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.

My little boy was what your doctor would describe as a greedy baby! 🤣

The health visitor advised me to give him the hungry baby formula at a few weeks old due to the amount he was consuming. Which was a bit more than your baby. At least 140 to 160ml each feed. At no point did they tell me to stop feeding him if he wanted.

He was well over the 90th percentile for quite a while, but completely balanced out later. X

Every two hours is a lot for a bottle fed baby. I’d expect 6/7 feeds in a 24 hour period. But I think looking at the growth charts is a better gauge. Some babies suck for comfort - with breastfeeding the flow is very slow indeed at the end of a feed. It is possible to overfed a bottle fed baby so do need to take care.

They wouldn't because you can't overfeed a breastfed baby.

There's no evidence hungry baby formula helps but regardless you'll need to seek medical advice.

Bottle fed babies usually self regulate too!

I had a 99th percentile exclusively breastfed baby and trust me, I had plenty of HCPs judge and say I was overfeeding!

OP, some babies are just big, someone has to be at the top of the chart. Could you seek a second opinion on her lip going blue though? Sounds like the GP got distracted and didn't help with that.

Until a baby is 2-4 months old a baby’s suck is a
reflex action that is triggered by something touching the roof of the baby’s mouth - i.e a bottle teat. It is not a conscious decision to suck. Therefore if a bottle is put into their mouth they will suck on it whether they are hungry or not, in exactly the same way they will suck on someone’s finger even though no milk comes out. It is completely reflex driven.

However, although the same theory applies with breastfeeding, due to the how the tongue works, when a breastfed baby is full they drop their tongue down low in their mouth and as a result the mother’s nipple also drops down from the roof of the baby’s mouth and as a result the active suck reflex is deactivated (this is a very simplistic description though of what is actually a very complex process of how a breastfed baby cant be overfed). Babies can still gently suck at the breast for comfort but that is a different mechanism of sucking compared to that of when they are actively sucking for milk.

With bottles though the teat is always touching the roof of the baby’s mouth and stimulating the suck reflex because the parent is holding the bottle there, so even if the baby is feeling full after half the bottle, up until a certain age they will continue sucking and taking milk purely as a result of the teat being in their mouth.

That’s why breast feeding is considered to be baby led (they have the ability to control their own milk intake) whereas bottle feeding is considered to be parent led as the baby’s milk intake is controlled by the choices/actions of the parents. Paced Feeding can help give the baby back some degree of control over their milk intake during the first 2-4 months until they are more actively in control of their own sucking actions (as opposed to it being a reflex action), but not to the same degree of a breastfed baby.

Some Paced Feeding methods advise that you actually take the bottle out of the baby’s mouth at regular intervals to remove the suck stimulus, because then when you re-offer the bottle to them you are giving the baby a choice as to whether they want more milk i.e if they open their mouth when you put the teat to their lips (without trying to force it into their mouth or overly encourage them to open their mouth) they are actively choosing to accept the bottle again, whereas if they keep their lips closed or turn away from the teat they are showing you they don’t want any more.

You will find lots of videos on YouTube of different versions of paced feeding but speaking to your health visitor is definitely advisable.

However, putting all this aside, if your baby is tracking the same percentile from birth and they aren't vomiting then it genuinely may just be they are hungry and have a high demand for calories. I completely agree with everyone on here that has said that a baby who seems hungry shouldn’t be denied milk.

Just go with your gut instinct OP, you know your baby better than anyone. I’m sorry you had a rough start, a stay in the NICU must have been very upsetting for you and so the last thing you probably need is this GP now putting doubts in your mind. Just do what feels right and seek support from your HV team, they will have seen situations like this 100s of times and I’m sure they’ll be able to give you lots of reassurance.

The curve on the chart and the points marked are all in line on 91st centile since birth.

You're doing really well to block out the noise at either end of the argument and trust your judgement, it's really hard when there's so many opinions out there and they conflict each other!

This. Also whereas breast fed babies have to suck hard to get milk bottle fed babies don't have to suck as hard so can overfeed. Have you tried offering you baby boiled cooled water before her feed so she quenshes thirst then move on to formula milk? Your baby might just be thirsty because it's hot. Every 2 hours seems often to feed. I breastfed but all 3 of my babies went 3 1/2 hours between feeds and longer during the night time. If hot during the daytime I'd offer cooled boiled water as per health visitor instructions if baby woke and cried in between feeds. They tended to have a little drink of water then go back to sleep.

I am not a doctor but my breast-fed babies could feed and feed and feed. Both big and GP very happy with progress and said if they’re putting on weight we are happy. If they were formula fed I can only guess they would have been guzzling bottle after bottle.

The goal is to get to double birthweight by 3-4 months old. Every baby is different, but all are growing and have significant feeding needs that will increase with growth spurts. Always feed on demand. Babies and children intuitively stop feeding when full.
At 5 weeks your baby likely right in a growth spurt (charts vary a bit).
Overfeeding is a bit of a myth.
Use a baby tracker app to chart feeds and nappies. Your baby should have around 6 wet nappies in 24h.

https://www.whattoexpect.com/first-year/ask-heidi/baby-growth-spurts.aspx

https://www.healthdirect.gov.au/how-your-baby-gains-weight

If she has too much she will throw it up.

I fed my son formula on demand even though he was a big baby. Never got advice to do anything else, even though I was at one point worried he was getting too big, they kept telling me to feed him on demand and that's what I did.

Babies know what they need and you're not going to harm a baby by feeding them. If they take more than they need it will just come back up.

My son is still a big boy at 1, but he's very healthy and happy.

And really, even if they do gain a bit more weight than they need, it will all level out once they are mobile and active as long as they have a good healthy diet and lots of opportunities to move as a toddler.

I would get a second opinion from another GP. She sounds very opinionated if nothing else, and no 5 week old baby should be being called 'greedy' - in fact that is not a word any doctor should be using about any patient.

I empathise with the different advice from different people - I had the same. But, you know yourself that this is bonkers advice. Sometimes you have to follow your instinct as well - if your baby is hungry then feed her!

Actually, I'm a bit alarmed the doctor is essentially saying ignore your newborn baby when s/he cries to be fed.

Both my babies ate every 2 hours before 6 months. They were both very fat and I was told I was over feeding them, but they seemed to always be hungry.
I came to the conclusion that advice seemed to be based on minimum requirements - from guidelines published for parents when bottlefeeding formula became more popular e.g you must feed at least every 3-4 hours became you must only feed every 3-4 hours.
Both kids are now slim and fit. Both still eat every 2 hours if doing any kind of physical activity.
Watch the baby not the charts and books.

you can’t overfeed when breastfeeding so it’s a stupid comparison. Breast milk is fundamentally different to formula. That’s why it’s “better” and no one would say you’re overfeeding. It would adapt - if she was just thirsty it would be mainly water, whereas formula will always be the same - hence overfeeding.

speak to your HV though, they know better with these things.

Judging is one thing, facts are another.

Totally different. They can't be overfed and suckling doesn't mean taking in milk.

She’s following her centile line beautifully then. It’s very likely she’ll slim down later on.

It does sound like she’s having more than we would expect (generally 150-180mls/kg/day) but if she’s tracking her centile and isn’t vomiting after feeds, this is evidently right for her. I would just say to make sure you are pacing feeds (sit her upright, bottle horizontal, draw it away every few sucks to see if she still wants it, burp regularly) and feed when she is showing cues rather than on a schedule. A dummy can be useful for formula fed babies too as some of the time sucking is more about comfort than nutrition - she’ll soon let you know (with fury!) if the dummy isn’t cutting it!

Also, did the GP measure length? Weight on its own is a bit irrelevant tbh…

For context, I had my kids 17 years ago in the US before moving to the UK, so this advice may be out of date or just never have been integrated into UK approaches. But overfeeding when bottle feeding on demand was something that was mentioned as a potential issue with bottle feeding. The advice was not limiting the amount of milk, but using nipples with smaller holes so the baby had to suck harder. This extends how much time it takes to get the milk and lowers the amount the baby wants to drink.

You baby seems to be maintaining their percentile position though, so agree with PPs that seems at odds with the suggestion she's over feeding.

@Mybaby2027 Sounds like the blue above your baby’s top lip is probably completely normal. It’s the second condition listed on this page:
https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Baby-common-presentations

Your baby is tracking nicely along a high percentile. Of course she’ll be taking in more formula than the 150ml/kg/day that is for babies on the 50th percentile. My baby was on the 25th percentile. She took in less than the supposed required amount. She was fully formula fed from birth and tracked along her percentile line consistently for about three years.

Burping could be a challenge with my DD. She definitely needed a few good burps after every feed. If she didn’t have them she’d be cranky with a sore tummy or would bring up a bit of partially digested milk. DH and I would swap her to the other parent if one of us had tried to burp her but no success. Often the other parent would have the technique she’d need for that burp that day. We both had our own ways of burping her.

Enjoy your baby and enjoy being a mum.

Many years ago my health visitors advice was as soon as she is drinking everything you give her, increase it by another ounce. Worked for us

‘…she said she will scream, cry and hate you for it but you have to do it.’

Thats a really shocking thing to say about a 5 week old baby!

Ignore her.

Congratulations on your new baby! Sounds like you had a bit of a scary start but I hope things are starting to settle down for you.

IMHO the best advice on this thread is to go and speak with your health visitor. I know services have been cut back so much but if you can get to a drop baby weigh session I always found them super helpful. Also I was too stupid with baby brain/sleep depravation to plot the weights myself on the growth charts so I used to ask the HV to do it but chatgpt can help with that now :) I had a really difficult time with feeding my DCnow8 also a 90+ percentile baby and despite their reputation most of the HVs were really helpful.

I hope you can take the GPs words with a pinch of salt, get the support from the HV and are able to make the most of these early days with your new baby.

I obvs meant a drop-in baby weigh session. Don't trust an HV who drops your baby! :D