3 month old refusing feeds - is it silent reflux?

[BaffledQueen]

I'm having trouble with my 3 month old baby not feeding. Since birth he's not been feeding as much as he should. He was born 9 pounds 10 oz and was on the 75th percentile. I didn't get him weighed for a month then found he'd dipped halfway between the 50th and 25th. I weighed him at home yesterday and (if accurate) it looks like he's now on the 25th. HV has initially recommended giving an extra feed in the day to bulk up but he has slowly been reducing his daily intake. We are lucky if he feeds 20oz a day. Apparently he should be having about 30.
When he was born we thought he had mild reflux (had experienced this severely with first born) so with advice from HV went onto Aptamil Comfort which was working well. That was until 2 weeks ago. Now he cries when he's presented with his milk, or he might have a few ounces and refuse anymore. There are many occasions when he will only take half an ounce or none at all. Giving him an extra feed has not worked out well, and nor has the advice to feed little and often. He can go hours without milk.
I am not concerned at the moment with his development as he is hitting his milestones, is alert and playful. However, I am concerned that if his intake is not enough, he might not thrive and may end up in hospital.
I am wondering if he has silent reflux which is causing him pain, and now that he's getting bigger if he has made the association between pain and a feed?

I've got an appointment with the paediatrician on 22nd but that feels like an age away. I think I will return to the doctor but not sure what to do in the meantime. Speaking to the HVs is no longer an option for me; I was fobbed of by a couple at the weigh in clinic last week and my actual HV is hard to get hold of.
Anybody got any ideas? Thanks.

Hi op, does he have any other symptoms? Is he unsettled after feeds etc?

Can you try upping his teat to a faster flow teat?

It would be unusual for a baby to have feed aversion as the only symptom of silent reflux but it is a possibility

Thanks for your reply. As soon as the bottle is taken away he is okay. I've noticed during his night sleep he seems a little unsettled and will turn his head back and forth very quickly.
We're on number three teats. We tried number 4 and variflow as well. We've been using a combination of doctor browns and tommee tippee bottles - does not seem to have a preference.

Babies with silent reflux tend to be unsettled in between feeds as the reflux tends to happen after a feed. Does he have loose stools or any rashes? Do you think a cows milk allergy could be a possibility?

He is quite happy in between feeds, whereas my daughter was miserable all the time for the first year of her life because of her reflux. So you might be right in that reflux is not the problem here.
On a number of occasions his stools have been very loose. I have mentioned this to the HV and doctors during check ups before but they said it was normal. Sometimes he has a bit of a rash but I've put this down to teething. I did wonder if teething was the cause of our feeding problems but now not sure. I've tried giving cooler milk or rubbing teething gel on gums before feeding but that hasn't helped either.

I am following with interest here as I had just come on to ask the same question!

OP, I hope you don't mind me jumping in here. My DD is 4m old and this week has really dropped the amount she is taking. She has diagnosed reflux and is on gaviscon and ranitidine. This seems well controlled and her current symptoms do not reflect those she had prior to reflux treatment. She is also on lactulose for constipation which is worsened by the gaviscon.

She had bronchiolitis at 11 weeks and was in hospital nil by mouth in hdu for a week. Getting feeds back up was an effort but she was hungry and wanted it. After two weeks she was back up to 6oz. A week later (now) she isn't finishing any bottles. Mostly she will take 4oz, sometimes only 2 or 3. She also thrashes her head from side to side.

I am concerned she is hungry but she doesn't actually want it. I wondered if she could be teething as she is vigorously chewing her fingers all the time and dribbles like mad.

Any advice would be welcome.

At 4 months she might need a faster teat?

Already moved up to size 2 teats.

Oh right, I just remember mine used to go off bottles when they needed to move up a teat size

I put her on size 2 teats a while back but now wondering about variflow.

The formula pack states she should have 5 feeds of 7oz a day (she's 4 months on 16th). She usually takes 6oz and still has 7 feeds a day as she feeds twice in the night still. She usually feeds three hourly but now I'm wondering if moving it to four hourly may help. So currently as she has reduced her intake she's having 7 feeds of between 3 and 5 ounces. She was 7lb 1 at birth and is now about 15lb - due to get her weighed on Tues.

Again, any advice and recommendations would be brilliant because I have no clue what I'm doing.

Hopelesslyhopeful - has there been any improvement? We seem to have turned a corner at last. I hope you have too.

Yes I think so! I think it was her telling me to move to four hourly feeds not three. We've moved to four hours and she's taking her usual amount and seems better in the night too. Fingers crossed.

Glad to hear youve had an improvement. So hard not to be concerned isn't it.

Most importantly, which I entirely forgot to mention, is that we have stopped her gaviscon. Even in conjunction with lactulose she was producing hard stools. She did a huge congealed vomit and I think she was just totally congested with undigested gaviscon and full of poo.

Since stopping the gaviscon she has opened her bowels much more satisfactorily and is happier and has definitely increased her feeds. Two nights ago she demolished an 8oz bottle before bed and slept through completely.

Wow! I'm glad it's all going in the right direction.