Baby crying only during feeding - health visitor and GP confused

[michgross]

Our 3.5 month old baby (corrected - 5 weeks premature) is really happy most of the time but over the last few weeks during feeding he cries a lot and seems very uncomfortable and due to this he hasn't eaten much. This is the same if he is breast or formula fed. We have to keep offering him the milk until he's had enough and stops crying and as soon as he stops eating he's very happy again. He was born low birth weight due to preeclampsia and has been growing well since then but he has barely put on any weight over the last few weeks.

Common problems have been mentioned by both our GP and health visitor like silent reflux, colic and allergies but they expected him to show symptoms outside of just feeding time for example when lying flat but he doesn't. We always burp him and he seems to burp well but hard to know if he still has wind. He starts crying as soon as he starts eating, not just once he's finished which makes me feel like it's the feeding process that's the problem and not something inside him like wind. But it's so hard to know.

I was wondering if anyone has experienced anything similar or can suggest what the problem is?

I'm not surprised they're confused, so is baby absolutely fine most of the other time?

I'd expect a baby with CMPA to show some of these symptoms. Does your LO have any of them?

Could it be teething or a blocked nose interfering, or similar? My little one get absolutely furious when she can't get the lovely milk because she can't breath, or her mouth hurts when she's trying to suck...

Have you tried feeding him sitting up position? My son cried if I cradled him to feed but was fine upright. Not sure if it was a physiological thing or if he just wanted to see what was going on!

Oh good you've just made me remember DD very angry crying if she ever had a blocked nose 😱

Teething? Mine started crying every time hungry/feeding from about 3 months onwards. He never actually cracked a tooth until five months though! Then I realised what it was and painkillers made it much better.

Could it be something to do with actual swallowing/sucking motion? Although I’d assume they’ve all thought of that!

Have you tried different bottles /teats /sizes? Is your bf let down too slow and it's cries of frustration? I read the key to that is get milk flowing by hand then latch dc on.

Might be an war infection, ears hurting when swallowing? GP should really be exploring more, maybe ask to see a different GP?

Ear infection not war 😫

My daughters silent reflux and cmpa symptoms started out just a feeding times. She did start at 10 days but it wasn't until 4 and a half months that she was diagnosed. By this point she cried continuously. From 2.5-3 months she didn't feed during the day for more than 5-10 seconds at a time and no more than 1-2 minutes in total she was desperate for a feed but it was like my breast was poison (it kinda was) so she would stop and scream. Overnight she did 3-5 minutes feeds totalling 10-15 minutes. Despite all this beautiful weight gain which was a big factor in the delay to her diagnosis. She has a lot of food allergies and the feeding refusal was one of our first signs of a new allergies. She screamed 2 minutes into the first feed after I ate a beef burger about 15minutes earlier!

What's the ratio of breast to formula at the moment? Is going dairy and soya free for a week or two and ebf an option if you see any changes continue the trial but see if you can get some prescription milk or buy some yourself

No the only symptom he has is crying during feeding and a refusal to feed. Can cows milk free formula milk be bought from a supermarket or does it need a prescription? It might be worth trying.

I don't think it's a blocked nose. Is there a way to know if he's teething at this early stage?

@michgross so LO doesn't have any of the symptoms in the article I linked? If they don't I wouldn't bother trying a formula for CMPA yet. I'd maybe try a Comfort Formula though. Which formula is LO on now?

The best way to check if it's teething is to give them a dose of Calpol and see if things improve. Have you felt in their mouth to see if any teeth are about to erupt?

Yes you can buy dairy free formula in any supermarkets. My little one had soya formula from 3 weeks but alot of cmpa babies also have soya intolerance so maybe speak to GP and ask to be prescribed one

I would ask to be referred to a paediatrician at the hospital - if your baby’s no longer gaining weight they would want to know.

I know I'm being stupid but I can't actually find the symptoms in that article. It says "The immediate symptoms (see table below)" but I can't find the table! I checked a different website for a list of symptoms and he doesn't have any of them.

Ok try this article.

We've been given infant Gaviscon to treat possible silent reflux but the problem we have is that you need to dissolve a single sachet in 115ml formula and the pack recommends two sachets up to 6 times a day. Our baby usually eats less than 60ml at a time so there's no way we can give him 230ml of formula, multiple times a day. Does anyone have advice for this or is there an alternate medication? We were hoping for something that we can give directly in a syringe.

Thanks. The only symptoms he has in that table are "Refusal or reluctance to feed" and "Weight loss or not putting on weight".

Thanks. The only symptoms he has in that table are "Refusal or reluctance to feed" and "Weight loss or not putting on weight

Id say they those two are enough to ask your GP to prescribe a formula suitable for babies with CMPA and refer to a Paediatric Dietician.

I had this issue with my son when he was a baby. He used to cry and squirm constantly during feeding (bottle). It took me taking him to the GP at feed times to obtain a paediatrician referral. This was 11 years ago so the waiting times weren't at the levels they ate now and we got an appointment very quickly, The paediatrician diagnosed silent reflux and prescribed ranitidine (from memory that's what it was called) and advised that we wean him onto solids at 4 months. There was a marked improvement once we did this.
Wishing you the best of luck as I know how difficult a time it is

Teething signs are drooling and chewing on stuff - toys/fingers/muslin etc. This can start months before actual teeth erupt. But I agree with pp, give one dose of Calpol and then try feeding an hour later - is there improvement? If no improvement I'd say it's unlikely to be the cause (or at least not the only cause)!
Ibuprofen is actually better than Calpol for teething, but I think your DC may be too young for that still?

You don’t have to give that much. In fact with the way it can cause constipation you want to give as little as you need to.

My youngest had one sachet in her bottle. We made up 120 (as 115 was impossible to gauge) and she drank as much as she drank.

the two sachets 6 times a day is just the max dose they can have. It’s not what they should have.

Also ask the GP to check his ears if they haven’t already. One of mine used to get ear infections quite regular and it was painful for them to suck so they’d go off their milk.

Does LO take an iron supplement? This made my prem very upset as it gave him stomach pain.