Feeding FAQ: 4-6 months – Formula Feeding

My son of almost 6 months has a very low milk intake by day which means he feeds on demand at night

For over two months my son of almost 6 months has put up a fight with his milk and taken it less and less willingly. In the past week I have had him at hospital as he arches his back and screams and only ever drinks his whole bottle, if that, at night around 7pm. Since he was two and a half months he started sleeping through the night. In the past three months he has started stirring in the night. Now he wakes nearly every hour shouting and sometimes crying. He only takes to his teatime solids and is not fussed with breakfast or lunch.

The hospital dietician advised to put him on a lactose and allergy special milk which I have just tried, giving him a bottle of half the new formula mixed with half of his own. He just spits the teat out. Today all he has taken is 2 oz at 7.30am, 4 oz at 11.30am and 2 oz at 3pm. He just won’t take anymore. In himself he is very content, smiley baby, apart from meal times. I was advised to start him on protein by my health visitor.

I make all his food, so he has chicken or fish pureed with vegetables.

I thought it may be reflux, so we have him on Gaviscon sachets which maybe beginning to work. I don’t get much sleep and with every feed time a battle I just don’t know what to do. He had not put any weight on in 2 weeks recently, but I was advised to give him as much dairy full fat food as possible. I use cheese, full fat yoghurt and avocado to do this. He has now put 5oz on in a week but still won’t take hardly enough milk. I have to feed him on demand at night if he wants it therefore I am going backwards and now any routine I had has gone out of the window! I’m also having him in bed with me as I just need to sleep!

At present he feeds at 7am 2ozs, 11am 4ozs, 3pm 3ozs, 5pm 3ozs, 7pm 6-7ozs and 11pm 3-4ozs, giving a daily total of 21ozs. He weighs 15.10ozs.

I try him with baby cereal and fruit around 8am but he never takes much. His lunch is at 12.30pm, chicken and vegetable with fruit afterwards. Again not much is eaten.

Teatime is at 5.30pm and he chicken and fish with vegetables followed by yoghurt.

My son naps at 8.50-9.20am, 1.30-2pm and 4-5pm. He settles at 7.30pm. He may wake at 1am, 3am, 5.30 and 6.30am. If he cries a lot I offer him milk to get him back to sleep.

It can be very worrying when your baby seems to lose all interest in milk and, as a result, puts on no weight. Now that he is well established onto solids, some of his daily milk intake will be coming from those foods. At six months a baby needs a minimum of 18-20ozs a day which includes that used in his foods. If you look at the total that your son drinks in the day and then add the yoghurt, cheese and milk used in preparing his food, he does seem to be taking a fairly good amount. His recent weight gain shows this. A 125gr [4oz] pot of full fat yoghurt or 30gr [1oz] of cheese is the equivalent of 7ozs of milk.

If you still want to try your son with the milk suggested by the hospital you could do so by replacing just 1oz of his usual formula with the new one and then gradually, over a period of days, increase the new formula ounce by ounce whilst decreasing his usual formula until he has grown used to the change.

As he still is not interested in taking a bigger amount of milk at each feed you may need to use split feeds to try to get him to take more. Since he is not always interested in breakfast or lunch why not stop offering him breakfast for a few days and see if he is more interested in lunch? Offer him milk at 7.30am and again before he settles to his morning nap. He may only take another 1-2ozs but it will all help increase his intake.

It is best not to offer milk at the same time as offering protein at meals. Milk can prevent the absorption of protein into the body by up to 50%. By giving your son his milk at 11am you are avoiding this but it seems he has his lunch quite late, at 12.30pm. Is he very tired by then? This could also be a reason why he does not eat so well. By cutting out breakfast, this feed could be offered at 10.30am and his solids at 11.30/11.45am. Again, offer him a small top up of milk before going down for this nap. Your son could then be encouraged to have a longer lunchtime nap, which would occur at the time of day when his energy levels naturally dip.

This should help him be ready to have another feed at 2.30/3pm. As he is having his longest sleep of the day in the afternoon it is noticeable he eats and drinks better after this. Tiredness can stop a baby from feeding or eating well. Take a look at the suggested times and lengths of naps for a baby of your son’s age on page 170 of The Contented Little Baby Book. As you are only just beginning to use the routines, you may need to use one suggested for a slightly younger baby first until your son’s daytime naps are more structured. This should help him be more settled at night time as well.

If you feel that your son is uncomfortable at night he may well have some acid reflux problems. Elevating the head of his cot, using two large telephone directories under each leg, could help him. You can buy special sleeping wedges which fit under the cot mattress to provide the same sloped position.

If your son continues to sleep in your bed you may find this would be useful to have, so he could be settled next to you.

Once you feel that he is beginning to take in enough milk by day, especially if he begins to take more in the form of dairy foods, you could begin to find ways to settle him back to sleep at night without always feeding him. Offering him a drink of cooled boiled water when he first wakes may help him to settle back again, even if only for another hour or so. He may associate waking at night with being fed and you will need to cut back on these feeds gradually, so he increases in the daytime. If he refuses to settle when given water then by all means feed him. By offering the water first you will find he should not need so much milk in order to settle.

If you read the section about the “core night”, page 148 in The Contented Little Baby Book, you will see how you can begin to stretch out his nights between feeds. It will take a while for your son to drop all of them but, if you keep trying to increase his feeds little by little in the day, he will not need milk to get him through the night.

As you are being seen by the hospital, and your health visitor is advising you, then be guided by what they suggest to you to help him continue to gain weight.