15 week old baby won't feed properly unless drowsy - help!!

[EmC1983]

A little bit of baby context: My 15 week old daughter is combination/mixed feeding; she has 4 6-7oz Aptamil bottles and 3 breast feeds a day (the bfs total about 1hr 10mins in total - 20-30min each). She's putting on weight on the 91st centile line at 15lb 7oz and is 69cm long. So, she's taking her food in the end, but it takes a lot of persistence and distress for both her, me and my husband to get to that point!

It's been getting worse over the last couple of weeks, but the past say 5 days have been the worst! She won't take bottle or breast unless she's been rocked and patted until quite drowsy. When awake and you offer the breast she pulls backwards and when she is given a bottle she pushes it away and starts crying with both. Sometimes, like yesterday, she becomes hysterical and takes ages to calm down. I really am at my wits end, it's so upsetting and I don't know how to make it change. I've spoken to a number of health visitors this past week, with little advise other than perhaps she's in the stages of teething or she's showing preference for breast or bottle (problem with that is she takes both and only takes them both when totally relaxed and half asleep!).

Any other ideas what might be her problem? I just hate seeing her so upset and then time and upset it takes to get her to feed.

Any advise or shared experience would be a God send! Thank you.

I should add, when she's not feeding, she's such a happy smiley baby who doesn't stop playing, kicking her feet, rolling on her side, grabbing at things and chattering (cooing) away to herself, her toys and of course us. She does dribble constantly though!!

Couple of ideas - feed her earlier? Ie slightly sooner than you think she is hungry? She might not be quite so desperate and might find it easier?

Check flow rate is correct for her - there's not a lot you can do about nipples, but, for example, if your flow is extremely fast and you are desperate to feed her, she might be literally unable to cope with the flow (my boobs were frighteningly fast with let down and went from nothing to about 7 separate sprays in a couple of sucks). - equally, the opposite could be true - the flow could be too slow and frustrating for her. Maybe try with different flow teats on the bottles - it might be time to change them?

Also - have you checked for thrush? The pulling off and crying could be symptomatic.

My dd2 had issues with her muscle tone - it was higher during the day, and she was unable to coordinate suck, swallow and breathing, so in the end we did most of her feeding at night. I am certain this is not the cause for your dd - mine has cerebral palsy and lots of oromotor problems!! But I do know how frustrating it is to have a hungry baby and for her to seemingly be unable to feed!

Thanks for your reply madwomanbackintheattic, she hasn't got thrush as I've been keeping a close eye on that - she had a bit of a white tongue when she was 6 weeks old. No white on tongue or spots of white on the roof of mouth or gums.

I will try feeding her earlier than I think she's hungry. I did do that once or twice the other day and one time it helped.

I will have a look at different teats and/or bottles; she's on 2s on Tommee Tippee Closer to Nature bottles at the moment. We've tried Dr Browns bottles on 2s as well, but they took an age to feed her and she seemed to not latch properly onto them - milk coming out of her mouth. She has a very good suck when relaxed on both the breast and bottle.

If you remain concerned you could try talking to your gp. My experience of hv's was they couldn't ever get past the 'breast is best' message to offer real advice. Drs tend to be a bit more realistic. (But that was just my experience)

I would do the opposite and leave it until she's really hungry. Then don't persist just feed her what she wants. She is putting on weight well so there is absolutely no need to worry about getting her to take more.

Also its totally normal for them to have days when they are hungry and days they are less hungry so eat less. It is healthy for them to manage their own appetite.

also why does she have 7 feeds? Is she actually demanding them? Both of mine had 5 bottles a day by that age.

Thanks for all your advise ladies. I'll perhaps try new teats and stuff. I'll recheck for thrush too, but pretty certain she's not coz she feeds well when sleepy and of course I can't see anything in her mouth.

I know fully bottle fed babies have 5 feeds, but she's isn't fully bottle fed.

I know she isn't fully bottle fed. What I mean is are you feeding her on demand?

Logic tells me that four bottle feeds is actually nearly 5 and surely 3 breast feeds must be more than one bottle? . I may be wrong about that though!

EmC is your baby crying to be fed but not feeding? I am asking because from your description she appears to be having a lot of feeds. I am a former health visitor and sick children's nurse and have had a lot of experience of babies and feeding.

Hi, yes she is crying to be fed and/or rooting and sucking fingers, then she'll start feeding and pull off or push bottle out her mouth. The reason she has 4 bottles is because 2 weeks ago I took her to get weighed and they said she was on the border of not putting enough weight on at 5oz a week and so I upped her formula on advise of h v. She then put 15oz on when I had her weighted on Friday (2 weeks later).

I'm taking her to docs later coz she seems to be dribbling A LOT and I think she's refluxing too. We'll see.

Emc taking her to your GP for a check is exactly what I would do.

Hi OP
I'm afraid I don't have any answers for you but wanted to say my 19 week old has just come out of a 3 week stint of doing exactly the same. Hes EBF and it was such a worrying stressful time. Every feed felt like a battle and apart from the odd night feed he would cry and pull off and on.
Then a couple of days ago he just started to feed normally again!!
After doing lots of mn searching it appears this isn't totally uncommon. Whether teething (my DS is also very dribbly) or a growth spurt I guess I'll never know!! I just tried to stay reassured that between feeds he was very happy and he produced plenty of wet n dirty nappies

Thanks Bevelino. As a health visitor, have you come across this fussiness with feeding before? As I say, she'll have all her bottles - I make 7oz and she'll take full bottle perhaps 2 out of 4 times, rest she'll have 6oz or so. It's just she'll only take when she's relaxed and dozy mostly. Hopefully GP may shed some light later too. I've not had a lot of useful help from my health visitors in past and my usual GP isn't that experienced with babies and has said some questionable stuff in the past which has been proved wrong. It's a different doctor today, so you never know. Just want her to be as happy feeding as she is the rest of the time! :)

Thanks Dasie. It's so worrying isn't it? I'm hoping it is just a phase or part of teething. Like you, late evening and night feeds are great, it's just the rest of the time. She is doing some new things at the moment too - she's started cooing and chattering in her cot on the mornings and I often find her on her side now, that or completely the other way around to how I put her in the cot - done a 180° turn!! :) it could be a developmental stage. The trials and tribulations of being a baby...and I first time Mummy! X

Well, she's actually fed less fussily today, but not as much as she did before the weekend. Today and yesterday she had 22/23oz of formula instead of 25-28oz and 2 breast feeds. The doctor checked for ear, nose, throat and chest infections and all clear. Breathing fine and no temperature. Also no thrush. Does think gums look a little tender/swollen and potentially source of her feeding discomfort. Got Calpol to ease pain and some Dentinox gel to numb gums when bottle feeding. Fingers crossed these work a little for my baby and she'll have a better feeding day tomorrow.

Emc yes babies are all different and some start off feeding very well and then for various reasons become fussy. What is certain is that an otherwise healthy baby will not starve and will feed sufficiently to sustain themselves. If your baby doesn't feed do not worry as she will take enough even if it is less than her normal intake.

Hi there, I do apologise if I end up writing an essay here, but hope it is helpful. My ds1 completely refused to drink milk when he was 9 weeks old, after a few weeks of crying every evening with what we and the HV thought was colic. He was admitted to hospital with dehydration and given some gaviscon for possible silent reflux. It didn't get any better, and feeds consisted of 2 hours of him screaming and refusing the bottle, and eventually him getting exhausted and maybe taking a small amount. He fed a bit better at night, and I ended up setting alarms to wake him twice during the night to 'dream feed'. If he woke up and realised what he was doing he stopped immediately and screamed. Between feeds he was a smiley charming little chap, but he only had to see a bottle of formula (my milk supply dried up quite early) and he would start screaming. The hospital faffed around a lot because no-one could quite believe that he really seemed intent upon starving himself, and if I heard "he'll feed when he's really hungry" once I heard it a dozen times, even though he was quite happy to go 24 hours without letting a drop pass his lips.

In the end he got referred urgently to a big centre and a top paediatric specialist in feeding problems in infants. He was diagnosed with silent reflux and possible cow's milk protein allergy and ended up on ranitidine, domperidone, omeprazole and neocate formula. The condition did improve, as his inflammatory markers on blood tests came down from sky high to normal over the course of a few months, but the long period of delayed proper diagnosis and management resulted in ds1 developing a feeding phobia, which did translate into delayed weaning and I now have an extremely fussy 5yo.

I'm a GP and have a special interest in babies with feeding problems as a result of what we went through with ds1. I suffered PND with all the stress and anxiety, and remember feeling dread on waking each morning that I had to go through it all over again with the awful feeds where I felt like I was torturing my baby. My thoughts on what you have described are that the most likely cause is reflux and / or cow's milk protein allergy (there is an overlap between the two conditions), and that teething doesn't usually cause prolonged feeding problems like this. He won't feed because he either hates the taste - very unlikely with breast milk - or because he is uncomfortable. And he is most likely to be uncomfortable because one or both of those conditions is causing inflammation. My advice would be to ask your GP if he might be able to have a trial of ranitidine, and for an urgent referral to a paediatrician who is ideally a specialist gastroenterologist. GPs do vary in how commonly they diagnose and manage reflux in babies, unfortunately, largely because we have become aware in recent years that reflux is so much more common than we had thought. Your GP may want to try gaviscon initially - which helps in mild reflux but my feeling is that it probably won't help and is also constipating. I would go back after a few days if no better and ask for ranitidine, which they should be happy to prescribe because it is the next step in the NICE guidelines. Definitely ask for an urgent referral though, because early diagnosis and treatment is important. I really feel for you and remember only too clearly how at the end of my tether I felt and also how alone, because the lengthy feeds made it so hard to get out of the house and see anybody. If you need anyone to rant at anytime or think I might be able to give you advice on anything, please do not hesitate to PM me. All the best x

Sorry - after all that, one more thing to say! Has anyone checked your baby's mouth properly for tongue tie? Completely unrelated to everything I mentioned above, but could also cause significant distress with feeding.

Hi Mummyxtwo,

Scarlett hasn't got tongue tie, she was checked at birth and again at her 6-8 week GP check. She has been given Gaviscon by GP now as he believes she may have a spot of reflux. I'm relieved to say though, that after those terribly worrying few days, she's now fed normally on Monday and Tuesday - fully awake and looking around during all day feeds, yeees!!!

Yay, so pleased for you! Hope it continues that way, good sign that she is happier and more comfortable now. All the best.