WHAT DO WE DO THEN NOT TO WEAN AT 4 MONTHS.

[45nanny]

I am a nanny to a 4month old ,who isdisplaying all the signs for needing extra food. He is already having 240mls at each feed(4 feeds ,plus a 100ml top up) and is draining the bottles. He is very unsettled and is waking at night haveing been sleeping through for at least the last month. He weighs over 18lbs and is on the hungry milk . How do we give him more milk?

as I say, I'd rather give my baby rice than powdered, processed milk with added chemical vitamins. but each to their own.

milk is more calorific, nutritious and filling than some mashed carrot

a big milk feed is more satisfying

milk is main source of nutrition for babies aged 0 - 12 months, food is a complement up until then

Whats wrong with pureed carrots?

Size has nothing, nothing to do with early weaning, ffs! Big babies don't need to be weaned early just because they're big. For what it's worth (and it's anecdotal, so not much) my daughter was over 18lb at 17 weeks. Didn't wean her till 26 weeks. And then she stopped sleeping through...

Nothing's wrong with pureed carrots - they just far fewer calories weight for weight than milk!

So if, you increased number of feeds and lo still unsettled you wouldnt try a bit of rice to supplement the milk?

no i wouldn't

Nothing wrong with pureed carrots Haychee - just not at 4 months. There is more fat, protein etc in milk than there is in pureed veg and I'm pretty sure that babyrice has very little nutritional value.

I agree that 4 feeds doesn't sound like a lot and would be giving extra feeds. Babies have growth spurts at 4 months and start waking in the night as Tinkerbellesmum explained.

Thank you for all your replies, it certainly is a subject that has no real answer. He is bottle fed ,having been previously breastfed, he just prefered to bottle feed and stopped wanting the breast(much to mums disapointment). As a nanny it's difficult ,because you are there to support and help the parents and not tell them what to do with their baby. So when i spoke to mum i suggested going back to 3hourly feeds and maybe introducing the dreamfeed again, whch he had happily dropped(on his own).They had already started him on adding rice to his night time bottle ,which they said seem to make him more comtent, but i think that going down the 5feeds a day is a better option.

adding rice to the bottle is not a good idea

it really isn't

it is outdated and is a choking hazard

just lots more milk

i don;t get what the dilemma is, 4 feeds a day is simply not enough for a 4 month old baby !

also instead of trying to feed every 3 or every 4 hours. why not just offer the bottle when the baby is hungry? it might be every 2.5 hours or every 1.5 hours especially whilst he is having a growth spurt, but being fed when he is hungry , rather than when he is expected to be hungry might very well make him more content

He has always been a very contented baby and his feeding pattern worked until this week. He was feeding 3hourly and this is when he was hungry. He has only been having four hourly feeds because this is what he was doing , but having watched him now i would say that he is just hungry and needs prehaps less milk at each feed ,just more frequently.

It's quite likely he didn't go off the breast. A lot of babies go through nursing strikes at some point and unless you have someone supporting you who knows that it does look like they've gone off it.

4 months is often a time when babies do start to become unsettled and seem like they are not satisfied, it is often due to a growth spurt... babies are not robots, they have off days, good days, days when they cry for no reason, days when they smile and coo constantly.. they very often do not fit the same schedule day in and day out.. does not mean anything is wrong !

DS is almost 6 months and ff, and quite big for his age. When he started draining the bottle etc which I think was about a month ago, we just gave him one extra feed, so instead of 7, 11, 2.30, 6.15 and a dreamfeed at 10.30 he is now 7, 11, 2.30, 5.15 and 6.30 plus dreamfeed. That worked fine and he is still happy as larry on just milk (although starting to show an interest in my food), and we will start him on some finger food when he reaches 6 months next week.

My dd was on about 50 oz by the time she was weaned at 6 months, in 2-3hourly feeds day and night. I think that is normal.

So, if you could not breastfeed SenoraPostrophe would you start baby rice the day your infant was born? I would be interested to know.

OP - you sound like a lovely, supportive, caring nanny, and the lo is lucky to have you!

Well seems that they are going down the baby rice in the last feed. I chatted to mb about it all and although they thanked me for my research into weaning babies, they decided to use baby rice. As a nanny it is difficult,when you dont agree, with the parents of the child you are taking care of ,but then it is my job and i stand by their choice as the baby is theirs not mine. As a mother myself i respect there wishes and so will just keep taking good care of their baby.. Baby seems a little more contented, not as happy as before,however they(and me) are all happy .

shame.

I am a bit concerned lulu that you don't think 4 feeds a day is enough for a 4 mth old baby.
My DD is 20wks and usually has 4 or 5 feeds a day.

She sleeps from 7pm-7am or 8pm-8am and has the following feeds on a typical day..

8am - 7-8oz

11.30am - 7-8oz

3pm - 7-8oz

6.30pm - 7-8oz
If she goes down at 7pm this is her last feed, if it is later or if she was up earlier she has a top up or an extra feed added in.

Does this sound like enough? She is a very happy, contented baby.

If she is happy, contented and putting on weight ok, then everything is fine. Just watch for her asking for more feeds, she's going to come up on another growth spurt soon, and respond to her accordingly.

The first and most important thing is to listen to your baby. (Sadly some people listen but aren't speaking the same language)

I fully support waiting to wean until 6 months and that babies can and do and should wait and that growth spurts are to blame for unsettled behaviour in a usually settled baby BUT ....

I don't understand why people talk about getting extra calories in. Yes, milk has lots of lovely calories (breast or formula) but food has bulk. So by continuing the same amount of milk but adding foods that stay in the tummy longer, then that will stave the hunger in a hungry baby? I can see why it works, don't get some of the arguements

It's an interesting question, whether babies on formula are different from BF babies when it comes to starting solids.

No definite answer, but recently there was a big study on HIV in South Africa, looking at the risk of HIV mums transferring the infection to their babies with different types of feeding: BF, FF and solids (and combinations).

BF exclusively to 6 months gave the best protection. Mixed FF/BFers came next (quite a close second), and babies on solids last of all.

The implication is that when it comes to maintaining gut integrity (which is what was being put to the test here), milk is better than solid food.

(And before anyone trots out the "developing countries" objection, you can't get HIV from poorly sterilised bottles so this is a red herring. The big issue was whether the babies' guts had good immunity or not, so the results are as relevant to UK babies as to South African ones).

Minority, I should think (though would like someone who knows more to confirm/deny) that it's to do with the reasons why the baby is hungry - theory being that a demand fed baby regulates its own appetite, and when appetite goes up, it reflects a biological need for more calories. This is therefore best served by more milk, rather than filling up with food which is less calorific, leaving the baby less hungry for the calories it needs in the form it can most easily digest. Same reason that young children/toddlers need full fat milk - they need calories, though semi skimmed would quench their thirst, fill their stomach in the same way.

It's like when you are on a diet and drink lots of water when you feel hugry to stop you from snacking.

Babies on growth spurts are on the opposite of a diet, they need lots of calories because it's the calories that they use to take them through the growth spurt. They're not hungry for the sake of being hungry.

My DS took 40-45 oz milk until he was close to 5 months..I then introduced solids slowly .

Up until he was 6 months old he took between 5-6 feeds per day (plus solids!!)..try increasing the number of feeds...

SenoraPostrophe is right - no large studies in Western world with randomised control groups. Also, few studies have managed to control fully for socio-economic status (i.e. most BF mothers from 70s onwards have been middle class, whereas before the opposite pattern) PLUS prebiotics now added to formula.

BUT, of course BF is always going to be best for baby but the pressure to do so for the full 6 months is simply not realistic in all cases .

Remember, "food is not love" - I've seen too many mums (including in Sweden where BF rates one of the highest in world) stressed out for the first 3 months because of issues with getting it to work.