How to Ensure Nutritional Needs for an 8-Month-Old Baby Refusing Milk

Weaning an eight-month-old baby?

The baby was born on July 4, 2016, and started refusing to drink milk on the evening of February 25, not taking even a sip from the bottle, only consuming solid foods.
Initially, the baby experienced diarrhea after taking cold medicine, and after the doctor prescribed anti-diarrheal medication, there was no resolution, leading to continued reliance on solid foods.
With the baby approaching eight months of age and not drinking any milk, I am concerned about how to ensure adequate nutrition from solid foods alone.
Additionally, the intake of solid foods is quite limited.
Feeding difficulties began at two and a half months and improved slightly by six months, but now the baby refuses milk altogether, which is very worrying.
Currently, the baby weighs approximately 7.1 kg, with a birth weight of 2540 g.
Weight gain has slowed around five months, and there has been no increase in height over the past month, remaining the same as at six months, although the baby can sit and crawl.
Can the doctor advise on how to supplement her nutrition from solid foods in the absence of milk?

rita, 20~29 year old female. Ask Date: 2017/03/01

Dr. Xiao Kaiwen reply Pediatrics

In principle, if the infant is not experiencing any illness (such as gastroenteritis with vomiting and diarrhea, or hand, foot, and mouth disease with oral ulcers preventing feeding, etc.), has normal activity levels, normal development, and weight gain without significant abnormalities (for example, an 8-month-old female infant weighing 7.1 kg is not considered to have significant malnutrition), this is classified as a benign period of milk refusal.
It is generally recommended to provide normal nutritional complementary foods (not snacks) during this time.
It is advisable to let the milk refusal phase take its course; forcing feeding at this stage may worsen the situation.
Typically, this milk refusal phase is temporary, and the infant will resume drinking milk afterward.
If there are still concerns, it is advisable to consult a pediatrician at a hospital.

Reply Date: 2017/03/01

More Info

Ensuring that an 8-month-old baby receives adequate nutrition can be challenging, especially when the baby refuses to drink milk. Milk, particularly breast milk or formula, is a primary source of nutrition for infants, providing essential nutrients such as protein, fats, vitamins, and minerals. When a baby refuses milk, it is crucial to find alternative ways to meet their nutritional needs through complementary foods.

Nutritional Needs of an 8-Month-Old
At 8 months, a baby typically requires around 800-1000 calories per day, with a significant portion coming from breast milk or formula. If your baby is not consuming milk, you will need to ensure that the complementary foods you provide are nutrient-dense and varied to compensate for the lack of milk.

Complementary Foods
1. Iron-Rich Foods: Since milk is a poor source of iron, it is essential to include iron-rich foods in your baby's diet. Options include:
- Iron-fortified cereals (mixed with water or breast milk to a suitable consistency)
- Pureed meats (such as chicken, turkey, or beef)
- Lentils and beans (well-cooked and pureed)
2. Fruits and Vegetables: These provide essential vitamins and minerals. Offer a variety of pureed or mashed fruits and vegetables, such as:
- Bananas
- Avocados
- Sweet potatoes
- Carrots
- Peas
3. Healthy Fats: Healthy fats are crucial for brain development. Include foods like:
- Avocado
- Olive oil (drizzled on purees)
- Nut butters (if there are no allergy concerns, and introduced cautiously)
4. Dairy Alternatives: If your baby is not drinking milk, consider introducing yogurt or cheese, which can provide calcium and protein. Ensure these are age-appropriate and not too salty or sugary.

5. Grains: Offer a variety of grains, such as:
- Oatmeal
- Rice
- Quinoa
- Barley

Feeding Strategies
1. Gradual Introduction: Introduce new foods gradually, one at a time, to monitor for any allergic reactions. Start with small amounts and increase as your baby shows interest.

2. Texture and Consistency: At this age, babies are developing their chewing skills. Offer foods with different textures, from purees to soft finger foods, to encourage self-feeding and exploration.

3. Meal Timing: Offer complementary foods when your baby is hungry but not overly hungry, as this can lead to frustration. You might try feeding solids before offering any milk or formula.

4. Positive Eating Environment: Create a pleasant mealtime atmosphere. Sit together during meals, and allow your baby to explore food without pressure. This can help foster a positive relationship with food.

5. Monitor Growth: Keep track of your baby's growth and development. Regular check-ups with a pediatrician can help ensure that your baby is growing appropriately and receiving adequate nutrition.

When to Seek Help
If your baby continues to refuse milk and struggles with complementary foods, it may be beneficial to consult a pediatrician or a pediatric nutritionist. They can provide personalized guidance and may suggest specific dietary adjustments or supplements to ensure your baby meets their nutritional needs.

Conclusion
While it can be concerning when an 8-month-old refuses milk, it is possible to meet their nutritional needs through a well-rounded diet of complementary foods. Focus on providing a variety of nutrient-dense foods, monitor your baby's growth, and maintain a positive feeding environment. If you have ongoing concerns, do not hesitate to seek professional advice to ensure your baby's health and well-being.

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