Help please with feeding aversion and nursery

[Liland]

Hi all - sorry this is long :(

My LO (19 weeks) has had a complicated start with CMPA, severe reflux and a feeding aversion. Exclusively bottle fed (tried many different types), nutramigen formula, omeprazole. I need some advice as I'm not sure anymore about my expectations and whether I'm being reasonable.

LO has started nursery full-time (in theory) 2 days a week, as I've been back from maternity for a month now (not my choice). I have an unusual job (am main breadwinner) which allows me to work full time from home with LO here with me (my employers support this, as they did for their last employee in my position with 2 LOs). Me and DP opted for 2 days nursery a week to help me stay on top of the workload.

Dealing with the feeding aversion has been hard. For about 2 months, I have been the only person able to get a decent amount of milk in LO. I've developed techniques to getting this in without being forceful, carrying around, distractions and such. He now has five 4-5oz bottles during the day and one 2-4oz bottle during the night. All good, he's finally gaining weight and caught up to his percentile.

On nursery days, I do the first full bottle, let him have a short nap, then drop him off. They've been fully briefed on his feeding problems and the tricks I use. The problem is, last time he went for 6 hours and only managed to get 3oz in, over two feeding times where I would have gotten two 4-5oz bottles in. I broke and picked him up then to make sure I could squeeze another full 3 bottles in him before bed. Today is the second day - he's been there for nearly 5 hours so far, and again, he's managed only 3oz. The baby room leader is not concerned because LO is apparently very cheerful, having naps, dribbling (so not dehydrated).

I'm trying to work up to leaving him there for most of the full day (which feels horrible in itself as he's so small, but that's another issue), but I'm so worried about him drinking so little there. Can he be ok on 3oz in 8 hours, if that was the case, with just two more bottles at home with me in the evening? So he'd have around 21oz total, currently weighing 7kg. I'm worried they're never going to get a god amount in him because they don't think it's a problem. I've lost all confidence these last few months and don't know anymore if I'm being PFB and crazy.

And is there any hope on the horizon for him feeding himself? I have him playing with an empty sippy cup (one of those soft teat no leak ones) during the day to try and get him comfortable with it. He can hold it in his mouth and have a chew/suck on the teat, but he's no where near sitting yet (he prefers to stand - not helpful), and he wouldn't be able to hold it at a high enough angle yet anyway. I have my heart set on self-feeding as a solution to the feeding aversion, but I'm terrified this isn't going to happen.

Bump because I can't even see this post on the parenting page

Hi Liland

I think I recognise your name from when I posted before about my own struggle with my baby’s feeding aversion, it’s horrible isn’t it.

I’m sorry I have no useful advice for your current situation but I just thought it might help you to know that so far, weaning has been going well with my baby - really this is not to brag but to try to give you hope that an aversion to milk doesn’t mean your baby will have an aversion to solids too and in a few more weeks you’ll hopefully be in the same position, it makes me worry less about her ridiculously low milk intake when I know she’s getting nutrients in another way, and she takes plenty of water from a Tommy Tippee sippy cup throughout the day and during her meals, so I don’t worry as much about her getting dehydrated either. I usually hold the cup for her as she will try to do it herself but like yours she can’t get the angle right yet, I let her play with it for a bit first then hold it myself to make sure she gets some.

Hope this helps at least vaguely and if not at least I’ve bumped your thread for you!

Could you feed LO at nursery on arrival, and then leave him to nap there? It doesn't solve your problem but would give you extra time at home to work without the interruption of him waking and then driving to nursery.

I also don't quite understand how many days he's done at nursery from your post. Are the two days a week consecutive?
Full time I'd be more concerned but when five days a week he is with you, I'd give it more of a chance. He will develop a bond with a staff member eventually which night help, but he won't starve if it doesn't! As long as he is happy and not crying with hunger I think you can let yourself relax a little.

Sorry, he goes Tuesdays and Thursdays. They did manage a little better today in the end, so that's good, and I think I can mosyly make up for it.

I cant feed him on arrival due to how he has to be fed - 45 minutes of walking around, looking at things, going on and off the bottle with intermittent crying. I also have no control over his feeding times - he wont feed unless he's ready for a nap. So I prefer to feed him at home and then let the food settle before I take him in, just to keep the milk in.

We did try early weaning as instructed, but while he was interested he couldn't get a puree down, he just brought it up straight away with his milk :/

I know they need to get to know him, and he them, it's just hard and I worry all the time. Too much no doubt, but someone has to.

MrsMaow, I'm really glad it's going ok for you :) I'd happily hold LO while he has a go himself, I'm just waiting a couple more weeks until he's a bit stronger.

Could you afford a nanny instead?

'as long as he's happy'... not sure about that sentence. I think a medical doctor might be in a better position to help with that, if a child had problems with allergies, not eating well or not enough, not putting on enough weight, that's not right. Not sure this is wise approach.

On a positive note, if he is better now and taking more milk than he did on his first day, there is some progress and that's good. I would probably suggest little and often, so smaller bottles more often during the day, however staff in a nursery have other children to look after so taking 45 minutes for one child every feed time might be a struggle. I would also go for a nanny if possible.

Is he on the Nutramigen hydrolysed formula, or a completely dairy-free, hypo-allergenic formula? If the former, i''m wondering if he should be on a completely dairy-free formula, with the CMPA. This might reduce symptoms.

No chance of affording a nanny :(

He is on the hydrolysed formula. With the exception of one daily projectile vomit, he has no reflux symptoms or allergy symptoms. I do of course (and nursery is) keep him upright most of the time and still follow all the reflux tips (tilted cot and such). The Dr said he was unlikely to outgrow the feeding aversion until he can do it himself... He has improved on this, it is a little easier (and less screamy) than it used to be during feeds. He generally stops fussing once he has 2oz in him and realises there's no pain.

I have told nursery to just snack him an oz here and there if that's how they can get it in him.

I guess I need to give it a bit more time, especially as there was improvement his second day. DP keeps saying if LO has two not very good feeding days a week, he'll still be fine weight wise as I have him the other 5 days. I'm just always doubting myself :(

it sounds like you are on top of it. I know it's hard but nursery staff are experienced and should be ok. If there's a concern that he isn't taking in enough they will let you know.