Baby drinking less than she “should”

[Kped]

I have a 10 week old girl, she was breastfed for 6 weeks at which point we switched to formula feeding. She has suffered from silent reflux and so dropped from the 50th percentile at birth to between the 26th and 49th percentile (so only a little drop).

The HV and doctor have told me a minimum amount she should be having each day, currently this is 760ml. However she never takes more than 650ml in a day - she no longer seems in pain she just doesn’t seem that hungry. We have tried to feed her every 3 hours but she will just refuse unless we wait for her to be hungry - this can be over 4 hours. During the night I try to dream feed her. Last night she took 40ml at 4am and now at 8am she only had 30ml - how can she not be hungry?!

She will however take 4oz sometimes in the day if she has gone 4 hours. My question is do some babies need less than what the guidelines tell us? She was weighed yesterday and was progressing along her percentile.

When she is awake she is alert and happy, plenty of wet and dirty nappies (although there is now a green tinge to her poo)

Sorry for the long post - everyday I feel so stressed that she is miles off what she “should” be drinking!!

Some babies take more and some babies take less than what they 'should'. As long as they are gaining and growing then they are taking enough.

What weight is she?

She doesn't know what the guidelines are. If you were breastfeeding you'd have no idea how many oz she was drinking.

If she is healthy, alert and gaining weight then you can feed on demand.

She is 11lb 4 at 10 + 3. Yeah I’m starting to realise the guidelines are doing me more harm than good! Just so unsure as a first time mum but I have seen older posts similar to this!

Her hunger cues have become less obvious now as she really sucks her hand whether she is hungry or not!

Could she have feeding aversion caused by the reflux?

Shouldistop - I have thought this, and so I hope as the reflux seems better now that she will pick up. For this reason I am now avoiding force feeding her but it means she does have a lower daily intake!! Any ideas on how to get past a feeding aversion?

Some things I've read are trying to feed when very sleepy or to sit in an office chair holding the baby securely, get someone to spin it round then give the bottle straightaway when baby is a bit disoriented.

If she does have feeding aversion then once she's past 16 weeks your doctor may recommend early weaning but obviously only do it on their advice.

Very similar situation with 18wo DD2, though FF from birth. By 6 weeks she was getting fussy at feeds, but as my eldest had severe reflux I assumed DD2 didn’t because she didn’t vomit up every feed and could be laid down flat. By 10 weeks she was practically refusing all but 1oz of each feed and screaming hysterically when we tried to give her more, yet was super content and smiley between feeds. She dropped two centiles, was seen by two different paeds who could only suggest maybe silent reflux. Managed to improve feeds by a combination of changing to goat milk and omeprazole, but she’s still not taking anywhere near what she should. A good day is 18oz. A bad day is 11oz. No one can give us a medical explanation for this, and we’ve just been told to persist but if she drops below 10oz a day she’ll have to be tube fed. She has a weigh in next week so fingers crossed she’s gained a little by then.

She’s content and smiley, sleeps badly but that’s my genes I think. Poops every other day and wets a good amount of nappies. She just now stops feeding after 2oz each time, and resolutely will not take any more until three hours later. I’m baffled. Like you say OP, surely she should be hungry and unsettled? Surely she should be asking for milk much sooner?

It’s all a mystery and I’m sorry you’re going through the same, but it helps to know it’s not just us.

Sorry to hear you’re going through this! I hope she gains and avoids being tube fed. Have they suggested early weaning yet? I’m concerned that we will still have an issue with solid foods.

Last night whilst asleep she dream fed 2 4oz bottles - this makes me think it could be a feed aversion as she was clearly hungry to take that but maybe didn’t realise she was being fed!

Our GP is reluctant to do anything at all at the moment as she has been gaining along her percentile (after dropping from the 50th) but I can’t see how she will have gained at the next weigh in?!

I was super skinny as a child and had a tiny appetite so I do wonder if there is some genetics behind it (or maybe I’m just wishful thinking that this is normal!)

Yes a friend of mine’s son apparently had a huge oral aversion due to untreated silent reflux. I’ve seen photos and he looked terrible. Essentially lived off Petit Filous until he was almost 18 months, despite intervention from a feeding specialist. He’s now a strapping 14 year old, but my friend says it was hideous at the time and she thinks that the reason it got so bad is because she was so young when she had him that no one listened to her.

However, as she pointed out to me, her DS was clearly hungry and unsettled, just refused to eat. It sounds like your baby is similar to mine and just seemingly has a teeny tiny appetite - unless there’s something else going on, though I’m at a loss as to how one would find out. A feeding aversion would make sense after SR, but then surely they’d be hungry constantly?

We weaned at 17 weeks for my eldest in order to stabilise her weight, since she threw up most of every milk feed. I remember much of what the dietitian got us to do last time - fortifying with formula, high calorie first purées like banana and avocado - so if I don’t get anywhere soon I’ll give it a go with DD2. It’s like you say though, what if they’re not interested in food either….

Solidarity!

Are you adding thickener or gaviscon to manage the reflux? When my DD had gaviscon added to her bottles she drank less... I don't know if it was taste or if it was more filling? Stopped the gaviscon a week ago (wasn't working anyway) and her milk intake has increased.
Also, I believe that babies should be taking 150-200ml of milk per kg per day. Is that where the Drs figure came from?

The Australian guidelines are much lower, so it's all a guesstimate. If you get stressed about it and try to force it you could end up with a feeding aversion, which is a special kind of hell. Good luck - just try to relax and be responsive.