Addressing Low Milk Intake in Infants: Concerns and Solutions

The baby is not drinking milk?

Hello Doctor, my younger brother is currently five and a half months old.
Since he was two months old, he has had poor feeding habits.
He drinks about 500 to 600 cc of milk daily, and in the past two weeks, it has worsened to less than 500 cc per day.
His height and weight have dropped from the 75th percentile at two months to the 50th percentile at four months, and he continues to decline.
We have tried feeding him rice cereal and juice, but his acceptance is very poor, and he does not drink water, which is quite concerning.
We have consulted a pediatrician, and there was some improvement while he was on medication, with his milk intake increasing to around 700 cc.
However, once the medication was finished, his intake returned to the original amount.
I would like to ask how to proceed.
Should we continue seeing a doctor? Could it be a digestive issue? Would medications like simethicone help? Is it safe for him to take? Do probiotics or lactobacillus available in the market help resolve my issue? Are there any other methods? Thank you for taking the time to respond.

Xiao Zhu, 30~39 year old female. Ask Date: 2003/07/10

Dr. Zhang Peixin reply Pediatrics

Hello!
1.
It can be concerning when an infant enters the weaning phase, especially if their growth curve drops from the 75th percentile to the 50th percentile, which approaches the definition of growth delay (crossing two growth percentiles).
It is advisable to consult a physician to evaluate whether any tests are necessary.
2.
Some medications can effectively stimulate appetite; however, it is essential to improve the quality of complementary foods and ensure the overall intake is appropriate.
If needed, consulting a nutritionist for assistance is recommended.
3.
Probiotics can be a viable option, but their effectiveness may vary from person to person.
Best wishes for health from Dr.
Chang Pei-Hsin, Director of Pediatrics, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2003/07/10

More Info

Addressing low milk intake in infants can be a challenging situation for parents, especially when it affects the child's growth and overall health. In your case, your five-and-a-half-month-old brother is consuming significantly less milk than the recommended amount, which is concerning given his declining growth percentiles. Here are some insights and recommendations based on current pediatric guidelines and nutritional knowledge.

Understanding Milk Intake in Infants
Infants typically require a substantial amount of milk for their growth and development. For a baby around six months old, the average intake is about 24 to 32 ounces (approximately 700 to 950 cc) of breast milk or formula per day. If your brother is consistently consuming less than this, it could lead to nutritional deficiencies and impact his growth trajectory.

Possible Reasons for Low Milk Intake
1. Digestive Issues: If your brother is experiencing discomfort after feeding, it could deter him from wanting to drink more milk. Symptoms like gas, bloating, or reflux can lead to a negative association with feeding times. Consulting with a pediatrician about potential digestive issues is crucial.

2. Feeding Techniques: Sometimes, the way milk is offered can affect intake. Ensure that he is in a comfortable position and that the bottle or breast is offered in a calm environment. Experimenting with different nipples or bottle types may also help.

3. Health Conditions: If there was a temporary improvement in intake while on medication, it could indicate an underlying health issue that needs to be addressed. Conditions like reflux or allergies can significantly impact feeding.

4. Developmental Readiness: At five months, some infants may start showing interest in solid foods, but this should not replace milk intake. Introducing solids too early or inappropriately can lead to decreased milk consumption.

Recommendations for Improvement
1. Consult a Pediatrician: Since your brother's weight and height percentiles are declining, it is essential to continue consulting with a pediatrician. They can assess for any underlying health issues and may recommend further evaluations or interventions.

2. Monitor Feeding Patterns: Keep a detailed log of his feeding times, amounts, and any signs of discomfort. This information can be invaluable for healthcare providers in diagnosing any issues.

3. Consider Nutritional Supplements: If milk intake remains low, your pediatrician may suggest nutritional supplements or fortified formulas to ensure he receives adequate nutrients.

4. Probiotics and Digestive Aids: While some parents find success with probiotics or lactobacillus supplements, it's essential to discuss these options with a healthcare provider first. They can help determine if these are appropriate for your brother's specific situation.

5. Gradual Introduction of Solids: If he is developmentally ready, you might consider introducing solids gradually, but ensure that milk remains the primary source of nutrition. Start with iron-fortified cereals or pureed fruits and vegetables, and monitor how he responds.

6. Hydration: Since he is not drinking water, it’s crucial to ensure he stays hydrated through milk. If he refuses water, try offering it in different forms, such as diluted fruit juice or flavored water, but keep in mind that milk should still be the primary source of hydration.

Conclusion
In summary, addressing low milk intake in infants requires a comprehensive approach that includes monitoring, consulting healthcare professionals, and possibly adjusting feeding strategies. Your brother's health and growth are paramount, and working closely with a pediatrician will provide the best guidance tailored to his needs. Remember, every infant is unique, and what works for one may not work for another, so patience and persistence are key.

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