5 month old does not want to eat anymore

[Kaylen]

I am posting this in the breastfeeding forum, but just to be clear, I am an exclusive pumper so she gets her breastmilk in a bottle.
She is a big baby (over 90 percentile in both height and weight) but around the time she hit 4 months she just started losing her appetite and refuses to eat. She has never eaten more than 4 oz at a time due to reflux and eats every 3 hours, but she was gaining weight steadily. Now she easy 2 oz and stops and doesn't want the bottle any more. She never cries of hunger and if we let her she would go who knows how long without eating. She is noticeably thinner. Some days her apetite comes back and she finished 5 oz bottles, but those days are becoming rare. What could be the problem?
She used to have 27-29 oz per day and now it's 25 -26 at most. It may not seem like a big difference but it's having effect on her weight and like I said we have to force her to eat even that much.

 

[_Meep_]

Firstly, I'm sorry you are dealing with this. I have been through similar myself and found it very difficult to deal with.

A little about what happened with our baby - having seemingly nursed normally for the first two months of life, she suddenly started to refuse feeds. First one breast, and then both. Very quickly, we had a full nursing strike on our hands. Apparently they rarely last more than a few days. Our first one lasted a month. She would scream and fight if I so much as put her into a nursing position, and she ended up taking all her feeds as dreamfeeds, because that was the only way I could physically feed her ... which was exhausting.

This behaviour occurred on and off, a week here and a fortnight there of utter misery, followed by a few days where she seemed ok and would accept the breast when I offered. And then it was back to square one again - total refusal and dreamfeeding.

We have never identified the cause for sure, though we do know she is prone to silent reflux (not severe) and her strikes tended to correlate with periods of dodgy gastric activity - spitting up more, lots of dribbling, trapped wind, hiccups, weird gulping as she swallowed her spit-up back down, etc. So there's that, though we don't know what caused it to flare up and then die back down. Our baby also had a previously unidentified posterior tongue tie cut at 4.5 months, and about a month after that, things did start to improve somewhat.

When you say your baby has reflux, what kind of reflux are we talking? Silent or spitty? Is your baby obviously in pain from the reflux or not too bothered? Is she on any medication for it?

When faced with the bottle, how does she refuse? Does she become distressed and fight and cry, or is she just obviously not interested?

I ask all this because if your baby is obviously suffering distress from the reflux and panics when she thinks she has to eat, then the reflux is almost definitely the issue and to help her learn to enjoy eating again, she will likely need medication. If there is no evident pain behaviour/panic and distress when it is feeding time, then there might be a different reason altogether.

Eating 4 oz at a time is not necessarily a bad thing - this amount has kept your baby up in the 90th centiles! - so it has obviously been enough for her body to very much maintain itself. However, you are concerned that her intake has dropped. With reflux, babies in pain often learn their milk 'limit' and refuse to take more. This could be what is happening to your baby. I personally don't think 4 oz can have been her milk limit if she was gaining so well on that.

You also mention her lack of appetite. This one particularly worried me with my daughter - once her rooting reflex disappeared, I hadn't a clue when she was hungry, as she just NEVER SEEMED TO BE. I am quite certain she would have gone all day if I had let her; it was baffling. This, as I understand it, is also a common behaviour among reflux babies.

I hope some of this can be helpful in maybe identifying whether reflux is likely to be the culprit in your baby's case. Sorry I've gone on a bit, lol.

The good news is that my baby has gotten so much better as she has grown older. She's now eight months old and it's been two months since we had a nursing strike. Plus, her silent reflux symptoms rarely show themselves any more, which is great. She still doesn't do any of the classic things you want your baby to do, as a mother, to show you that they are hungry! Lol. BUT, she no longer freaks out at the sight of a boob - in fact, she gets very excited, and it's so nice to finally feel like she actually WANTS to nurse. I feel more relaxed about things now - even if I feel like she hasn't taken 'enough', I don't try to push her to take more as I'm trying to trust that she knows what she needs better than I do.

Starting solids has really helped too. We started at 5.5 months.

I am sure things will get better for you eventually, but it is SO hard and of course you need to find a way to help your baby feel happier about eating and lessen the burden of worry on yourself. If she isn't already on medication, then I would speak to your doctor about trying something if you feel that pain is the cause here.

Sorry for the essay! If you have any questions or anything about our experience then I will answer.

 

[noon_child]

I agree with pp that her attitude to the bottle will indicate what might be wrong.

However breastfed babies don't take as large volume as formula fed ones. There is a hormone in breastmilk that tells a baby when it is full, and 3oz seems to be average. It may be your baby actually has less reflux symptoms now she's older and doesn't confuse pain for hunger (which young babies can do) so she drinks what she needs now.

Is she still bringing milk back up or is her reflux controlled? If she sicks less than she used to maybe she is actually getting the same?

Weight loss wise, only a health professional can tell you if it is a worrying amount. She may drop a bit only to stabilise and stay on track. If she continues to fall and fall it could be a worry.

Like pp when my LO got to about three months I could never tell when she was hungry. She was so distracted by the world and interested in everything i ended up almost feeding to a schedule (I'd offer every 3hrs) because she wasn't telling me she was hungry, or not that I knew.

 

[Kaylen]

She has silent reflux and we found out when she was 2 weeks old. She has been on medication since. When she has the reflux we can hear her swallowing and crying after each swallowing. She also gets milk thickener and she was also on colic drops. The combination of the 3 made a huge difference and she stopped crying completely, and her reflux seems to have gone away for the most part.
As for the bottle, she starts eating but not eagerly, drinks 1-2 oz, then starts moving the bottle to her cheek or chewing on it or just playing with it. We tried next size nipple but so far it hasn't made a difference. Sometimes she cries during feeds, sucks a little, cries again. Sometimes she starts crying when we give her the bottle. It's just like when she had the bad reflux but this time we aren't hearing the swallowing and the big crying only happens at bed time. The day time feeds are just jer not eating it.
To be gone now or we only hear it when she cries a lot and it seems the crying makes it come back. But she doesn't really have crying episodes much. She never spit up much. She used to throw up projectile style if she had more than certain amount of mill so that's why we had to keep her feeds small and frequent. We now know she can take 5.5-6 oz at least and not throw up. She was drinking this at bed time before this non-eating strike began.
I am taking her to the doctor on Monday if things don't improve. I am too doing dream feeds and she finishes 4 oz on those fairly easily. She used to eat once per night and now it's gone up to twice and not sleeping well this week at all.
She is going to be 5 months next week and o think we wil try to start her on solids tonight to see how she takes to it. I fed her milk with a spoon and she took the spoon and put it in her mouth. It was funny.
I feel so sad that our LOs have to go through such things. So little and innocent.

 

[noon_child]

As for the bottle, she starts eating but not eagerly, drinks 1-2 oz, then starts moving the bottle to her cheek or chewing on it or just playing with it. We tried next size nipple but so far it hasn't made a difference. Sometimes she cries during feeds, sucks a little, cries again.

Could she be teething? This always meant drop in appetite for my LO and the chewing the bottle reminds me of what bottle feeding friends said their teething LOs did.

 

[Kaylen]

I think she could be, but from what I've read teething shouldn't not last more than 3 days and this has been going on like a month and is getting worse. We tried to look at her gums but she isn't liking it and hiding with her tongue. I also tried feeling with my finger but couldn't feel anything.
She has had 3 bottles so far today, one of them a dream feed. We let her go for 4 hours to see if she will start crying but she didn't. She drank her 4.5 oz bottle though without fighting it. But way she is going she will not eat more than 20 oz by bed time and I will have to feed her twice over night again.

 

[_Meep_]

Three days - I wish! It definitely takes my daughter at least a week or two for a tooth to fully emerge (she now has seven).

My HV told me she had a friend whose kid teethed for about three months every. single. time he got a tooth. She also said any time there is movement in their gums that they are aware of, they are likely to exhibit teething symptoms.

 

[Kaylen]

Wow 3 months huh.
I don't know if she is teething, she doesn't seem to be in pain and she is happy and playing otherwise. We tried giving her sweet potato purée today for the first time but she didn't open her mouth. I think we picked a bad time as she was tired and cranky and wanted to sleep. I ended up eating a lot of the purée and it was delicious! I fix a huge batch myself. Now if only she would eat it. I didn't want to start her on solids so early but I am worried she isn't getting enough calories. We will try again tomorrow morning when she is in a better mood.

 

[noon_child]

I didn't want to start her on solids so early but I am worried she isn't getting enough calories. We will try again tomorrow morning when she is in a better mood.

If you want calories and would have continued with milk if she would drink it you could try starting with a food you could make out of breastmilk, like baby porridge, fruit smoothie etc. She might be enthusiastic if she thinks it's not a bottle but she'll still be getting milk!

 

[Kaylen]

She is eating a little better today. I got her to finish her bottles. I hope it gets better. I made the puree with formula (didn't want to waste the breast milk). She isn't eating any of it though. She is making faces like it tastes horrible.