too much! DD was on gaviscon for silent reflux so I know the pain - she'd literally scream and go rigid a couple of minutes into a feed, awful. She'd just refuse to re-latch. I was in tears over it pretty much every feed. She seems to have grown out of it fingers crossed. I also go by if she's moving up clothes size and by weighing myself and then again holding her - it isn't very precise but gives an idea. DD is also quite long but not very chunky - it's only over the last couple of weeks that she's started to develop leg rolls (which are bloody adorable)

I am no expert but I have 3 children and they have had vastly different milk intakes. One of them never had much milk and she is still a tiny thing now at 4 who barely eats anything. She will absolutely let you know if she’s hungry. Echo a pp above, weigh yourself then weigh with her in your arms. Do this every few weeks to make sure she’s putting something on. Wet/dirty nappies and happy baby so she should be fine xx

She’ll take a bottle no problem and never refuses a fed, thankfully but I’ve noticed she’ll be hesitant to have it every 3 hrs and it just makes her vomit. The HV gave me an appointment to get her weighed on Monday so I’ll know for sure then

Also just weighed myself and then again with her and it’s showing as 6.8kg more so that’s 0.5kg gain for her if that’s even a little bit accurate at least she’s not losing weight

Your baby sounds almost identical to mine. Exactly the same issues, except she has always been a reluctant feeder. I was so stressed about getting the bottles in her, counting up every drop she had. We were told to aim for 150-200mls per kilo of body weight as a rough guide. I struggled to get her to drink 120mls per kilo a day. She was very slow to grow. She was wearing 3-6 month clothes at nearly a year. If your 5 month old is growing out of 3-6 month clothes I'd say it sounds as though she's growing well and right where she should be (I'm no expert, just some random on mumsnet but I do think it's a good guide to go by the clothes size they're in). If it puts your mind at rest at all, my child now appears to be hitting all milestones slightly early so as of yet it doesn't seem to have harmed her development.

My daughter is 6 months and takes 5 6oz bottles a day however usually only takes around 4oz.she has never went over this. Unlike dd2 who eas at 9oz bottles. She just isnt overly interested in milk. Advised by HV we spoon fed her from 5 months and she is thriving.

There is far too much emphasis on weighing babies. If your baby is happy , growing and thriving you can be doing much wrong. Follow your instincts and have confidence. I wouldnt take my baby to be weighed.
Your eyes will tell you so much more than numbers. She will be ready soon for weaning and life will get easier

I just weighed my 5 month old in a box on my digital scales, then subtracted the weight of the box. She thought it was hilarious

Hi OP my little boy is 6 months and suffered with silent reflux. No matter what we do he won’t take any larger bottles even though I hear babies his age taking 8-9oz.

I do two dream feeds to keep his oz up - one at 10pm when I go to bed and one at 2.30/3.30am to keep his oz up. Would that work? We also weaned early with a dietitian support (pre lockdown!) and it really helped his reflux. So much so we have weaned him off his lansoprazole completely.

Just be careful not to push too much on her if she doesn’t want it because you can create a bit of a bottle aversion and it’s so hard to overcome. I tortured myself over every single oz and it took weeks to get him enjoying bottles again because I was forcing/cajoling him to drink more than he wanted!

Also make really sure you have the right teat for the Carobel. I made the mistake of having too small a teat size and he angrily refused to suck for a few days until I realised.

@RoLaren that is a brilliant idea! I've been fannying around trying to weigh myself then me and dd and funding the difference!

Off to find a box!

@Pinkflipflop85 - I remember my GP telling me she weighed her baby in the Christmas turkey roasting tin!

My 6 month old will only drink about 4 ounces in a feed. He has reflux too. So I just feed him about 2/3 hours depending on if hes hungry. Hes still putting on wieght and hv said sounds fine.

Thankyou everyone for your comments. Honestly it’s hard not to stress it’s my first and probably my only baby after 7 consecutive miscarriages. She really is my rainbow baby and I just want to do everything I can for her.

@Iheartwhitetshirts I’m using Mam bottles and tried her recently on their fast flow teat which which they describe as suitable from 4 months but it almost sounds like she’s choking on the milk. Tried her every week to see if she copes any better, some days she does and some days she doesn’t.

Weird thing is I found if I make up a 6 ounce bottle she’ll only drink say 130-140mls but if I make her a 5 oz bottle she’ll drain it. Don’t know what’s up with that!

Any tips on how to get her to cope better on a faster flow teat? Or is there a better bottle? Absolutely hated tommy tippee, she couldn’t take to them at all

Also hard not to compare to my sisters baby who is only 2 weeks older than mine. She’ll drain 9oz 5 times a day, no reflux and can be put down straight after a feed.

I’m ashamed to say I want to bitch slap my sister everytime she tries to give me advice about my daughters milk intake because she has no bloody idea what it’s like on this side of the rd!

@Ohtherewearethen yea she’s too long for them but she’s skinny. Honestly wouldn’t complain as an adult but so worrying when it’s a baby