5month old feeding less on bottle - Using Aptamil Advanced formula

[AK06]

My 5month old since her 16 week vaccination is barely finishing her bottles. Ir reflects in her weight where the gain is very slow compared to before 4months.

I used to pump breastmilk and combine feed her with formula. I had a lot of breast milk frozen which I now thaw, warm up to feed.

I am using mam bottles teat size 2. I tried 3 but she chokes and and coughs. Even on size 2 lately she chokes on breast milk.

I froze my breast milk. But once I thaw it in the fridge and warm it in warm water it tastes so different to freshly expressed milk. Sometimes it makes me gag when I taste it and I wonder whether it puts her off too. But breastmilk helps her digest faster and better making her overall intake better than formula only.

Formula wise I am using Aptamil Advanced. She weighed 2.4kg at Birth. At 22weeks she weighed 5.3kg. Everyday bottle feeding is a struggle. I tried dream feeding. Some days it works but again it is not consistent. If I leave it up to her to leas me and give me hunger cues, the maximum we would have every 24hours is 450ml or close to 400ml which is a nightmare for me at the moment.

GP advised to try Kendamil. Health visitor however is insisting not to change formula now and mess around with her gut. I asked about solids but again they dont want me to start it until she turns 6month.

Past few weeks I am trying to feed her every 2hours hoping she would finish her bottle of feed her whilst she is drowsy, asleep in the car seat after a ride. If she for example has 60ml on one feed, I would expect her to be hungry by the time it gets 2hours or at least 3. But here it even sometimes stretches to 4hours and I dont know if the formula is not digesting well and why she simply would not feel hungry. Today for example we reached 340ml at 4pm. Since 4pm she did not wanted to feed. She fed again at 10pm in her sleep of 120ml. The 6hour stretch is too long especially when she takes in a small feed previously. Her total intake today was only 460ml.

They said babies do not starve themselves by nature, but drinking 400ml every 24hrs is extremely low and concerning me. I have another weight check on 5th march which is 4 weeks from her last weight check of 5260g.

I am reluctant to change formula now because in case it will mess with her gut.
One health advisor suggested trying solids, another said to wait 6months. I am so confused.

Can you start pumping again? Relocating should be relatively easy if you have only just stopped. Also, I would start with some basic solids at 5 months. They are constantly changing the recommendations on when to start. My son had reflux so I started weaning at 5 months and he was clearly ready to get going.

That isn’t a lot of milk and can’t be explained away by you using EBM as a EBF baby takes around 739 mls/25floz a day.

I would have a read of this on stored Human Milk from LLL and I would also swap her milk. Maybe try Hipp Organic and if that doesn’t improve matters try Hipp Comfort?

Another thing to consider is the possibility of Tongue Tie. Have a read of these symptoms and see if any are familiar.

The same with CMPA

I’ve alao not heard of a HV suggesting not to change formula to not to upset her gut for about 40 years.

Your DD does seem to be following her centiles for weight though. Is she bright and alert at times and is she meeting her milestones?

Has the HV recorded her weight for you on each visit and has she checked her length and head circumference since birth?

1.Is she alert ? Yes she is alert and active. She sleep through the night and wakes up once at 4am on average for a feed after a 12am feed. She has good naps in the car. At home unless there is a sudden sound or something she would have a nap for about 30-45minutes. It used to be longer.

1. Milestones: She rolls onto her tummy. Heads up. Smiles at everyone. Mostly turns to the side where noise is coming from. Follows objects and people especially me walking around. Grabs onto toys. Holds toys in hand and tries to take it to her mouth. Now recently lifts her feet up to grab with her arms and tries to put it in her mouth. Makes all these cooing, aaing sounds, makes loud squeeking sounds too. Loves to look around her environment and recently started to show signs of seperation anxiety with new people or environments and cries.

1. Tongue tie- We did have this checked during her first weeks as she would not latch on me properly to begin with but we introduced bottles and at one consultation the health visitor said that her latch is good but she is now used to the bottle which is why she prefers it over the breast.

1. Health check: GP did not check her height or head. Her head circumference currently is 40cm and her height is 58cm.

Health visitor keeps dismissing my concern because she looks good, alert and may be she just likes small feeds. Her weight is growing but very slowly to my liking.

Allergies- GP did not check any of this really. I am scared to try a new formula and mess things up. I have a 5 year old son to manage too with his school runs, classes etc. She has never cried in discomfort, pain, poos every other day and seems happy when awake. Since 16 weeks my only concern is the amount of milk she consumes. Half way through she does not want it and we have some days where the hours have gone like 5 hours and suddenly she gulps the entire bottle and finishes her feed. I even tried to feed her in dark quite places.

She does sound as though she’s meeting her milestones and is content. Do you know if she’s tracking her head and height centiles? I’m having trouble plotting them on the graph with my tilt screen

Who checked her for TT? Unfortunately many HCPs will pass comment on TT when they haven’t had the appropriate training.

And if she is stopping half way through a bottle then gulping one down later i would definitely try a comfort style formula. If you’re worried about swapping brands maybe try Aptamil Comfort but Cow & Gate Comfort seems to have very similar ingredients and is made in the same factory. It’s also cheaper.

Lots of four month olds do become very distractible during feeds. I had to breastfeed (and bottle feed) somewhere very, very boring for several weeks until baby got over it and focused on feeds again. Eg coffee shops were a disaster so I would go to changing rooms in shops, but then I had to position the baby so they couldn't see themself in the mirror... My partner walked our baby round and round a motorway service station (screaming) because they were hungry, but they were too distracted to latch. I then took the baby out to the car and they finally fed once all the distractions were gone.

It was a stressful period but feeding focus did return! As they were mostly BF I didn't notice if there was a slowing in growth and milk intake, I just assumed they were fine. So it's possible there is a benign reason.