Advice or reality check please!

[Caspino]

My 5 week old gives hunger cues so I give him a bottle (formula fed). We pace feed and wind regularly during a feed. After about a half ounce or ounce he either gets restless and pushes the bottle away or falls asleep.

5 minutes later and he is rooting for a bottle again and this continues basically most of the day so it feels like he is never off the bottle.

I have tried a dummy which he rejects and playing/comforting etc to see if he is comfort seeking but 9 times out of 10 he wants a bottle but half an ounce later and the cycle repeats.

We moved him up a teat size but no change, I don't think he is cluster feeding or having a growth spurt because it's been like this for weeks.

He eats much better during the night and takes between 3 and 5oz during night feeds which are every 2 hours.

I really wouldn't mind except I have a toddler home with me full time who needs her share of attention and I feel like im stuck to a bottle so wondering if this is normal or if there's anything I can do to encourage more efficient feeding?

Any advice or experiences appreciated!

Sounds really normal. Breastfed babies are the same - basically attached to the boob but not necessarily having a lot at a time. Can you feed and play at the same time? This is what I did.

Usually with bottle feeding you're looking to give a bottle every 3 hours. How often are you giving one if he's only taking an ounce a time?

I bottle fed mine on a 3 hourly schedule during the day.

Stop the pace feeding. It’s meant for very premature babies who haven’t developed the suck, swallow, breathe routine yet. It just makes them frustrated and windy. If you keep stopping to wind him, he thinks the milk is being constantly taken away. Then brought back again.

Keep baby fairly upright for feeds but the teat full of milk (this reduces the amount of air taken in). Keep an eye on how he’s feeding but don’t pause unless it seems like he wants to.

Sounds like reflux.

I’m a postnatal carer so care for newborns - I’d be looking at the naps and awake times as sometimes they can be a contributing factor to what you’re describing. Feel free to message me and I’ll happily see if I can help

Thanks for all of your replies! I think there's a combination of things, so I've stopped pace feeding but we are seeing an increase in spit ups and discomfort after feeds so thinking reflux is also an issue. Chatting to my HV about it anyway to see if we can get this little guy more comfortable.

Also, white noise was an absolute godsend last night so I've invested in a machine lol

I’m not sure why it would be recommended to stop pace feeding? We bottle fed our DS from birth and pace fed him from the start and it worked well. I’m sure it depends on the baby but not necessarily just for premature babies. I’d speak to your health visitor, check for tongue ties and also I’d think it was quite normal for them to feed little and often when little as they’re tummy’s are so small. Hopefully HV can reassure you. We fed on demand and he fed every 2 hours until 6 months. Just because they’re bottle fed it doesn’t mean they won’t get hungry before 3 hours…

Are you thoroughly winding after the feed? I had a demonstration in the SCBU from a neonatal nurse and winding was a LOT firmer than I would have imagined for a tiny baby. But really did help with windy discomfort.

Yes we wind thoroughly, like it takes an age to get his wind up but we get there eventually.

Little and often is fine it was more the pushing off the bottle in obvious discomfort then crying for it again because hes obviously still hungry. We do think its reflux and have been given infant gaviscon to try so we'll see if that's any help!

Forgot to mention that there was tiny bits of blood in his spit up a few weeks ago which we saw the GP and went to A&E about and they felt it was irritation to his oesophagus which kind of tracks with reflux but no-one recommended any treatment for it then, just to keep an eye on it.

I’d see someone who knows what they’re doing with bottle fed babies

potentially emerging aversion?
Is there an oral restriction? Tongue tie?
reflux has a cause, so worth checking out what is going on. Any local lactation consultants with bottle feeding backgrounds you could see? Or poss a tongue tie practitioner who sees a lot of bottle fed babies.