Feeding FAQ: 4-6 months – Formula Feeding

I think 18 week Alicia’s reflux is making her hysterical twice a day

I have some concerns regarding my daughter. She is 18 weeks old and she has two instances during the day where she can get quite hysterical! The first instance is after her morning nap. I wake her at 9.45am, gently rousing her without immediately picking her up. She is content for about 15 minutes then she starts crying and is only consoled by holding her over my shoulder. I would like to try and get her closer to an 11am feed but I am worried that she’s getting hungry. I don’t want to feed her too early as I want her to sleep well at lunchtime.
She is woken at 7am and given nearly 7oz of milk. The second instance during the day where she is really unhappy is between 4 and 5pm. She actually gets quite hysterical and I don’t know what is wrong with her. She takes 5┬Żoz at 2.15pm. She also has 6-7oz of milk at 10.45-11am. She always sleeps well during her morning nap and always has to be woken up. Her lunchtime nap generally goes well but sometimes she wakes up and cries for 20-30 minutes. I never go into her and hope that she will settle herself back off. The only problem with this is that her brother of 25 months is in bed in the next room and I’m concerned he’ll be disturbed. Alicia is given a split feed at 5.45pm and 6.15pm of 7ozs as she cannot take it all in one go. We have just dropped her 10.30pm feed as she was down to 2ozs. For the last 5 days she has slept from 7pm to 7am and doesn’t wake up crying for her feed.
She weighed 6lb 2ozs at birth and now weighs 11lb 9ozs. She has only put on 6ozs in the last two weeks. The problem is that I cannot physically feed her more food. After 6ozs of food she starts griping with discomfort and looks in pain. Alicia, I believe, suffers from silent reflux and her GP has only just agreed to refer her. She is on Gaviscon Infant however I have noticed recently that she is bringing up milk again.
Should she be drinking more milk? Why is she so hysterical during those two times each day? Does the strict routine suit her or is she unwell? Can anyone help as her GP and HV are very reluctant to give me advice? Do I need to start weaning her? She chews her hands all day and her tops are always soaking wet!

I hope by now that you have a referral to a specialist. Reflux is such a distressing condition, and I can only sympathize with you over the reluctance of doctors and health visitors to give advice. Once her medication is sorted out I really feel things will improve for you, but times are difficult for you now.

I would suggest that you begin to feed Alicia at 10.30am at the latest. From my experience of reflux I find feeds spread out with a break of 10-15 minutes mid- feed can really help. Once she is really awake but before she starts to cry, begin the feed and then stop for a nappy change halfway and give her some time sitting in a baby chair to allow the first part to settle. Then offer her the second half by 11am.

I think her crying between 4-5pm is due to tiredness. Is it worse on the days when she has woken during her midday nap? Babies can be quite hard work at this time of day and need constant distraction. This is not easy when you are caring for your son as well and at this time of day need to prepare his tea. Do you think you could get her to have a short nap between 4.30 and 5pm? Has she a musical mobile over her cot which could amuse and calm her?

As regards weaning, it does sound as if Alicia is beginning to show signs of being ready to wean. I know in our last reply to you we explained why the guidelines have changed. I think weaning at this age should be discussed with your doctor, or better still at your specialist referral. There are specialist milks which can help with this condition, they are slightly thickened but obviously need medical diagnosis before being prescribed. They could well help Alicia feel more satisfied after each feed so that weaning need not begin just yet.

One of the symptoms of reflux is excessive drooling. As you say it is difficult to give Alicia more milk at each feed but she sounds as if she is getting hungry now. I hope this has gone some way to giving you some hope. Reflux is a subject which we are bringing to light, but unfortunately there is still a long way to go before it is more widely acknowledged in some professional circles.