Feeding FAQ: 6-9 months – Formula Feeding

My six-month-old daughter has a small appetite for milk

My daughter’s feeding and sleeping patters are going completely off track. We need help encouraging her to eat/drink more during the day so we can eliminate the nighttime waking. She was 5lb 15oz at birth and has maintained a slow but gradual progress and now weighs 13lb 3oz at 6 months. I have assurances from health visitors that she is fine, and she has had hospital tests to check that there is no underlying problem. However, since introducing solids at 22 weeks my daughter’s weight gain has dropped and, at the weigh-in last week, she had only put on 1.5 oz in two weeks – although the health visitor did not seem concerned. Her milk intake is hit and miss. Most days she achieves 20oz (including what is added to solids), but it is a struggle and often she only reaches 20oz by having a feed in the night. I have tried different bottles and, on advice, switched formula to Aptamil Forward, but she will not take more than 4oz at a feed, except the 6.30pm feed when she will happily take up to 7oz. I have also tried giving a small amount, letting her play, then feeding again, but she is not interested. She just appears to have a very small appetite. Progress with solids has been ok but she will only eat with enthusiasm if she is really hungry. I have tried giving a few ounces then solids but she will not eat anything and I now have to leave a gap of at least an hour between milk and solids. During the day my daughter is a very active and happy baby. At 10.30am and 1.30pm she seems genuinely hungry, but a couple of ounces still seem to satisfy her. I have also adjusted the times of feeds, but there is still no increase in milk intake. Bedtime is 7pm and she goes to sleep straight away and, other than the night feedings, will sleep until 7am. I have tried to extend the lunchtime nap, but without success. I stopped giving her baby rice, but she has a wide variety of vegetables and the odd jar, which has been eaten with enthusiasm!
At present she takes: 7am – 3oz formula; 8.30am- 2 tsp baby porridge made with 0.5oz formula and 1 cube fruit; 10.30am – 1.5oz formula; 11.30am – 2 cubes veg, 2-3tsp yoghurt, small amount of water; 1.30pm – 3oz formula; 5pm – 3 cubes veg, small amount of water; 6.30pm – 5-7oz formula; 11pm – 3oz taken reluctantly after being woken; 1.30am – wakes and takes 3-4ozs.
She naps at 9.15-10.00am, 12.15-1.00pm and 4.00-4.30pm.

During the second half of the first year, a baby will slow down in the weekly weight gain. At your daughter’s age, the average gain is 3.5 ounces per week. With her small daily intake of milk she is gaining more slowly than this average, but this seems to have always been the pattern. It appears that her best feeds are those in the evening and night when she is not receiving any solid food near to them. Although you have been advised to put your daughter on to Aptamil Forward, you should be aware that second stage milk is much heavier and takes longer to digest than first stage milk. As your daughter has always had a small appetite, the combination of having this heavier milk alongside solids is possibly the reason for her cutting back on quantity. Discuss this issue with your doctor and ask if he considers it a good idea to put your daughter back on stage one formula at the 7am, 11am and 2.30pm feeds She may then be willing to drink more at these feeds. Until her appetite for solids increases at lunchtime, don’t increase breakfast. As she is having breakfast at 8.30am she is not really hungry at 10.30am. She is then taking just enough to top herself up and is not inclined to increase her solids at lunch. When protein is introduced, you need her to eat enough once her milk feed has been dropped. Hunger could also be the reason for her being unable to sleep longer at lunchtime.
If you are able to increase her overall daily intake by making these changes, you will be able to cut down on her night feed, which in turn should help her to be hungrier at 7am. Until she is feeding better in the day, keep the feed at 11pm, even if only small, as you will then know she is not likely to be waking from hunger in the night and you can settle her using cool boiled water.