Infant Feeding Issues: Tips for Managing Milk Refusal and Colic

Q: Infant Feeding Issues: Tips for Managing Milk Refusal and Colic

Response： (1) Infants have a limited stomach capacity, so it is advisable to avoid giving water and glucose water between feedings to allow for more milk intake. <br>Glucose water is not necessary; if the baby sweats a lot or loses more fluids in an air-conditioned environment, y

Infants not drinking milk?

Hello Dr.
Hong,
My baby is now over three months old.
Recently, the interval between feedings has extended from three hours to four hours, so I adjusted her milk intake from 120cc to 150cc.
However, in the past few days, she often seems uninterested in feeding when it's time, appearing more playful or even throwing a tantrum instead of drinking.
Is this what is referred to as a feeding aversion? How can I improve this situation? If this persists for too long, could it affect her development and lead to malnutrition?
Additionally, she often wakes up crying after sleeping for a short while at night, but calms down after passing gas and having a soft stool.
Could this be colic? If so, how can I prevent and manage it?
Thank you!
A concerned mother

Danxin de mama, 20~29 year old female. Ask Date: 2001/02/15

Dr. Hong Shaohui reply Pediatrics

Response: (1) Infants have a limited stomach capacity, so it is advisable to avoid giving water and glucose water between feedings to allow for more milk intake.
Glucose water is not necessary; if the baby sweats a lot or loses more fluids in an air-conditioned environment, you can offer 20-25 cc of water between two feedings.
After four months, you can start introducing diluted fruit juice.
In fact, the milk intake does not always need to increase as long as the infant is digesting well and showing stable growth in height and weight.
(2) Before a bowel movement, infants may experience some discomfort in their abdomen and often cry; this is known as colic, and it is generally normal as long as it lasts no longer than 30 minutes.
When the baby is crying, gently tapping on their abdomen may produce a sound similar to drumming.
You can also apply some ointment, such as vapor rub or mentholated oil, around the navel area to help alleviate the symptoms.

Reply Date: 2001/02/15

More Info

Hello! It sounds like you're navigating a challenging phase with your baby, and it's completely understandable to be concerned about feeding issues and potential colic. Let's break down your questions and provide some insights based on current pediatric guidelines and practices.

Milk Refusal and Feeding Patterns
Firstly, it's not uncommon for infants around three to four months to go through a phase of milk refusal or to show less interest in feeding. This can be attributed to several factors, including developmental milestones, distractions from their environment, or even the onset of teething. At this age, babies are becoming more aware of their surroundings and may prioritize play over feeding, which can lead to what is often referred to as a "nursing strike" or "milk refusal."
What You Can Do:
1. Follow Their Cues: Instead of strictly adhering to a feeding schedule, try to observe your baby's hunger cues. If they seem uninterested in feeding, it might be best to wait a little while before offering the bottle again.

2. Create a Calm Feeding Environment: Minimize distractions during feeding times. A quiet, dimly lit room can help your baby focus on feeding rather than being distracted by sights and sounds.

3. Experiment with Different Positions: Sometimes, changing the feeding position can make a difference. Some babies prefer being held in a different way or may respond better to a more upright position.

4. Gradual Increase in Volume: If your baby is consistently refusing to drink the adjusted amount, consider offering smaller amounts more frequently rather than forcing them to consume a larger volume at once.

Concerns About Nutritional Intake
Regarding your concern about nutritional deficiency due to reduced milk intake, it's essential to monitor your baby's growth and development closely. If your baby is gaining weight appropriately and meeting developmental milestones, occasional fluctuations in feeding patterns are usually not a cause for alarm. However, if the refusal persists or if you notice any signs of weight loss or failure to thrive, it would be prudent to consult your pediatrician for a thorough evaluation.

Colic and Crying Episodes
As for the nighttime crying and the possibility of colic, many infants experience colic, characterized by excessive crying, often in the late afternoon or evening. This can be distressing for both the baby and the parents. Colic typically resolves on its own by around three to four months of age, but there are strategies to help manage it:
Preventive Measures and Remedies:
1. Burping Techniques: Ensure that your baby is burped adequately during and after feedings to help release any trapped gas that may cause discomfort.

2. Tummy Time: Engaging in tummy time while your baby is awake can help strengthen their abdominal muscles and may aid in digestion.

3. Warm Compress: Applying a warm compress to your baby's tummy can provide comfort and help relieve gas pains.

4. Gentle Motion: Rocking, swinging, or taking your baby for a ride in a stroller or car can sometimes soothe a fussy baby.

5. Probiotics: Some studies suggest that probiotics may help reduce colic symptoms, but it's best to discuss this with your pediatrician before starting any supplements.

When to Seek Help
If your baby's crying seems excessive or if you have concerns about their feeding habits, growth, or overall well-being, don't hesitate to reach out to your pediatrician. They can assess your baby's health, provide guidance tailored to your situation, and rule out any underlying issues.

In summary, while it can be concerning to see changes in your baby's feeding patterns and behavior, many of these issues are common and often resolve with time. By observing your baby's cues, creating a conducive feeding environment, and employing soothing techniques, you can help navigate this challenging phase. Always trust your instincts as a parent, and seek professional advice when needed. Your baby's health and happiness are the top priorities!

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