Milk Aversion in Infants: Causes and Solutions

What is milk aversion?

Hello, Doctor: My baby DD is currently over 2 months old.
For the past few days, he has been very fussy, especially when it's time to drink milk.
He clearly wants to drink, but when I switch to milk, he just cries and sometimes spits it back out (he drinks every 3.5 hours).
It feels like he's going through a rebellious phase, almost as if he's in distress, and he fusses for 10 to 15 minutes before he will drink milk.
Previously, he could drink 120 to 140 cc, but now he only drinks 70 to 80 or 90 cc, and sometimes he can manage 110 cc.
Is this considered milk aversion? Is it normal for DD to drool sometimes? Is it normal for him to have tears when he cries? Is it okay for him to lie down while drinking milk? I apologize for asking so many questions, and I greatly appreciate your time in answering them.
Thank you, Doctor.

Xiao Yu Er, 20~29 year old female. Ask Date: 2005/04/05

Dr. Lin Wenxian reply Pediatrics

Dear Mother of Little Fish,
Greetings.
Regarding the issue of decreased milk intake, this is a common concern that many mothers bring up during outpatient visits, and your baby's situation is not unique.
Generally, parents expect that as their baby grows older and gains weight, the milk intake should also increase, and the intervals between feedings should become longer.
However, some babies do not follow this pattern.
Upon observing these babies with reduced milk intake, we find that their energy levels and neurological development are normal.
How can we explain this?
The reasons behind this phenomenon are not entirely clear, but there are several theories.
One explanation is that the growth rate decreases, leading to a reduced demand for milk.
A baby's growth rate is not constant; it may be fastest during the first month, resulting in a higher demand for milk.
As growth slows down, milk intake may decrease, and later, as growth accelerates again, milk intake may return to previous levels, which parents might interpret as a return to "normal."
Some suggest that this could be a characteristic of certain ethnic groups, while others believe it may be related to genetics.
The birth weight and the maternal uterine environment are closely linked, which means that a baby's birth weight might exceed the expected genetic weight.
Consequently, there may be a period of reduced milk intake after birth before returning to the expected growth curve based on genetics.
The so-called "nursing strike" typically occurs around four months after birth, but some babies may start this phase earlier.

What should you do? It is advisable to feed according to the baby's demand.
As long as your baby is healthy and developing well, you only need to observe.
There is no need to let the caregiver's anxiety affect the baby's feeding.

From another perspective, breastfed babies do not usually experience this issue, as they can feed directly from the breast whenever they are hungry, which is the most natural situation.
Mothers can see that their babies are growing and developing without worrying about the exact amount of milk consumed.
Currently, mothers are encouraged to breastfeed directly, as breastfeeding has numerous benefits.
The best breastfeeding position is to lie the baby in the mother's arms while nursing.
As for drooling and tearing, these are not illnesses.
Some children may drool more easily, but this typically resolves as they grow older.
Wishing you and your baby good health and all the best!
Sincerely,
Dr.
Lin Wen-Hsien
Director, Pediatrics Department
Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/04/05

More Info

When it comes to understanding milk aversion in infants, particularly in your case with your 2-month-old baby, there are several factors to consider. Milk aversion can manifest as a refusal to drink milk or a significant decrease in the amount consumed, which can be concerning for parents. Let's explore the potential causes and solutions for this situation.

Causes of Milk Aversion
1. Developmental Changes: Infants go through various developmental stages, and around 2 months, they may start to show preferences or aversions to certain things, including milk. This can be a normal part of their growth and development.

2. Gastroesophageal Reflux (GER): If your baby is experiencing discomfort while drinking milk, it could be due to reflux. This condition can cause the baby to associate feeding with discomfort, leading to aversion.

3. Taste Sensitivity: Babies have a heightened sense of taste and may react negatively to the flavor of the milk, especially if there are any changes in the formula or if the milk is not fresh.

4. Illness or Discomfort: If your baby is feeling unwell, they may refuse to drink milk. This could be due to a cold, teething, or other minor ailments that can make feeding uncomfortable.

5. Overstimulation: Babies can become easily overstimulated, which may lead to fussiness during feeding times. A calm and quiet environment can help them feel more comfortable.

Solutions to Consider
1. Maintain a Calm Feeding Environment: Create a soothing atmosphere during feeding times. Dim the lights, reduce noise, and hold your baby in a comfortable position. This can help reduce anxiety and make feeding more enjoyable.

2. Experiment with Feeding Positions: While it is generally safe for infants to be fed in a semi-reclined position, ensure that your baby is comfortable. Some babies prefer being held upright, while others may like to lie back slightly. Pay attention to your baby’s cues.

3. Monitor for Signs of Discomfort: If your baby is crying or showing signs of distress during feeding, it may be worth consulting with a pediatrician to rule out any underlying issues such as reflux or allergies.

4. Gradual Introduction: If your baby is refusing milk, try to gradually reintroduce it. You can mix a small amount of milk with a preferred formula or breast milk to help them adjust to the taste.

5. Check for Teething: If your baby is drooling and seems uncomfortable, they may be teething. Teething can cause discomfort that affects feeding. Offering a teething toy before feeding might help soothe their gums.

6. Consult a Pediatrician: If the aversion persists or if your baby is not gaining weight appropriately, it’s essential to consult with a pediatrician. They can assess your baby’s overall health and provide tailored advice.

Additional Considerations
- Salivation and Crying: It is normal for infants to drool and cry, especially during developmental milestones like teething. If your baby is crying with tears, it indicates they are hydrated, which is a good sign.

- Feeding Frequency: At 2 months, babies typically feed every 2-4 hours. If your baby is only taking smaller amounts, it’s crucial to monitor their weight gain and overall health.

In summary, milk aversion in infants can be attributed to various factors, including developmental changes, discomfort, or taste sensitivity. By creating a calm feeding environment, experimenting with positions, and consulting with a pediatrician if necessary, you can help your baby navigate this phase. Remember, every baby is unique, and what works for one may not work for another, so patience and observation are key.

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