9 month old and cmpa milk.

[NeyNey2021]

Hiya all,

I'm having a bit of a melt down.

Bubs is 9 months old. She's always hated her milk. But now we're having a mare with it. She's cmpa.

This is her routine:
715am-730am breakfast. This morning. Toast. Cheerios. blueberries and strawberry. Plus water.
830am milk - 4oz.
930am reoffer milk - 1oz/2oz
945am till 11am nap.
12pm lunch. Crumpet. Meat of some kind. Cucumber. Cheese thing. Maybe a puff thing. Water
1pm milk reoffered at 2pm too. This can vary from 5oz to 8oz here.
530pm dinner.
7pm milk. Up to 8oz. I push this feed in.

She's not making the requirements a day. I mean I wouldn't drink that milk either. It's disgusting 🫣

I know advise is milk before food. But if I do this. She will just cry hysterically until she's given her food 🤦‍♀️😳 then vomit her milk 🤦‍♀️

Am I being too sensitive and concerned about this? Do I take her lead? Even if she's below the recommendation of milk?

Thank you 👍

Can you use the milk in cooking? Obviously she still needs milk at 9 months but it doesn't all need to be in bottles. Can you mix it with other foods or use I to make sauces etc? If you were breastfeeding you wouldn't be able to measure it anyway and would be told to judge on your babies growth, bowel movements and urine output etc, so maybe don't get too hung up about the actual volume of milk and focus on ensuring a balanced diet overall. Obviously it would be easier if she'd drink the milk but you can't force her can you? It doesn't seem to be that uncommon for babies to cut down on bottles around this age and were it not for the CMPA I'm sure you'd be advised to increase dairy in the rest of her diet by including things like yoghurt, cheese etc. Obviously you can't do that, but can you find alternatives and make sure you're including plenty of non dairy calcium sources?
Do you have a dietician as this is the sort of thing I would expect them to be able to advise on. Or maybe a different brand of milk would be more palatable? If you don't see anyone already I would ask your GP to refer you.

I can. But tbh. We don't do much cooking where its needed. We're BLW too. So she won't let me feed her at all.

Yes I do think we do get hung up on how much milk babies drink. So I'm thinking I am too. But think it's such a change of how much decrease I'm panicking. Like she will be starving.

I can encourage her. But not force. As she will just vomit it up. She has plant based yoghurt and cheese everyday.

We were reffered to a Dietician but that was not so useful. Literally sent a load of information and told basically to get on with it 😬🤦‍♀️😳🫣

I know I shouldn't worry. But it's hard as just a few weeks ago she was having 26oz of milk a day. But really got into her food xx

How are they doing with weaning? At 9 months the amount of formula they need is more varied as some babies are getting lots of nutrition from food and need less milk and others are engaging less with weaning and still need high levels of formula.

My daughter switched from breastmilk to alfamino formula at 10 months but we had been using it in bits of food from 8 months to get her used to the taste. She only ate a few spoons of food a day. She has 3-5oz first thing 5oz before her 2 naps, 8 Oz before bed then 3-5 Oz 1-2 times overnight so 27-30oz a day ish but because she wasn't eating she had gained any significant weight since she was 7 months old. She only gained around 200g between 7 and 13 months. It was only when she had that amount of formula and 3 meals a day she gained weight again.

I would keep giving food, keep an eye on weight. Add in sources of formula into food if you can. Make veg puree as a pasta sauce with an oz or two of formula. It's still whole food she can eat herself but has some formula in. If she's eating well and gaining weight and having at least 500ml of formula most days I would relax a bit. If the formula drops below 500ml regularly you might want to add in a multivitamin. How's your HV? Could they offer advice or get the dietician to step up? My HV had to step and get my daughter dietician to be helpful. She told me my daughters allergies were in my head and that I need advice from my HV about weaning properly. Thankfully my HV set her straight that I was weaning the best I could and she absolutely had allergies. After that she was great and much more supportive

The recommended amount by 10 months is 13.5 Floz so it sounds about right to me OP.

I think they are doing ok weaning. For this morning she ate 5 blueberries. Couple cheerios and some marmite on crumpet. Then 4oz. Then just before her nap another 1oz.

Mmmm perhaps I should be weighing her at home and keep an eye on it. She's hitting 21oz max a day.

Yes perhaps I can sneak some formula in that way 🤔 without giving to my toddler too lol 😆

We have already been discharged from them now. Too high of a need for Dieticians apprentely. Wow that's good for your health visitor 👍

She's only just turned 9 months 🫣

I would introduce some healthy fats into her diet too. Avocado, nut butters etc. I find my cmpa DC are very skinny and it's because their diet has very little fat in it, which they need!

I would also consider supplementing calcium if she takes less and less milk. I found when my 2 dropped milk then they just can't get enough by food alone.

She has peanut butter everyday. Babybel cheese everyday and yoghurt everyday. But will buy some avocado 🤔

Yes I can feel she's thinning out I can tell by the nappy. But 10 days ago we were snot filled and temperatures galore. So maybe playing a part

I would avoid the vegan cheese at this age tbh. They're high in salt, highly processed and have very very little nutritional value. F you soak cashews you can whizz them up with a bit of nutritional yeast into a cheese sauce.

Then for lunch she's had quarter babybel. Fafflel. Cucumber (none consumed just chewed) peanut butter on pitta finger. Probably ate half.

Too high needs that's ridiculous! My daughter has 20 food allergies, reflux so a restricted foods for that to reduce reflux and look after her teeth and she had dietary restrictions due to toddler diarrhoea for about 18 months too. Never any mention of too high needs, she has said she doesn't have many children on her books with that many allergies

We had regular weigh ins as the HV was supporting me through post natal depression. You'd need baby scales or you could see if your HV will do some weight monitoring for a bit.

You could make porridge bars that are firm enough to hold using formula. I would ask for a referral back to the dietitian I think at 9 months you almost want to be seeing what can be added to food to mitigate lower formula. My daughter had a bottler aversion at 10 months but I had to stop breastfeeding first we investigated where she could eat enough to manage without breastmilk or formula considering a good day was a few mouthfuls and a baby day was nothing at all even if breastfeeds were withheld.
Do you think a dream feed overnight would help get a bit more formula in?

I think at this point you need a holistic view. What I would do is keep a detailed diary for 3 or 4 days about what they are eating a drinking. I would then go to the HV, they should be able to refer back to the dietitian. Do you have an infant feeding team? They might be an option to get a review for what is levels of food and formula is ok and what requires a bit of management.

It's such a tricky age as what's normal is a bit more varied and the time of year doesn't help as there's so many bugs around and that has an impact of food and formula intake too.

Too high needs that's ridiculous
I could be wrong, but I interpreted what the OP wrote to mean not that her child's needs are "too high" but that the demands of the service are so high that they can't keep every child under review. The inference if anything is that the OP's child's needs are actually not high enough to be seen. And that might not be unreasonable if everything was going smoothly. A single allergy isn't that difficult to manage generally, if the child will follow the recommended, diet, so some written information may be all that's needed.
However, @NeyNey2021 your baby doesn't seem to be cooperating with the plan. In an ideal world the dietician would already know this because you'd be having review appointments, but, like many NHS departments these days they obviously don't have enough capacity to perform regular reviews and unfortunately that means people can fall through the cracks. I agree with the previous poster that you should go back to the GP/HV and ask for a re referral to a dietician because you now have a new problem with the formula refusal. Sadly these days you sometimes do need to keep pushing to be seen, but I think it would be a perfectly valid request to make.

As you say. The needs of the Dietician is in too high of demand for what they call simple cmpa to keep us under them.

Yes your right about weight. I have emailed the health visitor this afternoon. Explaining the situation and to go from there. I'm sorry re your little one and all those allergies. Sounds tough.

We have tried many dream feeds before and doesn't work. She will scream excessively when she realises what's happening then throw the milk up 🤦‍♀️

What's an infant feeding team?

Yes it's such a difficult age. I don't remember my first being this difficult 😳 😅

She is having 20 to 21oz a day. So I have a feeling they won't be too concerned. But I am. She's a tall and in 12 to 18 months clothes. Growing like a weed. But I know she's lost weight. Her skinny little belly.

She's always been finicky with feeding but lately it's been horrid 😬😳

So I spoke to Hv. They have said they aren't to concerned. As she's at the stage of crawling lots. Pulling self up. Been unwell with antibiotics. And 20/21oz is the minimal for this age 🤷🏼‍♀️ they said she has a 10 month review soon and to wait until then unless any real concerns in a couple weeks tome to go gp.

Thanks @MrsAvocet I miss read the comment.

Having that check in point with the HV sounds good. Hopefully things pick up between then and now and if not you've already got the concern logged.

In my area the infant feeding team was a nursing team that could help with any feeding issues. We saw them a few times as a newborn and my daughter had feeding aversions and was awful to feed before we identified food allergies and got her reflux properly treated. She went down to 5 second breastfeeds and only fed for a minute or 2 total during the day and did most of her feeding overnight. I believe they can help with all aspects of feeding though.

Is there any history of reflux? If so I wonder if that is contributing and the recent cold has triggered a bit of a flare up? My daughters reflux is made worse with colds and teething and when she was a baby it made her avoid milk. Once she was older it went the other way and she overfed to sooth the discomfort. I

Yes. True at least it's logged.

Oh wow. Bit of a journey for you. Infant feeding sounds lovely system.

Yes definitely reflux here. I think it has upped recently. We don't have meds as we have managed with it so far. But maybe it's been triggered it for her, with antibiotics and she's completely addicted to her dummy atm. I assumed it was teething due to being 9 months and no teeth 🤣🤣

Are you using a thickener with the formula? The hypoallergenic formulas are thinner than regular formula which can trigger reflux. It might be that the combination of things formula, cold, possibly teething (-its the extra drool that can trigger the reflux) is meaning that your current reflux management is not quite enough at the moment.
Maybe something to keep an eye on over the weekend and have a chat with the GP on Monday for a review. In the meantime be extra keen on the behavioural things. Upright after feeds and all that.

We tried a couple thickeners. She would vomit it all up. We have tried on a few occasions, but found she actually drinks better without it 😬 maybe it's the taste too. It is gross as I know you know.

Yes definitely will. We had a good day so far. 7oz this morning. Then 8oz before nap. If she takes another 8oz at bed. I will be happier with that then the norm.