Am I feeding my formula fed baby incorrectly?

[user2233]

AIBU to now think I'm feeding my baby incorrectly?

Hi,

I had my baby at 37w2d and she weighed 2810g at birth. She's now almost 8 weeks (tomorrow).

I've included her weight chart for reference.

Up until the last two days I've been feeding her 2oz every two hours but it seems as though recently she's been wanting more as she's finishing her feed completely and crying for more straight after. I'm trying to now up her feeds to 3oz but my issue is she's still wanting to be fed every 2 hours. Surely 3oz every 2 hours can't be correct for her weight?

Background information:

She has a suspected CMPA and is currently drinking prescribed milk m

What do you do at night? Do you wake her every 2 hours for a feed or let her sleep
For reference I have a 7 week old on 5oz every 3-4 hours in the day, he does 6 -7 hour stints at night before a bottle

My HV was always talking about over feeding..don't worry too much..give a larger amount and see how this goes. Baby will adjust to feeds and take what they need.

I’ve had two babies with CMPA - one who vomited constantly and the other with silent reflux and diarrhoea.

I remember reading that they digest the dairy free milk much quicker than usual formula and it sounds like baby is hungry. I never used a chart with mine just fed them as much as they’d drink - always making sure a bit of milk was left at the end of the feed so I knew they were full.

If you think baby is still having issues with CMPA you can get further dairy free milk with the protein broken down even further (DS1 was on Nutramigen but DS2 needed Neocate Syneo). So don’t worry if you don’t think the first milk you try has completely solved it!

"Paced feeding" sounds like feeding on demand and common sense!
Pretty sure at 8 weeks mine were draining 6 ounces every 3 hours

If she's more settled then definitely try upping it at least an ounce and see how it goes. Don't worry too much about overfeeding....if baby is hungry she's hungry!

She needs larger volumes. She will go longer between feeds once she is satisfied per feed. 2 hourly feeds at 8 weeks is unsustainable.
Her weight gain this last month has been quite slow and I expect she is being under rather than over fed.
She is bigger and more robust now that you can feed responsively.
id continue to have her weight monitored to ensure growth.

Paced feeding is where you prop baby up, keep bottle horizontal and make sure they are actively sucking to get the milk instead of pouring it in. It helps them take as much as they want/ need and reduces the risk of overfeeding- my baby would then turn her head and pop off when she was done.

2oz is a very small amount - that's how much I was suggested to give my baby as a top up after a breastfeed at that age! When after a shite Bf journey I finally stopped trying to latch her around 8-9 weeks and she would have 4-5 Oz, 3-4 hourly. My pals babies were chugging 7-8 Oz by then!

Thank you everyone.

I think I've gathered that she was being underfed. I was concerned and mentioned it to the HV but she said it's likely her being fussy due to the CMPA and not to over feed. However, like you're all saying I think I should go off of what baby wants as opposed to what HV says.

3 oz every 2 hours seems quite a small amount, but my youngest is almost 10 so it's been a long time since I've had a young baby on formula lol.

I'd go with the flow, babies are not generally greedy, they take what they need. If she wants more, give her more!

HV know naff all about infant feeding, take what they say with my pinch of salt.
I say this as someone with a HV in my friendship group- they are very nice but they mainly do developmental milestone checks and safeguarding reviews. They really don't know a lot about the practicalities of having an infant! 😂

I’m sorry, OP but your HV is a moron. You can’t over feed a newborn. Babies are intuitive eaters, they know when they are full. Your baby wants more milk. As a PP said, there should be milk left in the bottle at the end of a feed when the baby is full and stops.
The new milk should help, but if reflux continues then you should look into your prep method (TT perfect prep machines and the like are the worst for reflux), pace feeding, and the bottles and teats you are using. If you’ve eliminated all of these things you can consider an oral assessment as there may be a lip or tongue tie impacting their feeding. Unfortunately HV and midwives are not experts on this, and when you formula feed the NHS don’t want to know as long as your baby isn’t losing weight, so you may need to go privately for this.
First things first though, definitely up baby’s feed if they are hungry.

8w usually have 4/5 oz every 3hrs

Obv all are diff so it's a rough guide

2/3oz isn't enough and if crying /unsettled as hungry

Rough guide is 2.5/3 oz per lb of body weight over 24hrs

Or

150/180ml per kg of body weight

I'm Old school so your babies weight is 3800g is 8.4llbs

As a guide if a Baby finishes the bottle and looks for more I make an extra 30ml/oz and for next feed make the bottle bigger

@Omma23 thank you. Yeah she said that a breastfed baby can't be over fed BUT a formula fed baby can so I should be mindful of that. However, based on her cues, it makes sense to up the volumes of her feed. I just wish that the midwives and health visitors were more helpful. Even for the CMPA I had to really nag and nag them to get them to take us seriously. The majority of the professionals I came across kept saying 'her digestive system is just immature, she'll grow out of it'. Until I called 111 out of hours and the GP I spoke to did a questionnaire and said that she has scored high enough to be put on prescribed milk!

My room of bottle feeding was I was happier with a small amount of waste. If she is finishing off her bottles - she needs more. Also feeding every two hours at 8 weeks is still very frequent. Do you feed on demand or are you setting alarms all night to feed?

I found with both my bottle fed babies who were both very different that feed sizes increase but frequency reduces. Overall milk oz over 24 hours is what I would count.

If you have been told to feed every 2 hours - ignore me - otherwise for my babies - I fed on demand.

Also - I found it impossible to force feed a baby. If they are hungry they feed.

She'd barf it all up if you were giving too much!

It's hard when it's your first, but your instincts were right. I'd double her bottles (for reference, I remember my tiny 36 weeker twin having 1oz at less than a week old and guzzling it down - they were both definitely on 4oz each and maybe more at 9 weeks!) and take it from there. You can start aiming for more like 4 hours between feeds.

OP have you got a walk in clinic with your HVS near you, it'll be easier for you to talk to someone face to face.

Normally it is recommend to feed babies on demand not on a set schedule and if and when baby starts draining the bottle you increase by 1 scoop e.g. 90m to 120ml, they may drain some but not all of these sizes bottles, keep an eye out for feeding cues

As you have had issues and prescription milk it would be better to chat to someone to discuss this face to face, after all that's what the HV service is there for. Our local one offers a weekly weigh and advice clinic

Paced feeding is a method of feeding that mimics breastfeeding patterns

Also one clear clue i had was when her hand/fists were clenched she was hungry and they relaxed as she fed so unclenched was a sign she was full

My wee one, at a few weeks old, used to cry after feeds and wouldn't stop. I was feeding her the recommended amount on the formula packaging. I wondered what was wrong and tried everything nothing worked. Then one day I decided to up the amount of formula I was giving her. She was a new baby after feeds, so content. I felt awful, like I'd been starving her, but I just blindly went with what I was told to do.

My point is, babies don't always stick to 'the recommended amount'. Some need more. Just see how she gets on with a little more. She'll stop if she's had enough.

Our baby was in neonatal for a few weeks and the doctors told us that up to 12 weeks to use this calculation:

150ml X weight (kg) / number of feeds a day

= 150 X 3.8 / 12 = 48 ml

But I agree with everyone else that if baby is happy eating, gaining weight along the percentile line and not being sick then it's probably fine. Maybe check with your health visitor x

However if the child had more in each bottle it probably wouldn't need a feed as often. That's only really useful for working out the requirement in 24 hours.

I found feeding amounts so tricky!!!

HV told me when my baby was draining his bottle, to up it...which I did....which resulted in terrible reflux. She was having about 6oz at 6 weeks old...maybe even before then.

Went to the doctor about refluc...doctor said was feeding too much un one go and have this guideline:
at 2 weeks - 2oz feeds
3 weeks - 3oz feeds
4 weeks - 4oz feeds...and to leave it 4oz feeds until 5 months...then increase by 1oz per month. So, 5 months - 5oz feeds, 6 months - 6oz feeds and so on.
But, he said if baby was hungry, to feed more often...mine needed feeding roughly every 2 hours!
We did follow this guideline - the reflux stopped immediately and baby was happy and also a good size (too big if anything).

Every baby is different though!

@user2233 The only time you can over feed a baby (any baby) is when there is a medical condition (some types of hernias etc.) that stop a baby becoming full. Otherwise when they are done they will just stop.
Still feeding every two hours you poor thing! Hopefully that time between feeds increases with larger bottles.
At 8 weeks your baby should be having approximately 25-33oz milk per 24 hours, so 2oz every 2 hours is still under this, not accounting for growth spurts etc. where she may need more.
Definitely try letting her lead. She may naturally want fewer, large bottles. By giving her more milk each bottle and tracking how much she takes, in a few days you’ll see she’ll be slap bang in the normal range for her age whether she has fewer large bottles or many smaller bottles. Either way she’s feeding as much and as often as her body is telling her.
Well done for pushing to get her milk changed. The “professionals” can be so hit and miss and advocating for your baby is so important. Well done for having the confidence to do it. It’s not always easy when you keep getting fobbed off by people who should - in theory- be more knowledgable than you.

Hi op my DS was premature and had awful silent reflux and we had to increase feeding slowly. We were still feeding 3 hourly at 5 months old on paediatrician advice. I think the main thing to remember is you won’t hurt her by giving a bit more milk for a day or so even if she’s a little bit sick. I would build up volume slowly if her tummy is sensitive. Add an oz per feed and see how she does or similar.
You will then have an idea of what she can tolerate. And you can always reduce it if needed (we had to do this a couple of times, it was a real battle between managing the hunger and pain/sickness/symptoms).
I really feel for you, it’s really tough when they are feeding in that pattern.

My best advice is, be led by your baby. Some babies will want to feed little and often and some will want to have larger amounts less frequently, and the same baby can feed differently on different days. Look for hunger cues and offer them a reasonable sized bottle (so 3 or 4 oz, as you say they're already draining a 2 oz bottle). We used to offer a small top up of 1 or 2 oz if they drained their bottle and then we would increase the size of the bottle at the next feed. They will take what they need. I don't think it's possible to overfeed, as long as you let them stop sucking when they want to stop, by turning their head away for example.

My DC (now 3.5yo) had very bad reflux in the early weeks. It stopped suddenly at about 8 weeks. After a few months, we got a TT perfect prep machine, which was brilliant and we didn't have any issues with reflux from it.

Take the recommended amounts, calculations, advice, etc with a pinch of salt. Your baby is your best guide. And trust your instincts.

Good luck!

I fed DD little and often at the beginning as she had bad reflux so she was on roughly the same as yours and I gradually increased it so she started to go longer between feeds. Even now though she's just reached 9 months she's never drank more than 6oz in one sitting she still much prefers little and often (including with food). I'd just follow babies lead, make 4oz and see how much she takes, if it's too much she'll bring it back up and you'll know to cut it down a bit next time but don't worry about over feeding, babies will generally stop when they are full, if they are taking it then they need it.

My baby was soon draining the recommended amount of formula in no time at all and looking round for more. I asked my GP if I should up the amount and he said "no, baby's tummy is only the size of a walnut". Well, 'Baby" hadn't got that memo and was hungry! They also wanted to feed every 2 hours on the dot. Didn't matter if they were playing, sleeping whatever, when they were hungry they had to eat or they'd become distressed.
I was worried that this pattern would lead to poor eating habits/obesity in later life but this wasn't true at all. As PP have said, babies are instinctive feeders not greedy.