Should You Stop Night Feedings for Your 9-Month-Old? Pediatric Insights

Q: Should You Stop Night Feedings for Your 9-Month-Old? Pediatric Insights

Hello： <br>1. <br>Your son is currently 9 months and 20 days old, weighing 7.8 kg, which corresponds to approximately the 3rd percentile on the growth chart for boys. <br>His weight is indeed on the lighter side. <br>The normal caloric requirement is 100 kcal/kg/day, so your baby

Complementary foods? Should I stop night feeding?

Hello Doctor,
I have a few questions:
1.
My son is currently 9 months and 20 days old, but he only weighs 7.8 kg.
He has been hovering around 7 kg for a while, and I am really worried.
He is currently eating Nestlé hydrolyzed HA2 formula, about 120 cc every 3 hours, totaling around 700 cc a day.
His intake of solid foods is not ideal; he doesn’t eat much porridge, only taking 7-8 small bites twice a day.
He does eat fruits, like half a bowl of pear puree once a day, and sometimes he has other fruits twice.
Is this amount insufficient in calories and calcium?
2.
During his health check, the doctor did not mention much, only suggesting to increase solid food intake.
However, despite trying various methods, he still doesn’t eat much, and his growth curve is quite low.
Should I consult a doctor for medication?
3.
He has bowel movements every two days, and they are green.
Is this normal?
4.
There are undigested foods, like carrots, in his stool.
Should he continue eating these foods or stop?
5.
My baby sleeps at 8:30 PM and wakes up around 11 PM for a feed, then again around 3 AM.
Family members say that he shouldn’t have night feeds at nearly 10 months old, but considering his small size, I think he should drink if he wants to.
Should I eliminate the 3 AM feed? Is there any concern about his bone health if he doesn’t get enough rest?
6.
When my baby gets upset or doesn’t want to do something, he clenches his fists and tenses his whole body.
Is this a concern? I have been trying to prevent this behavior, but he expresses himself this way whenever he doesn’t want to do something.
What is the best way to handle this?
Thank you, Doctor, for your response.

Xiao Yu, 30~39 year old female. Ask Date: 2006/08/31

Dr. Pei Rensheng reply Pediatrics

Hello:
1.
Your son is currently 9 months and 20 days old, weighing 7.8 kg, which corresponds to approximately the 3rd percentile on the growth chart for boys.
His weight is indeed on the lighter side.
The normal caloric requirement is 100 kcal/kg/day, so your baby should be consuming about 780 kcal daily for proper growth.
Currently, he is on Nestlé Hydrolyzed HA2, taking 120 cc every 3 hours, totaling around 700 cc per day, which provides approximately 467 kcal (700*2/3).
The addition of complementary foods is very important to prevent nutritional deficiencies.
You can introduce rice cereal or wheat cereal to increase caloric intake, as well as toast and crackers.
2.
The health booklet contains guidelines for introducing complementary foods, and various healthcare institutions also provide educational materials for reference.
Additionally, if his appetite remains poor, you may want to consult a pediatric gastroenterologist for assistance.
3.
Having bowel movements three times a day to once every three days is normal, and yellow-green stools are also acceptable.
4.
The presence of undigested food in the stool, such as carrots, which are high in fiber, is normal.
If there are no signs of diarrhea, you can continue to offer these foods.
5.
If your baby is hungry and wants to drink, he can do so, even at night.
The gastrointestinal system does not need an extended rest period overnight.
6.
When your baby is upset or unwilling to do something, he may clench his fists and tense his body.
This is part of his temperament, and you can try to soothe him.
Some babies may even hold their breath and have spasms; these situations are mostly temporary and will improve as he grows.
Wishing you health and happiness!
Sincerely,
Pei Ren-Sheng

Reply Date: 2006/08/31

More Info

When considering whether to stop night feedings for your 9-month-old, there are several factors to take into account, particularly regarding your child's growth, nutritional intake, and sleep patterns.
Firstly, it’s important to assess your child's weight and growth trajectory. At 9 months and 20 days, with a weight of 7.8 kg, your child is on the lower end of the growth curve. It’s crucial to ensure that your child is receiving adequate nutrition to support healthy growth and development. The recommended daily intake for infants this age is typically around 700-1000 cc of formula or breast milk, along with appropriate amounts of solid foods. If your child is only consuming about 700 cc of formula and is struggling with solid foods, it may be beneficial to consult with a pediatrician or a nutritionist to evaluate whether your child is getting enough calories and nutrients, including protein and calcium.

Regarding the introduction of solid foods, it’s common for infants to be picky eaters, especially as they transition from purees to more textured foods. If your child is only taking a few bites of porridge and is not consuming enough vegetables or proteins, it may be helpful to experiment with different textures and flavors. Sometimes, offering foods in a fun and engaging way can encourage infants to try new things. Additionally, involving your child in family meals can create a positive eating environment.

As for your child's bowel movements, having a bowel movement every two days can be normal for some infants, but the consistency and color of the stool are also important indicators of digestive health. Green stools can sometimes indicate that food is passing through the digestive system too quickly or that your child is not fully digesting certain foods. If you notice undigested food in the stool, it might be worth discussing with your pediatrician whether to continue offering those foods or to modify the diet.

Regarding night feedings, it’s generally recommended that by 9 months, many infants can sleep through the night without needing to feed. However, if your child is waking up at 11 PM and 3 AM for feedings, it may be a combination of hunger and habit. Since your child is on the lighter side, it’s understandable to be cautious about eliminating night feedings entirely. If your child is consuming enough calories during the day, you might consider gradually reducing the amount offered during night feedings. This can help your child adjust to sleeping through the night without relying on feedings.

Lastly, the behavior you described, where your child clenches their fists and tenses up when upset, is a common way for infants to express frustration or discomfort. It’s important to provide comfort and reassurance during these moments. Encouraging your child to express their feelings in other ways, such as through verbal communication (as they grow) or through play, can help them learn to manage their emotions better.

In summary, while it’s essential to consider stopping night feedings, it’s equally important to ensure your child is receiving adequate nutrition and support for their growth and emotional development. Consulting with a pediatrician can provide personalized guidance tailored to your child's specific needs.

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