CMPA 5montj old refusing bottle- help!

[miniworry]

Please help I’m going out of my mind with worry. My 5 month old formula fed baby has never enjoyed his milk and it’s been a battle to get his milk into him as soon as he went onto pepti 1 for CMPA, even with Nesquick in. However he’s averaged around 22 ounces per day and is generally on his centile line.

This week though has been horrendous with him taking max 3oz per bottle and going 4 hours between bottles but today he has just point blank refused them. He cries like he is hungry but then when I offer it he just rubs his eyes and shakes his head. From 5am until 3pm today he had had 3oz total and in the end I tried feeding him asleep and he drained the entire 6oz bottle. But I can’t just feed him when he’s asleep!

I’m so worried about dehydration with it being warm here but he seems happy in himself and is having wet nappies at the moment.

What can I do? We started weaning this week under paeds advice for his reflux but he’s having a couple of spoons max of a single veg purée so that’s not going to offset the serious lack of milk

How much is the minimum he can have to be acceptable? And Any help would be really appreciated as Im getting so stressed by it all. I really don’t want him to be developing a bottle aversion 😩. Everyone keeps saying ‘a baby won’t go hungry’ but he must be starving!

No experience with CMPA so hope someone else with more knowledge will be along but it sounds awful and very worrying for you.

In terms of hydration will he take a little cooled boiled water?

Have you tried offering his milk in a cup?

Has the paediatrician advised only single veg purées? If not could you push on with introducing something with more calories like porridge with added formula milk?

You can't just feed him asleep but if it worked then try that again, if you could get some dream feeds into him it would help.

Don't hesitate to contact the paediatrician if there's little improvement and if you see any signs of dehydration take him in to hospital, he may need fluids.

Good luck and hope he's more receptive to drinking today.

It must be so worrying and I have no idea on how he minimum amounts. What I would say though is that it sounds as though it's time to move to a completely DF formula?

Could he be reacting to the milk proteins in the milk and because feeding is causing him discomfort he doesn't want to feed?
My daughter was breastfeed but refusing to feed was a very early sign that I had eaten something she was allergic to. It was also a sign that her silent reflux was upsetting her.
It might be worth a chat with the GP about an amino acid formula and potential reflux treatment if there are other signs. A lot of the dairy free formulas are very thin and can trigger reflux resulting in the formula needing a thickener for mild cases and omperazole being prescribed too but worse case of reflux

Agree with asking for some Reflux Medication too if they aren't on it already.

Have you tried offering some calorie dense purées like Bananacado?

We've actually got a tin of neocate amino acid milk here at home so maybe lll try him on that but my worry is that if this is even thinner he will refuse it even more. We are currently using a thickener in the milk already and he did have omeprazole a while ago but we stopped using it so maybe we can give it a go. So far this morning he's had a grand total of 11 ounces since 4am 😭 most of that was whilst falling back to sleep at 4am.

It can't hurt at this point to try something else. Why did you stop the omperazole? Has the volumes dropped since you stopped it?

My daughter went down to 5-10 second breastfeeds because of allergies and reflux! I know your pain. She did better overnight when she was slightly calmer

@Superscientist I stopped it because it was such a battle getting it into him (the mups tablet dissolved) as he was only 10 weeks and he seemed to settle well on the Pepti 1 once he started it so I didn't think he needed it.

The reflux has always been there but never seemed to bother him until we had to stop the carobel thickener due to a reaction and switch to magic mix thickener.

So maybe now it's time to try it again now he is older and is starting to take some spoon feeds, I could hide it in there.

I'm so relieved, he took a 180ml bottle at 4pm after he woke up and another 100ml just now so he has hit 20oz for the day (including dream feeds).

He would sleep through though if I didn't rouse him to feed so I feel cruel!

@Superscientist I also think he could be teething because he's tugging his left ear and chewing everything in sight. I gave him a frozen pea puree sucker earlier and it was gone within minutes.

Teething causes reflux to get worse because they start producing more saliva which increases reflux
The main thing I have learnt over the last 4 years of having a reflux child is it's not linear. At the start I was sold the story that she will grow and as she grows the reflux decrease. What I have found instead is there are lots of things that trigger reflux so it can go in and out of control. Teething made it worse, so did colds, growth spurts too. As she grows taller it seems like it gets weaker but then gets stronger again. Weaning at first made her reflux worse as some of the weaning foods can trigger reflux.
It might be worth a chat with your GP about restarting the omperazole. It is a lot easier of you can mix it into food. My daughter is allergic to the carob in carobel so we stuck with gaviscon. She did need lactulose for the constipation when she was on 9+ sachets a day. After a 2 months we could stop it. The best time for her reflux was 9-13 months when she stopped growing. We managed to drop the gaviscon and domperidone but it returned when she started gaining weight again. We restarted the gaviscon and domperidone but now she only needed them before bed as this was when her reflux was most problematic