Brief Answer:
Try to switch back exclusively to breast feeding. Burp the baby properly.

Detailed Answer:
Thanks for asking on Health Care Magic.

Let me emphasize on the fact that breast milk is the best possible milk for a baby and there can be no alternatives for the same.

Most formula milks are cow milk based and hence difficult to digest. I understand that you are formula feeding your baby but that is also responsible for the vomiting you mention. That is also the reason for the child not increasing her feeds.

The baby is not able to digest the formula fully and the left over undigested food matter is being degraded by the intestinal bacteria and leading to gas formation. Moreover they formula feeds make the child more prone to complications and infections.

Mother's breast milk is produced on the demand of the baby. Hungrier the baby, more vigorous is the suck. More is the suck, more is the amount of breast milk produced. Giving formula automatically reduces the demand of the baby and thereby the production of breast milk. All you need to do is to switch back to exclusive breast feeding and the production will increase automatically.

All you need to do is to monitor the urine output. If the frequency is more than 6 times in 24 hours, you would know that the amount of feeding is adequate. If the amount of passage of urine is less or if the child is lethargic you would need to get concerned and take the child to a doctor without delay.

I clearly understand what you mean by the cough. It so happens that the junction of the food pipe and the stomach is not quite tight in children of this age and the stomach contents often reflux back into the food pipe. This triggers profuse oropharyngeal secretions which makes the child gag. This is what you are observing.

Treatment for cough would not solve this problem. You should burp the baby for at least 15-20 mins after each feed. All you need to do is to hold the baby head end elevated for this duration. This will take care of the reflux. Moreover, the extra air taken in along feeds would escape and the milk will not regurgitate back from the stomach to the food pipe.

Let me know if you have further queries.

Regards

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Brief Answer:
Once you walk down the wrong path, its harder to come back to the right one

Detailed Answer:
Thanks for writing back.

Once again let me state that I understand your apprehension. The very fact that you are giving formula feeds is enough to upset the balance. There is no question to the fact that your breast milk production is inadequate at present. But the question is whether you can afford to let the baby grow adequately hungry for the suck to be vigorous enough to stimulate the breast milk production? The fact is that instead of being the judge of the hunger of the baby, you need to leave the baby no other option other than merely to suck on your breasts. It is then that the breast milk production will resume. Of course it will not occur in a day and you would need to see the baby crying of hunger. But I see no other way out.

About the cough, I would rather consider it accepable. If you are properly burping the baby after each feed nothing else could be done. Please note that even if the stomach is overdistended (the opposite of hunger), the reflux could occur even though you might be burping the baby.

Regards

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Brief Answer:
You have to try the hard way

Detailed Answer:
What you are asking is like 'can I pass the test first (before studying) so that it can motivate me to study?' The answer is, no, it does not work that way. If the child passes urine less than 6 times in 24 hours it would indicate the requirement of additional feeds (due to dehydration) and not otherwise. Otherwise you need to keep suckling the baby. It is only after a few days of such ordeal that breast milk will come. No shortcuts. Breast milk will take care of the nutrition and you can expect a healthy growth thereafter.

Regards

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Brief Answer:
Feeds seem inadequate.

Detailed Answer:
Thanks for writing back. The nutritional requirements of your child are something like one ounce (30 ml) of milk for every kg body weight. So, for a 3 kg baby the requirement would be about 90 ml per feed. The feeds are to be given at an interval of 2-3 hours.

Bonnison would help if abdominal distension is to reduced. Do not give it routinely, give it when needed.

Regards

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