Milk Aversion in Infants: Causes and Solutions

Lactose intolerance

Hello Dr.
Zhao, my child just turned five months old today.
They weigh 8 kilograms and were born weighing 3420 grams.
Since they were three months old, they have been refusing to drink milk for the past two months.
Before the refusal, the baby would drink about 150cc every four hours, but now, after the refusal, they only drink about 50cc every five to six hours.
On average, they consume less than 400cc in 24 hours.
During this time, we tried an appetite stimulant prescribed by a pediatrician, and while on the medication, the baby was more willing to drink milk.
However, once we stopped the medication, they began refusing milk again the next day.
The baby not only refuses milk but also water.
If we force them to drink, they start to vomit.
We have attempted to use a feeding tube, but the baby refuses to swallow the milk and lets it flow out of the corners of their mouth.
We have also tried rice cereal, apple puree, and sports drinks, but the baby just won't eat.
I am unsure if the lack of food is causing the baby to become more fussy.
They cry continuously, both day and night, and after calming them down, they start crying again for no apparent reason.
Around four months, when they were taking the medication, they were more willing to drink milk, and at that time, their weight was already 8 kilograms.
However, now at five months, their weight has not increased at all.
The pediatrician keeps telling us to find something that the baby likes to eat, but what can a five-month-old eat? Would changing the formula help with the milk refusal issue? How should we go about changing the formula? Should we take them back to the pediatrician for further examination? A helpless mother.

Jinchih, 30~39 year old female. Ask Date: 2001/03/02

Dr. Zhao Yongkang reply Pediatrics

1.
It is normal for children to have bowel movements.

2.
Many gastrointestinal medications commonly used for children are probiotics, which can assist in their digestive function and can actually be taken long-term under a physician's guidance.

3.
At five months old, you can start introducing complementary foods; additionally, a visit to a pediatric gastroenterologist for an examination is recommended!
4.
If you live in Hsinchu, our hospital has pediatric gastroenterology clinics with Dr.
Kang Dan-chi every Tuesday afternoon, and you should bring your child for a thorough examination.

Reply Date: 2001/03/02

More Info

Understanding milk aversion in infants can be a challenging experience for both parents and healthcare providers. In your case, your five-month-old child has shown a significant decrease in milk intake, which is concerning, especially given the importance of nutrition during this critical growth period. Let's explore the potential causes of milk aversion and discuss possible solutions.

Causes of Milk Aversion
1. Gastrointestinal Discomfort: Infants may develop aversions to milk if they associate it with discomfort, such as gas, reflux, or other gastrointestinal issues. If your baby experienced any discomfort after feeding, it could lead to a negative association with milk.

2. Taste Preferences: As infants grow, they begin to develop taste preferences. If your child has been introduced to solid foods, they may prefer the flavors and textures of those foods over milk.

3. Medical Conditions: Conditions such as allergies or intolerances can lead to milk aversion. If your child has a milk protein allergy, it could cause discomfort or adverse reactions, leading them to refuse milk.

4. Psychological Factors: Sometimes, infants may refuse milk due to stress or changes in their environment. If there have been significant changes in routine or family dynamics, this could affect their feeding behavior.

5. Developmental Changes: At around five months, infants are becoming more aware of their surroundings and may be more distracted during feeding times, leading to decreased intake.

Solutions to Address Milk Aversion
1. Consult a Pediatrician: Since your child has been experiencing this aversion for two months, it is crucial to consult a pediatrician or a pediatric gastroenterologist. They can evaluate for any underlying medical issues, such as allergies or gastrointestinal disorders, and provide tailored advice.

2. Experiment with Different Formulas: If you suspect that your child may have a milk protein allergy or intolerance, consider trying a hypoallergenic formula. These formulas are designed to be easier on the digestive system and may be more acceptable to your child.

3. Introduce Solid Foods Gradually: At five months, your child can start to explore solid foods. While breast milk or formula should still be the primary source of nutrition, introducing small amounts of pureed fruits, vegetables, or cereals may help stimulate interest in feeding. However, ensure that these foods are appropriate for your child's age and development.

4. Create a Calm Feeding Environment: Minimize distractions during feeding times. Hold your baby in a comfortable position and create a calm atmosphere to help them focus on feeding.

5. Use Different Feeding Techniques: If your child is refusing to drink from a bottle, try different types of bottles or nipples. Some infants prefer certain shapes or flow rates. Additionally, you can try cup feeding, which may be more appealing to some infants.

6. Monitor Feeding Cues: Pay attention to your child's hunger cues. If they are showing signs of hunger, offer milk or formula, but avoid forcing them to drink. Forcing can create negative associations with feeding.

7. Hydration Alternatives: If your child is refusing water, consider offering small amounts of diluted fruit juice or electrolyte solutions, but consult your pediatrician first to ensure they are appropriate for your child's age.

8. Patience and Consistency: It may take time for your child to adjust to feeding again. Be patient and consistent in your approach, and continue to offer milk regularly without pressure.

Conclusion
Milk aversion in infants can stem from various factors, including gastrointestinal discomfort, taste preferences, or psychological influences. It's essential to work closely with your pediatrician to rule out any underlying medical conditions and to develop a tailored feeding plan. Remember, the goal is to ensure your child receives adequate nutrition while fostering a positive feeding experience. With time, patience, and the right strategies, many infants can overcome milk aversion and thrive.

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