Infant Refusal to Feed: Causes and Solutions for Parents

Three-month-old infant shows signs of milk aversion?

Hello Doctor, my baby is currently three and a half months old.
Usually, he/she consumes 130cc every three hours, with six feedings a day, and does not require night feedings.
However, this week, he/she has only been drinking about 50cc each time and then refuses to drink more.
Now, the total daily milk intake has decreased by more than half compared to before.
Could this be a sign of milk aversion? How long might it take for this aversion to pass? Currently, I am trying a strategy of smaller, more frequent feedings, but the amount he/she drinks is still quite low.
Will this significantly impact my baby's growth? I feel that forcing him/her to drink is not the right approach.
Could you please provide me with some advice and strategies? Thank you!

CoCo, 30~39 year old female. Ask Date: 2014/08/22

Dr. Xiao Kaiwen reply Pediatrics

If the infant is not experiencing fever, throat inflammation, herpetic pharyngitis that prevents feeding, vomiting, diarrhea, or any signs of infection, and is active with height and weight following their growth curve without significant deviation, this is considered a benign phase of feeding aversion.
It can be evaluated by a pediatrician.
The duration of the feeding aversion varies for each baby, but it does not negatively impact their growth.
A common approach is to offer small, frequent meals, and to start introducing complementary foods when appropriate.
The key principle is to avoid force-feeding, as this may prolong the aversion period; instead, allow the process to unfold naturally.

Reply Date: 2014/08/22

More Info

Infant feeding issues, particularly when it comes to refusal to feed, can be a source of significant concern for parents. Your situation, where your three-and-a-half-month-old baby has suddenly reduced their intake from 130cc every three hours to only about 50cc, is not uncommon. This phenomenon is often referred to as "feeding refusal" or "nursing strike," and it can be distressing for both the infant and the parents.

Understanding Feeding Refusal
Feeding refusal in infants can occur for several reasons:
1. Developmental Changes: Around three to four months, babies undergo various developmental milestones, including increased awareness of their surroundings. This newfound curiosity can distract them from feeding.

2. Growth Spurts: Infants typically experience growth spurts, which can temporarily alter their feeding patterns. They may feed more frequently or, conversely, may seem less interested in feeding.

3. Gastrointestinal Discomfort: Issues such as gas, reflux, or other gastrointestinal discomfort can lead to a refusal to feed. If your baby seems uncomfortable or fussy, it may be worth discussing with a pediatrician.

4. Taste Preferences: As babies grow, they may develop preferences for certain tastes or textures. If you are introducing new foods or if there are changes in the milk (like switching brands or types), this could affect their willingness to feed.

5. Illness: If your baby is unwell, even slightly, they may not want to feed. Monitor for any signs of illness, such as fever, lethargy, or unusual fussiness.

Solutions and Recommendations
1. Maintain a Calm Feeding Environment: Create a peaceful and distraction-free environment during feeding times. This can help your baby focus on feeding rather than being distracted by their surroundings.

2. Frequent, Smaller Feedings: Since you are already practicing "small frequent feedings," continue this approach. Even if the total amount is less, frequent feeding can help ensure they are getting enough nutrition over the day.

3. Monitor Growth and Development: Keep track of your baby's weight and growth patterns. If they are gaining weight appropriately and meeting developmental milestones, it may be less concerning. Regular check-ups with your pediatrician can help assess this.

4. Experiment with Feeding Positions: Sometimes changing the feeding position can make a difference. Try different holds or positions to see if your baby responds better.

5. Check for Discomfort: If you suspect gastrointestinal discomfort, consult your pediatrician. They may recommend dietary adjustments or medications if necessary.

6. Stay Patient and Flexible: Feeding refusal can be temporary. Many babies go through phases where they eat less. If your baby is otherwise healthy and active, this phase may resolve on its own.

7. Avoid Force Feeding: Forcing your baby to feed can create negative associations with feeding. Instead, encourage feeding but allow them to dictate their intake.

Conclusion
In summary, while it can be worrying to see a sudden decrease in your baby's feeding, it is often a phase that many infants go through. By maintaining a calm environment, monitoring their growth, and being patient, you can help your baby through this period. If concerns persist or if your baby shows signs of distress or illness, do not hesitate to consult your pediatrician for further guidance. Remember, every baby is unique, and what works for one may not work for another, so finding the right approach for your child is key.

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