Concerns About 4-Month-Old Baby Refusing Milk: Tips for Parents

A 4-month-old infant not drinking milk?

My younger brother is 34 weeks old and weighs 2465 grams.
He is currently over 5 months old and has not been drinking breast milk well since he was 3 months old, only consuming about 90 ml.
His activity level is normal.
Is it common for a baby to have such a prolonged nursing strike? What can be done to encourage him to drink more, and could this lead to nutritional deficiencies?

yiha90, 30~39 year old female. Ask Date: 2010/07/21

Dr. Xiao Kaiwen reply Pediatrics

The information you provided is somewhat insufficient, including the current height, weight, and head circumference.
It is unclear whether the mentioned age in months is the corrected age (or simply the chronological age calculated from the date of birth).
Additionally, it would be helpful to know if complementary foods are being introduced and whether the parents are also relatively small in stature.
Having this information would facilitate a better assessment.
Thank you.

Reply Date: 2010/07/21

More Info

When it comes to a 4-month-old baby refusing milk, it can indeed be concerning for parents. It's important to understand that many infants go through phases of decreased appetite, often referred to as "nursing strikes" or "feeding aversions." This can happen for various reasons, including developmental milestones, teething, or simply a temporary change in their preferences.

In your case, since your baby was born prematurely at 34 weeks and has been showing a reluctance to drink milk since around 3 months, it's crucial to monitor his overall growth and development closely. A weight of 2465 grams (approximately 5.4 pounds) at birth is on the lower side, but if he is gaining weight appropriately now and is active, that is a positive sign. The key indicators of adequate nutrition in infants include consistent weight gain, normal growth patterns, and overall alertness and activity levels.

Here are some tips to encourage your baby to drink more milk:
1. Check the Feeding Environment: Sometimes, distractions or discomfort can affect a baby's willingness to feed. Ensure that the feeding environment is calm, quiet, and comfortable. Holding your baby in a cozy position can also help.

2. Experiment with Different Feeding Positions: Babies can have preferences for how they are held during feeding. Try different positions to see if your baby responds better in one over another.

3. Offer Smaller, More Frequent Feedings: If your baby is overwhelmed by larger amounts of milk, try offering smaller amounts more frequently throughout the day. This can make feeding feel less daunting.

4. Monitor for Signs of Teething: If your baby is teething, it may cause discomfort while feeding. Look for signs of teething, such as drooling, chewing on objects, or swollen gums. If teething is the issue, offering a teething ring or a cold washcloth to chew on before feeding may help soothe discomfort.

5. Consider the Temperature of the Milk: Some babies prefer warm milk, while others might like it cooler. Experiment with different temperatures to see if your baby has a preference.

6. Introduce Solid Foods Gradually: Since your baby is approaching the age where solid foods can be introduced (around 6 months), you can start offering pureed fruits and vegetables. This can help supplement his nutrition while he navigates his milk preferences.

7. Stay Calm and Patient: Babies can sense their parents' anxiety. If you remain calm and patient during feeding times, it may help your baby feel more relaxed and willing to drink.

8. Consult a Pediatrician: If your baby continues to refuse milk and you are concerned about potential nutritional deficiencies, it is essential to consult a pediatrician. They can assess your baby's growth and development and provide tailored advice. They may also recommend a nutritional evaluation to ensure your baby is receiving adequate nutrients.

In summary, while it is common for babies to go through phases of reduced milk intake, it is essential to monitor their growth and development closely. If you notice any signs of nutritional deficiency, such as poor weight gain, lethargy, or changes in behavior, seek medical advice promptly. Your pediatrician can provide guidance and reassurance, helping you navigate this challenging phase of your baby's development.

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