Why Your Baby Refuses Bedtime Milk: Tips for Parents

The baby refuses to drink milk before bedtime?

Hello Doctor: My baby is currently 2 months old and I am feeding him a combination of breast milk and formula.
When he was one and a half months old, I tried to eliminate the night feeding, so my last feeding was at 10 PM and the first meal in the morning is at 6 AM (he usually 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 and could sleep through the night, I fed him 180 cc of formula for the last meal, but there were two instances of significant spit-up, where milk came out from both his mouth and nose.
Additionally, he 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 quite thick and sticky.
Recently, he has also started refusing to drink his bedtime milk (after the spit-up incidents, I adjusted the feeding amount to 120-150 cc), and he only drinks about 60 cc before refusing and crying vigorously, leaving my husband and me unsure of what to do.
Now, with irregular bowel movements and refusal to drink bedtime milk, what should I do, Doctor? (I am currently feeding him every four hours, with 3 meals of breast milk and 2 meals of formula, each meal being 120 cc, and the bedtime milk being 150 cc.)

Peipei, 20~29 year old female. Ask Date: 2016/12/05

Dr. Xiao Kaiwen reply Pediatrics

At two months old, an infant's stomach capacity is still limited, so it is not advisable to feed them too much milk before bedtime (feeding 180cc at once for infants under two months is somewhat excessive).
At this stage, feeding should be based on the infant's needs.
As the infant grows and their 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 a pre-bedtime feeding at this time.
Additionally, a two-month-old infant's bowel muscles are not yet fully developed, so as long as the stool is not very hard and dry, constipation should improve as the bowel muscles mature.
In the meantime, using physical methods such as abdominal massage and anal stimulation is acceptable.

Reply Date: 2016/12/05

More Info

When it comes to feeding a two-month-old baby, especially one who is transitioning between breast milk and formula, there are several factors to consider, particularly if the baby is refusing bedtime milk. This situation can be quite challenging for parents, as it involves understanding the baby's needs, preferences, and developmental stages.

First and foremost, it's important to recognize that babies at this age are still developing their feeding patterns and preferences. It's not uncommon for infants to go through phases where they refuse certain feedings, including bedtime milk. This can be influenced by various factors, including discomfort from overfeeding, gastrointestinal issues, or simply a desire for comfort rather than food.

In your case, you mentioned that your baby has experienced episodes of vomiting and constipation. These issues can significantly affect a baby's willingness to feed. If your baby has had a negative experience with feeding, such as vomiting after a large meal, they may associate feeding with discomfort, leading to resistance during subsequent feedings. It's crucial to ensure that the feeding amounts are appropriate for your baby's age and size. The general guideline for formula feeding is about 2.5 ounces per pound of body weight per day, divided into several feedings. For a two-month-old, this typically translates to around 24-32 ounces of formula per day, but this can vary based on individual needs.

Given that your baby is currently refusing bedtime milk, here are some tips to help encourage a more positive feeding experience:
1. Adjust Feeding Amounts: Since your baby has experienced vomiting, consider reducing the amount of formula offered at each feeding. You mentioned adjusting to 120-150cc; perhaps starting with smaller amounts (e.g., 60-90cc) and gradually increasing as your baby shows readiness could be beneficial.

2. Create a Calm Environment: Ensure that the feeding environment is calm and soothing. Dim the lights, reduce noise, and hold your baby in a comfortable position. This can help your baby feel more relaxed and open to feeding.

3. Monitor for Discomfort: Pay attention to signs of discomfort during feeding. If your baby seems fussy or in pain, it may be worth consulting with a pediatrician to rule out any underlying issues, such as reflux or allergies.

4. Establish a Routine: Babies thrive on routine. Try to establish a consistent bedtime routine that includes a calming activity before feeding, such as gentle rocking or reading a book. This can help signal to your baby that it’s time to wind down and prepare for sleep.

5. Consider Alternative Comforts: If your baby is resistant to feeding, try offering comfort in other ways, such as using a pacifier or gently rocking them to sleep. Sometimes, babies may just need the comfort of being held rather than feeding.

6. Hydration and Constipation: Since you mentioned issues with constipation, ensure that your baby is adequately hydrated. If your baby is exclusively formula-fed, consider discussing with your pediatrician whether a different formula might be more suitable, as some formulas can be constipating.

7. Consult Your Pediatrician: If the refusal of bedtime milk continues or if you have concerns about your baby's feeding habits, growth, or bowel movements, it’s essential to consult your pediatrician. They can provide tailored advice and check for any underlying health issues.

In conclusion, it's essential to approach feeding with patience and flexibility. Babies go through various phases, and their preferences can change frequently. By adjusting feeding amounts, creating a calming environment, and monitoring for discomfort, you can help encourage a more positive feeding experience for your baby. If issues persist, don't hesitate to seek professional guidance to ensure your baby's health and well-being.

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