GP says five week old formula fed baby is being overfed

[Mybaby2027]

I really need some advice as my Husband and I have left the GP feeling confused. Baby girl is 5 weeks old, taking between 100-120ml of Aptamil every 2 hours, so 4-4.5oz. If we are out in the car or pram she will go longer. Once each night she goes 3 hours usually between 3-5am kind of time, I am guessing she must get into a deep sleep around then.

I had to take her to see the doctor yesterday about something and they came to the conclusion that she is big for her age and is overfed. She got out her calculator and calculated the amount of formula she should be having for her weight, which is 5.255kg. She said 65ml every 2 hours, and that I am way over feeding her. I have checked with my friends and family who all say their babies were on over 4oz at 5 weeks old and weighed the same roughly. The GP told me I must reduce her milk down to 65ml every 2 hours, she said she will scream, cry and hate you for it but you have to do it.

I obviously didn’t listen and I reduced it down a little bit, so yesterday after we got home she was having 90ml. She was crying and crying with her hands in her mouth constantly licking and sucking them. Today I have given in and put it back up to 120ml. Some of the bottles she’s sucked dry completely, some she only takes about 100ml. I am instead going to slowly try to extend the 2 hours and see if we can get her to go a bit longer instead, but keep offering her 120ml. My Mum is saying the advice is ridiculous and to feed the baby when she shows hunger signs and to let her have whatever amount I feel she needs right now, which is between 100-120ml.

The GP said she is greedy and is only drinking it because it is there… this logic makes no sense because when I make her up a 90ml bottle she is not satisfied at all… she is not burping a lot which is an issue we have been focusing on. We have been getting into all sorts of positions to get her to burp and I have noticed a big improvement after trying some tips my family gave me. But still… she wants the higher amount of formula so the theory about her being in discomfort because of wind and trying to sooth herself with the milk can’t be true in her case either.

She was 8.2 pounds at birth, now she is 11.5 pounds or 5.255kg. I pointed out that I have been asking every health professional since the day she was born that we have come into contact with, how much to feed? None would give me an answer and just said every baby is different and to follow their cues, like hands in mouth etc. but suddenly this lady comes out with a calculated answer. I don’t know what calculation she is using and where it is from or if recommended. She didn’t tell me which website she was referencing this info from. I don’t know what to believe.

I would speak to your health visitor if you can. They would normally advise feeding on demand. It’s concerning that the GP used terms like “greedy” which just don’t make any sense with a tiny baby.

You could look at paced feeding if you haven’t already, as that might be helpful.

Your GP sounds way out here.

Is baby spitting up or showing signs of discomfort after eating?

DDs were deffo on 4oz by that age but maybe a bit further out, 3 hours or so between feeds. But if baby is hungry earlier than baby is hungry!

Was your GP going by the weight of the baby or just by the amount?

If she was breastfed you would have no idea how much was going in and would have to judge solely on whether baby was putting weight on nicely. Is she following the curve for her percentile?

stick with your HV as they are much more clued up on babies. GPs are often not.

Def agree with checking in with the HV. This is NHS Wales website (not sure where you are) https://111.wales.nhs.uk/livewell/pregnancy/bottleformulacommonquest/ but has some guidance about volume. If the GP was using the lower 150ml figure x 5.225kg then / 12 feeds, it would come to 65ml. But if you have a hungrier baby, on the higher 200ml and presumably you arent getting 12 feeds a day given the longer night stretch, it might be more like your figure of 100ml. So I wouldnt worry too much.

Thank you for the replies! She is a tiny bit sick after some feeds if she is laying down. No discomfort that I have noticed. Yes that must be what she used to calculate, I would say she is at the higher end. I can’t just drop her straight away to 65ml that’s dangerous advice as she would lose a lot of weight. She’s just had 120ml at 12.30pm then again at 3pm. So some improvement she went 2.5 hours, but drained both bottles. She was crying for milk with hands in mouth at around 2.30pm but I gave her a dummy she fell asleep and woke up again at 3 and then I fed her.

Feed on demand and until she’s done. If she was a breastfed baby nobody would know!

Ignore the GP and speak to the health visitor, but I wouldn't change anything

Exactly if she was breastfed she would eat till her hearts content… no one would say a thing either 🤦🏻‍♀️ honestly I am really angry about this advice she’s given us. I always take all advice with a pinch of salt as all the NHS staff we have come across since she was born have told us different stuff. I think a lot of it is their own biased opinions, which it should be evidence based advice only. How can multiple NHS staff give different answers around all things baby??? They should all be on the same page surely, going from clear guidelines.

If shes draining most of the bottles then I'd increase the ones that she finishes. Do you think she could have reflux and be drinking the milk to soothe reflux pain?

She's likely having a growth spurt and her feeding will calm down again

My baby gained 15% of bodyweight between weeks 2-3 of life, the GP congratulated me... because I was breastfeeding. I would agree with trying to give the dummy, but otherwise feed your lovely baby, and see the HV who will hopefully be equally sensible, unlike the GP!

Look into pace feeding. I had to supplement with formula with DD1 for a couple of months after birth and she would guzzle formula (and then chuck half of it up) because bottles are so easy to get milk from v the breast. Pace feeding and a slower flow teat helped her feed more responsively and take in the right amount.

Every baby is going to be different, at that age my eldest and youngest were both on 3oz where as my middle child would drink 4 to 5oz

I’d make a complaint, to be honest. If nothing else it’s extremely cruel to force a baby to go hungry!

As long as she’s not in pain. Some babies overfeed because they have tummy ache and the milk soothes it briefly. At 4oz I would expect a bigger gap between feeds personally. I think the gp is bang out of order using words like greedy m

I accept it's a long time ago and advice changes but I always understood it was impossible to overfeed a tiny baby and they should be fed on demand.

DS1 was a hungry baby and it sometimes felt like he fed constantly. 25 years on he's a strapping 6'3" and a very healthy weight.

Health visitor told me if baby is draining the bottles then increase amount. I would seek advice from HV.

Not a mum so not an expert, but that's what I was thinking! How do you know when a breast fed baby has had 55mls? You wouldn't, you'd feed till they'd enough, surely?

Another suggestion for paced feeding here. The ‘medical’ model works on the basis of 150 mls per kilo of baby’s weight to work out the amount they should be having so I would have a look at this while also recommending demand paced feeding. If she is still draining a bottle I would try the dummy first to see if it settles her but of course offer more milk if she doesn’t.

What is her weight doing on her centiles??

It’s 150ml/kg/d as feed (and fluid) requirements in that age group, that amount could then be split by how often she feeds (if 2 hourly the amount works out to 65ml) as a target. The GPs approach doesn’t seem very nice but that is essentially the right volume as an average requirement, although paced feeding and giving more if babies are genuinely hungry for a short period of time is important too as this is just a ballpark and demand feeding is the best approach. No baby would be bang on average with their feeding exactly. very wrong to say a baby is greedy!
the advice for reflux is to do frequent small vol feeds to reduce the regurgitation so that is roughly right but it might be a shock to change suddenly to that amount so you are using your instincts to soften that which seems sensible!

just to play devils advocate as I work in Paediatrics- many parents do overfeed babies as they misinterpret their crying / cues to mean they are hungry, no judgement it’s just a fact as so many parents are not getting the support they need to help their baby. It’s tough listening to a baby cry. It’s also hard being a parent end of, so doctors should be more kind in the way they explain this but they don’t always manage it.

My DS always ate more and more frequently than the guide. I remember a HV telling me he should be going 3 hours between feeds at one point and DS sobbing his little heart out. I refused to follow her advice after that. It did DS no harm whatsoever and he’s a skinny and lanky 6 year old now!

Exactly. Imagine being so little, so hungry and so confused but you can’t voice it!

Maybe try a bigger bottle.

Formula feeding isn't the same as breast feeding because milk flows out the bottle without the need for sucking. Because of this you can overfeed a formula fed baby. Try using paced bottle feeding and a slow flow teat.