Am I overfeeding?

[Teenybooboo]

Long time lurker but first time poster..please can someone give some advice/reassurance.

Background: My baby is 20wks old today and ff on demand. He has silent reflux so has Gaviscon infant and started a couple of days ago on Ranitidine.
He is on the 50th percentile for his weight and I have started weaning.

We went to baby clinic today and the HV said to me that I am over feeding my baby that's why he is being sick, he has 5oz milk 5/6 times a day and weaning has 5 spoons of veg/fruit(the little tommee tippee ones) 3 times a day.
She has written in the baby's red book that I should cut back the weaning to twice a day but give more food at each sitting.

I have really had my confidence knocked as the baby seems to coming along great with the exception of the sickness (he is not bothered by it at all)
and I'm really not sure what I'm doing right/wrong, am i supposed to cut back on his milk? (which seems ridiculous and I will not do, as I cannot let him cry because he is hungry) and why is feeding more twice a day better than less 3 times a day?

Would appreciate any advice or thoughts

I might be mistaken but I didn't think silent reflux had anything to do with over feeding. (or under for that matter)

I was also under the impression that it would be better to cut back the milk rather than the food, since the point of weaning is to replace the milk with solids. If the solids are replacing the milk then he won't be hungry,

maybe as your lo is less than 6 months she feels you are giving too many solids at the expense of milk. The milk intake sounds fine as a minimum of 20oz is recommended from 6 months alongside 3 meals so 25-30oz is fine at only 20 weeks. Dont cut back on milk and try not to give too much food as you dont want the milk intake to drop further

no, please dont cut the milk intake of a 20 week old baby!

Hi
Thanks for the replies. Rest assured I wasn't going to cut back on the milk regardless of what she said. I was just confused that she said that I was overfeeding but then basically told me to only change the way I give the food.

Sometimes he has 5 bottles sometimes its 6 really its up to him. I haven't cut back on his milk at all, just added some food in. Maybe this is what she means by the overfeeding?!

So baby is having 25-30oz of formula and probably 3-4 tablespoons in total of low-cal veg/fruit purée a day - is that right?

Has baby shot up from a low percentile to the 50th%ile (so crossed more than 2 percentile lines)? Or is his length percentile not close to his weight percentile (e.g. 50th for weight and 0.4th for length)?

What does the paediatrician say about baby's weight gain/growth pattern? Have they raised any concerns with you?

I really wouldn't worry about restricting milk intake in a under 6m baby - breastmilk or formula milk should be the major single part of a baby's diet until 12m so at under 6m you certainly don't restrict milk (unless he was taking 60oz a day and gaining vast quantities of weight perhaps then you'd consider not giving as much!).

Silent reflux can lead to baby overeating as the swallowing of milk/saliva can ease the burn of the acid as it comes back up but then you'd see huge quantities of milk being drunk not 25-30oz which is a pretty normal volume tbh.

'So baby is having 25-30oz of formula and probably 3-4 tablespoons in total of low-cal veg/fruit purée a day - is that right?'

Yes that's exactly right

He has been on the 50th for weight since birth and not strayed from it and has only been measured once at 8 weeks when he was 56cm (9th I think).

No-one else has mentioned anything, the Dr thought it was reflux rather than overfeeding, but told me to mention the sickness to the hv, to see what she thought!

But if you were over feeding then surely he'd be gaining far more than he needed to so would be shooting up the centiles? Or does the HV think he is managing to vomit up exactly what is extra?

Is he sick as well as in pain? Silent reflux is where there is no visible vomit, the acid/vomit just travels up part of the oesophagus but doesn't come out the mouth (hence the 'silent' reflux) but causes pain in the patient - in babies they tend to scream on laying flat, prefer to be on an incline or upright, arch their backs a lot, sneeze/hiccup more than usual, and generally be very grumpy and uncomfortable. Ordinary reflux is where there is excessive vomiting as well as the other symptoms.

That's what I thought would be an obvious symptom to feeding too. His weight gain is exactly on the line, so I was very happy with that and had no concerns until she mentioned it today.

The doctor said it was silent reflux but based on what you have described above it is neither. Basically what happens is after his first feed in the morning he is sick, doesn't bother him at all, he carries on smiling, he opens his mouth and the milk just comes out. Then for a little while after he is randomly sick again, no crying, doesn't look in pain, but comes up more like rice pudding (sorry tmi) which is what the Gaviscon does. Then starts all over again from next feed but it gets less as the day goes on.

Erm, it sounds like your DS is what's known as a 'Happy Spitter' (spit up being the American term for posset/milk sick). If he's not bothered by it and it's not affecting his weight gain why risk the side effects of meds?

This is an interesting read - it's guidance from an NHS trust re. reflux and I quote 'The main aim of any treatment is a happy thriving baby. It is not always possible or necessary to stop all the vomiting.'

When I think of the trouble I had getting DD1 diagnosed with reflux 6 years ago even with faltering weight gain for weeks then weight loss, extreme pain, constant feeding (1 3/4 hour long feeds every 2 hours), copious vomiting while screaming, I can't believe how the tide has turned where a Dr is medicating a happy even though they are sick, growing well baby .

I'd go for a 2nd opinion tbh or push for a paed. appt rather than seeing the GP.

Thanks for the advice, think I will go and see a different doctor for another opinion. The Gaviscon definitely does help to reduce the sickness though.

Sorry it was so hard for you to get help, I think the guidance for GPs may have changed as when I went to clinic there was 5 other babies there and they were all on Gaviscon & Ranitidine either that or the doctors at our surgery are too quick to give meds.

She's fine now - very tall and slim 6y She had Gaviscon which did nothing bar constipate her so was switched to domperidone (aka Motilum) which worked wonders for her.

Glad the Gaviscon reduces the vomiting, I know it's the first line drug for reflux babies, and 6y ago anything other than Gaviscon had to come from the Paed as GPs weren't allowed to prescribe off-label reflux meds to children (or didn't want to accept responsibility for off-label use). Did the Dr talk through positional help with reflux?

This quite a helpful website with lots of supportive info (a lot of the reflux websites seem to have a commercial interest so can't be really be trusted to be impartial).