Why Your Baby Refuses Bedtime Milk: Tips for Parents

The baby is not drinking bedtime milk?

Hello Doctor: My baby is currently 2 months old and is being fed with a combination of breast milk and formula.
At one and a half months, I tried to eliminate the night feed, so the last feeding was at 10 PM and the first meal in the morning is at 6 AM (he wakes up crying around 3:30 or 4:30 AM, and I use a pacifier to soothe him back to sleep).
Initially, to ensure he was full enough to sleep through the night, I fed him 180 cc of formula for the last meal, but he experienced two episodes of significant spitting up, where the milk came out of both his mouth and nose.
Additionally, he has had several days where he struggled to have a bowel movement, and he still has irregular bowel movements.
I stimulate his anus to help him pass stool, which is often very thick.
Recently, he has also started refusing to drink his bedtime milk (after the spitting up incidents, I adjusted the feeding amount to 120-150 cc).
He only drinks about 60 cc and then strongly resists and cries when I try to feed him more, leaving my husband and me unsure of what to do.
Now he has irregular bowel movements and refuses to drink his bedtime milk.
What should I do, Doctor? (Currently, I feed him every four hours, with three breast milk feedings and two formula feedings, each meal being 120 cc, and the bedtime milk being 150 cc.)

Peipei, 20~29 year old female. Ask Date: 2016/12/04

Dr. Xiao Kaiwen reply Pediatrics

At two months old, an infant's stomach capacity is still limited, so it is not advisable to feed too much milk before bedtime (feeding 180cc at once for infants under two months is a bit excessive).
At this stage, feeding should be based on the infant's needs.
As the infant grows older and the stomach capacity increases, the amount of milk will gradually increase, and naturally, the intervals between feedings (including nighttime) will lengthen.
It is not appropriate to train for bedtime feeding at this time.
Additionally, a two-month-old infant's bowel muscles are not yet fully developed; as long as the stool is not very hard and dry, any constipation will gradually improve as the bowel muscles mature.
In the meantime, using physical methods such as abdominal massage and anal stimulation is acceptable.

Reply Date: 2016/12/04

More Info

When it comes to feeding a two-month-old baby, especially regarding bedtime milk, several factors can influence a baby's willingness to drink milk before sleep. Your situation, where your baby is refusing bedtime milk and experiencing constipation, is not uncommon among infants. Here are some insights and tips to help you navigate this challenging phase.

Understanding the Refusal of Bedtime Milk
1. Digestive Discomfort: The experience of vomiting and constipation can create a negative association with feeding, particularly at bedtime. If your baby has had a bad experience with milk, they may resist it in the future. It's essential to ensure that the feeding process is comfortable and that your baby is not overfed, which can lead to discomfort and spitting up.

2. Feeding Amounts: You mentioned adjusting the feeding amount to 120-150cc, which is a reasonable range for a two-month-old. However, if your baby is consistently refusing milk, consider whether they might be full or simply not hungry at that time. Babies have varying appetites, and their needs can change from day to day.

3. Sleep Associations: Babies often develop associations between certain activities and sleep. If your baby has been using a pacifier to soothe themselves to sleep, they may prefer that over milk. It’s crucial to create a calming bedtime routine that signals to your baby that it’s time to sleep, which can include gentle rocking, singing, or reading a story.

Tips for Encouraging Bedtime Milk
1. Create a Calm Environment: Ensure that the feeding environment is quiet and soothing. Dim the lights and minimize distractions to help your baby focus on feeding.

2. Experiment with Feeding Positions: Sometimes, changing the feeding position can make a difference. Try holding your baby in a more upright position or finding a comfortable angle that might help them feel more secure while feeding.

3. Monitor Feeding Times: If your baby is waking up around 3:30 or 4:30 AM, consider adjusting the timing of the last feed. You might try offering a smaller amount of milk closer to bedtime, which can help prevent overfeeding and reduce the likelihood of spitting up.

4. Hydration and Constipation: Since you mentioned your baby is experiencing constipation, ensure they are adequately hydrated. While breast milk and formula provide hydration, sometimes a small amount of water (if recommended by your pediatrician) can help with constipation. Additionally, gentle tummy massages or bicycle leg movements can stimulate bowel movements.

5. Consult Your Pediatrician: If your baby continues to refuse bedtime milk and experiences ongoing constipation, it’s essential to consult your pediatrician. They can provide tailored advice and check for any underlying issues that may be affecting your baby's feeding and digestion.

Conclusion
Navigating feeding challenges with a two-month-old can be stressful, especially when compounded by issues like vomiting and constipation. By creating a calm feeding environment, adjusting feeding amounts and positions, and consulting with your pediatrician, you can help your baby develop a more positive association with bedtime milk. Remember, patience is key, and every baby is unique in their feeding preferences and needs.

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