Common Concerns for Parents of 2-Month-Old Babies: Feeding and Sleep

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Dear Doctor,
I apologize for the mistake in my previous email! (I've been a bit tired lately.) May I ask you the questions again regarding my last inquiry? (I’m really sorry!)
1.
My baby is now over 2 months old, drinking formula, and currently weighs 5 kg.
She is a girl.
Recently, she seems to not want to drink milk.
Could this be because she is in a playful phase? She often smiles and plays with me while drinking.
2.
How long can milk be stored? My baby usually only drinks a little (about 20-30 ml) before she starts playing, and after about half an hour, she cries for more.
I feel like it’s a bit wasteful to throw it away.
3.
My baby has started to prefer drinking while lying down for the past two days.
Is this okay?
4.
What is the definition of hyperactivity? My baby often stays awake until around 2 AM and then doesn’t sleep again until after 11 AM, and she likes to kick around a lot.
Is this normal? I’m a bit worried! I’ve heard that children who sleep a lot grow faster; will my baby not grow as well because she doesn’t like to sleep?
5.
My baby prefers to be held upright rather than lying down.
Could this potentially harm her cervical spine?
6.
At this stage, is eating more important than sleeping? If she exceeds her milk drinking time, should I wake her up?
7.
I know that newborns don’t need much water, so I haven’t given her much.
However, with summer approaching, should I provide her with more water? Sometimes when she drinks milk, she will also drink water (she spits out the milk but wants the water).
Is this okay?
I apologize for asking so many questions in my first inquiry.
Thank you for your understanding, Doctor!

Ben Ma Mi, 20~29 year old female. Ask Date: 2005/04/16

Dr. Lin Wenxian reply Pediatrics

Dear Mommy,
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 lengthen.
However, some babies do not follow this pattern.
Upon observing these babies with reduced milk intake, it is noted that their energy levels and neurological development are normal.
How can this be explained? The reasons are not entirely clear, but there are several theories: one is that the growth rate decreases, leading to a reduced demand for milk.
The growth rate of babies 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 speeds up again, milk intake may return to previous levels, which parents may perceive as a return to "normal."
Some suggest this could be a characteristic of certain ethnicities, while others believe it may be related to genetics, as the birth weight is influenced by the maternal uterine environment.
Therefore, if the birth weight exceeds the expected genetic weight, there may be a period of decreased milk intake before returning to the expected growth curve.
The so-called "milk aversion period" typically begins around four months after birth, but some babies may start earlier.
What should you do? The best approach is to "feed according to the baby's demand." As long as your baby is healthy and developing well, observation is sufficient.
There is no need to let the caregiver's anxiety affect the baby's feeding.
Formula milk prepared for the baby should be consumed during the meal and not saved for the next feeding, as bacteria may grow at room temperature; ideally, it should not be left out for more than one hour.
Babies do not simply eat to sleep and sleep to eat; they also have needs for activity, warmth, and affection.
We would be more concerned about a baby who sleeps excessively and shows low activity levels.
Each baby may have different intensities of needs; some may be very active, some may require a lot of security, some may dislike drinking water, and some may enjoy playing with others.
Spending time with your baby will help you gradually understand their needs, much like how partners in a relationship come to know each other's personalities over time.
I personally recommend providing care based on your baby's needs and striving to meet their needs for love and warmth.
This approach will help raise a child who is more confident and independent.
The behaviors mentioned in your letter (such as enjoying being held upright, lying down while drinking milk, loving to play, and kicking their legs) can all be considered normal.
If you have concerns, you may take your baby to a pediatrician for further examination and consultation.
Wishing you and your baby good health and all the best!
Sincerely,
Dr.
Lin Wen-Hsien
Director of Pediatrics, Tainan Hospital, Department of Health, Executive Yuan

Reply Date: 2005/04/16

More Info

As a parent of a 2-month-old baby, it's completely normal to have many questions regarding feeding, sleep, and overall health. Let's address your concerns one by one, providing insights based on pediatric guidelines and common practices.

1. Feeding and Playfulness: It's not uncommon for babies at this age to become easily distracted while feeding. They are beginning to explore their environment and may find it more interesting than eating. This behavior is typical and usually resolves as they grow older and become more focused on feeding. If your baby is gaining weight appropriately and producing enough wet diapers (at least six per day), then she is likely getting enough nutrition, even if she seems to be playing more than eating.

2. Milk Storage: Prepared formula should ideally be consumed within one hour if left at room temperature. If your baby only drinks a small amount and then stops, it’s best to discard any leftover formula after an hour to prevent bacterial growth. While it may feel wasteful, safety is paramount when it comes to infant feeding.

3. Lying Down to Drink: It is generally acceptable for babies to lie down while drinking, but it's important to ensure that they are in a safe position to prevent choking. Always supervise your baby during feeding times. As they grow, they may develop preferences for how they want to be held while feeding, which is normal.

4. Understanding Hyperactivity: The term "hyperactivity" is often associated with older children and is characterized by excessive movement and difficulty focusing. At 2 months, your baby is still developing her motor skills and may kick and move around as part of her natural development. If she is active and playful, it is usually a sign of healthy development rather than a concern for hyperactivity.

5. Sleep Patterns: Sleep is crucial for growth and development in infants. While it’s true that sleep helps with growth, every baby has a unique sleep pattern. If your baby is sleeping for long stretches at night and waking up for feeds, that’s a positive sign. If she seems to be awake and playful during the day, it’s also normal. You don’t necessarily need to wake her for feeds unless she hasn’t eaten for several hours and is not gaining weight adequately.

6. Importance of Nutrition vs. Sleep: Both feeding and sleep are essential for your baby's growth and development. At this age, it’s important to ensure she is getting enough nutrition while also allowing her to establish her sleep patterns. If she sleeps longer than usual, you can let her sleep unless advised otherwise by your pediatrician.

7. Hydration Needs: Infants typically do not need additional water until they are about six months old, as breast milk or formula provides all the necessary hydration. However, in hot weather, you can offer small amounts of water if your baby seems thirsty, but this should not replace her formula or breast milk intake.

8. Holding Preferences: Babies often prefer to be held in certain positions, and as long as they are comfortable and safe, it’s fine to hold her upright. Just ensure that her neck and spine are well-supported to prevent any strain.

In summary, your baby’s behaviors are quite normal for her age. Always trust your instincts as a parent, and if you have any specific concerns about her health or development, don’t hesitate to consult your pediatrician for personalized advice. They can provide reassurance and guidance tailored to your baby's unique needs. Remember, every baby is different, and what works for one may not work for another.

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