Feeding FAQ: 3-4 months – Formula Feeding

My 13-week-old baby has digestive problems and is taking less and less milk

My daughter is my third baby on the CLB routine because it was such a success with older siblings. I started the routine even in hospital, but she still very quickly developed problems feeding. Initially breast fed, she gulped air as she fed, and as soon as the milk hit her stomach I could hear loud rumbling. She only fed for a bit before screaming, or feeding for a few minutes and refusing any more. Huge burps kept coming – excessive wind I think caused by ingesting so much at a feed. I introduced an expressed bottle in the second week which went fine, but no formula until 6 weeks. As she got older she sometimes fed for longer but would often bring up the feed. Still I would persevere with the routine feed times and sleep times, but often splitting the feeds. I tried all the colic remedies on the market with no success.
At the eight week check, the doctor said she had bit of colic, reflux and an immature digestive system, and that I was to preserve until 12 weeks when it should get better.
In the last 3 weeks I have put her on infant Gaviscon which although seems to be keeping the feeds down, she seems to be taking less and less. She is getting fretful even with the first ounce of milk, taking a few gulps and then not wanting any more. I can’t split the feed when she’s only taken 1oz so I try and wind her, put her down and try again 10mins later in a different position or sitting up in her chair. As you can imagine, she and me start to get distraught, until she falls asleep (at the right time, but only to wake up ½ hour later screaming and even then not wanting to feed at the lunch time nap). I’m keeping a diary and she takes only 20-24 oz in 24 hours.
I now feel like a first time mother who hasn’t a clue. I don’t want to abandon the routine as I know no other way but I need some help as to how to handle the feeding. I have tried different bottles: Dr Browns and Haberman with no success.
The worst time for getting food down her is in the morning. She goes from 11pm until 5ish. She might take 1-2oz between 5 and 7am, but hiccups and screams if I try and feed her at 7/7.30. I give her water if she wakes before 5.
Have you seen this before? How do I handle the nights when I know she’s not taking enough during the day? How can I persuade her to take more in one go?
I have tried the following things:
– Sitting somewhere quite to feed her
– Playing music/TV as background noise to distract her
– Lying her on a bean bag so her back is straight
– Sitting her in her upright chair alternating with a dummy
She weighs 11lbs7ozs and feeds at 5.30am 1-2ozs, 7.30am 3ozs, 10.30am 2ozs, 11.30am 2ozs, 1pm 1oz, 2.30pm 3ozs, 5.55pm 3ozs, 6.30pm 3ozs, 10.30pm 3ozs.
She naps at 9-9.40am, 12-12.50pm,1.30-2pm, 4-4.30pm and settles at 7pm.

As your daughter’s feeding is not improving at all return to your doctor and insist on a referral to a gastric specialist. At her weight she needs more in the region of 28 ozs a day . Although the Gaviscon has stopped the vomiting the way she feeds taking in so little before becoming distressed needs investigating.
There are a couple of practical things you could do straight away. On your notes you are feeding her with a no3 teat and Avent bottle. You could try a smaller teat size as this one will be quite fast . This may be causing her to gulp at the milk and swallow excessive air whilst doing so. You could also try a variflo teat which means you can regulate the flow from slow to fast. Avent make their own but Tommee Tippee also make a Variflo teat which will fit Avent bottles too. This has a x cut in the top instead of holes and works with different speeds according to the rate and strength of the babies suck. This can help a baby who becomes overwhelmed with milk flowing too fast.
Sometimes babies who are difficult to feed can do better if you hold them in an upright position and move around the room at the same time. Walking seems to calm them enough to take in the milk steadily, rather than gulping at it.
At night time and during naps let your daughter sleep on a raised mattress. Do this by placing telephone directories or large books under the legs of the top end her cot or used rolled towels under the mattress so she is sleeping on a sloped rather than flat surface. You van buy special wedge shaped pillows from some nursery outlets which will also slope the mattress.