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Infant Hesitating To Have Breast Milk But Drinks In Feeding Bottle. What Could Be The Reason?
Question: Hi Doctor,
Warm wishes from me.
My son was born on 26/apr/2013, today he is exactly 6 months old.
His current growth parameters: 6.48kg , 68cm, OFC - 42cm
His birth parameters - 3.7kg, 49cm, OFC 34cm
1. Are his growth parameters normal for his age ?
2. What should be the content of intake of food given to him? I meant what vegetables, fruits , food etc ? and frequency? Currently we are giving food made from 1. Ragi 2. Cerelac 3. Breast milk 4. XXXXXXX smashed paste
3. He is quite active during the day , he sleeps by 12am and wakes up by 9am , is the sleep pattern ok?
4. During morning he hesitates to have breast milk from his mother, but if we express the milk and put in feeding bottle and give him he takes the milk. ? What can be the reasons for that? But at night when he wakes up 2-3 times , he haves milk from breast.
5. Many times during day when he sleeps for short time and wakes up - he suddenly cries and when we take him and talk to him he quitens down.
6. He passes stools once a day or once every two days. Is this ok?
He has quite bad history at birth - he was diaognised for PDA/PAH/RDS/Septicimea/meconium asperation.
He was in NICU for 12 days and discharged later. he was treated for urine infection after discharge also. After discharge blood culture was normal.
After 1.5 months after birth - his weight was 3.15kgs, he didnt add weight for first 1.5 months. he had lost 500gm during NICU admission.
The urine culture was done 2 months back - Culture was negetive.
7. Also should we get Echo /urine culture/ US scan done/chest xray? In order to confirm that he is doing ok for the above.
8. What other things we need to be careful about at home , so that we can prevent any kind of infection for the baby?
9. What should be approximate weight gain each month , for baby 6 months + , approximate growth parameters for one year baby boy?
10. He was given these injections at end of 4th and 5th month - Pentaxim IM , Rotavirus vaccine, Prevenar 13 as vaccination. Are these ok?
also when these injections are given next one week - he is dull /feverish/ doesnt laugh much/ doesnt add much of weight . etc. are these ok?
11. From past 4 days paediatrician has advised him - Ultra d3 , orofer xt, candid. are these ok?
12. During when he is awake - He sucks his thumb most of times , is this ok?
13. He recoginises faces of people at home, he turns back on his own, he tries to go fwd after turning but he cant . When he lift him , he can stand for few seconds with us holding in hand. are these ok?
Pls reply kindly for these.
XXXX
Warm wishes from me.
My son was born on 26/apr/2013, today he is exactly 6 months old.
His current growth parameters: 6.48kg , 68cm, OFC - 42cm
His birth parameters - 3.7kg, 49cm, OFC 34cm
1. Are his growth parameters normal for his age ?
2. What should be the content of intake of food given to him? I meant what vegetables, fruits , food etc ? and frequency? Currently we are giving food made from 1. Ragi 2. Cerelac 3. Breast milk 4. XXXXXXX smashed paste
3. He is quite active during the day , he sleeps by 12am and wakes up by 9am , is the sleep pattern ok?
4. During morning he hesitates to have breast milk from his mother, but if we express the milk and put in feeding bottle and give him he takes the milk. ? What can be the reasons for that? But at night when he wakes up 2-3 times , he haves milk from breast.
5. Many times during day when he sleeps for short time and wakes up - he suddenly cries and when we take him and talk to him he quitens down.
6. He passes stools once a day or once every two days. Is this ok?
He has quite bad history at birth - he was diaognised for PDA/PAH/RDS/Septicimea/meconium asperation.
He was in NICU for 12 days and discharged later. he was treated for urine infection after discharge also. After discharge blood culture was normal.
After 1.5 months after birth - his weight was 3.15kgs, he didnt add weight for first 1.5 months. he had lost 500gm during NICU admission.
The urine culture was done 2 months back - Culture was negetive.
7. Also should we get Echo /urine culture/ US scan done/chest xray? In order to confirm that he is doing ok for the above.
8. What other things we need to be careful about at home , so that we can prevent any kind of infection for the baby?
9. What should be approximate weight gain each month , for baby 6 months + , approximate growth parameters for one year baby boy?
10. He was given these injections at end of 4th and 5th month - Pentaxim IM , Rotavirus vaccine, Prevenar 13 as vaccination. Are these ok?
also when these injections are given next one week - he is dull /feverish/ doesnt laugh much/ doesnt add much of weight . etc. are these ok?
11. From past 4 days paediatrician has advised him - Ultra d3 , orofer xt, candid. are these ok?
12. During when he is awake - He sucks his thumb most of times , is this ok?
13. He recoginises faces of people at home, he turns back on his own, he tries to go fwd after turning but he cant . When he lift him , he can stand for few seconds with us holding in hand. are these ok?
Pls reply kindly for these.
XXXX
Brief Answer:
Explained in detailed answer.
Detailed Answer:
Hi XXXXXXX
Thank you for your query on Healthcare Magic.
1. His growth parameters are in normal range as per the growth charts.
2. From 6 months onward the child can be given complimentary feeding in
addition to breast milk. You can continue the current diet which you are giving
now. You can start with one semisolid feed and gradually increase to 2 to 3
feeds per day in addition to breast milk.
3.His sleep pattern is okay.
4.Hesitation for breast milk during morning is due to development of flow
preference (nipple confusion) as he accustomed to bottle feed because of easy
flow from bottle nipple whereas he needs strength to suck milk from breast.
During night this preference will be lost.
5.Day time nap or sleep is common and because of disturbance he will cry and
once he finds some body for cuddling then will become calm. This is normal.
6.Passing stool once in 2 to 3 days is normal. It is not considered constipation in
infants. Usually the stool will be soft like paste and there will be no discomfort
while passing stool.
7.Repeat tests like 2D Echo as per the doctor advice to look for the closure of
PDA. Go for other investigations depending on presence of particular or specific
symptoms with the advice of his pediatrician.
8.Keep the child warm. Maintain strict hygienic precautions while preparing,
handling, and during his feeds. Avoid taking him to crowded places and prevent
his exposure to people with cold, cough, and infections.
9.The weight gain from 6 to 9 months is 15 grams per day, from 9 to 12 months
is 12 grams per day. The gain in length from 6 to 9 months is 1.5 cm per
month, from 9 to 12 months is 1.2 cm per month. The gain in head
circumference(OFC) from 6 to 12 months is 0.5 cm per month. Theses are
approximate values may vary from one child to another.
10.The vaccination given to him is appropriate and there may be some fever,
decreased appetite and activity for a few days after the injections. So
nothing to worry.
11.The medication prescribed by the pediatrician are okay and you can continue
them as per the instructions.
12.Mouthing usually starts around 6 months age. For this reason the child sucks
his thumb or toys. Kids explore things by keeping in their mouth. It is a normal
phenomenon.
13.The milestones you described at the end are normal for age and are
appropriate.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Explained in detailed answer.
Detailed Answer:
Hi XXXXXXX
Thank you for your query on Healthcare Magic.
1. His growth parameters are in normal range as per the growth charts.
2. From 6 months onward the child can be given complimentary feeding in
addition to breast milk. You can continue the current diet which you are giving
now. You can start with one semisolid feed and gradually increase to 2 to 3
feeds per day in addition to breast milk.
3.His sleep pattern is okay.
4.Hesitation for breast milk during morning is due to development of flow
preference (nipple confusion) as he accustomed to bottle feed because of easy
flow from bottle nipple whereas he needs strength to suck milk from breast.
During night this preference will be lost.
5.Day time nap or sleep is common and because of disturbance he will cry and
once he finds some body for cuddling then will become calm. This is normal.
6.Passing stool once in 2 to 3 days is normal. It is not considered constipation in
infants. Usually the stool will be soft like paste and there will be no discomfort
while passing stool.
7.Repeat tests like 2D Echo as per the doctor advice to look for the closure of
PDA. Go for other investigations depending on presence of particular or specific
symptoms with the advice of his pediatrician.
8.Keep the child warm. Maintain strict hygienic precautions while preparing,
handling, and during his feeds. Avoid taking him to crowded places and prevent
his exposure to people with cold, cough, and infections.
9.The weight gain from 6 to 9 months is 15 grams per day, from 9 to 12 months
is 12 grams per day. The gain in length from 6 to 9 months is 1.5 cm per
month, from 9 to 12 months is 1.2 cm per month. The gain in head
circumference(OFC) from 6 to 12 months is 0.5 cm per month. Theses are
approximate values may vary from one child to another.
10.The vaccination given to him is appropriate and there may be some fever,
decreased appetite and activity for a few days after the injections. So
nothing to worry.
11.The medication prescribed by the pediatrician are okay and you can continue
them as per the instructions.
12.Mouthing usually starts around 6 months age. For this reason the child sucks
his thumb or toys. Kids explore things by keeping in their mouth. It is a normal
phenomenon.
13.The milestones you described at the end are normal for age and are
appropriate.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Venkata ,
Thanks for your kind reply. I am happy to see your answers :)
1. To add , what amount of water can we give him during the day and frequency?
Thanks
XXXX
Thanks for your kind reply. I am happy to see your answers :)
1. To add , what amount of water can we give him during the day and frequency?
Thanks
XXXX
Brief Answer:
Water intake depends on child thirst.
Detailed Answer:
Hi XXXXXXX
Thank you for getting back and for your kind appreciation.
From 6 months onward, you can give sips of water during feeding and in between feeds.
The amount of water intake depends on child thirst and the atmosphere out side.
There is no specified quantity of water to give, but offer water to the child and once his thirst gets satisfied, he will stop taking water.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Water intake depends on child thirst.
Detailed Answer:
Hi XXXXXXX
Thank you for getting back and for your kind appreciation.
From 6 months onward, you can give sips of water during feeding and in between feeds.
The amount of water intake depends on child thirst and the atmosphere out side.
There is no specified quantity of water to give, but offer water to the child and once his thirst gets satisfied, he will stop taking water.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Venkata,
Thanks again , appreciate the follow up!.
By when would kids recgonize their own name ? when we call them.
Can we put cartoon videos and show to him ? and what distance we should keep the laptop away from him while watching?
Should we put shorts / pants during day while he is awake or cloth diapers only is sufficient to cover his legs?
Also my wife applies kajol for his eye brows and big circle kajol on his fore head? is this safe? any risk like he will touch the kajol with his hand and puts in his mouth or so?
We have children digital weight machine at home, we are wieghing him everyday at night. is this frequency fine?
also how far should we keep the mobile, laptop, tablet instruments away from him?
Thanks,
XXXX
Thanks again , appreciate the follow up!.
By when would kids recgonize their own name ? when we call them.
Can we put cartoon videos and show to him ? and what distance we should keep the laptop away from him while watching?
Should we put shorts / pants during day while he is awake or cloth diapers only is sufficient to cover his legs?
Also my wife applies kajol for his eye brows and big circle kajol on his fore head? is this safe? any risk like he will touch the kajol with his hand and puts in his mouth or so?
We have children digital weight machine at home, we are wieghing him everyday at night. is this frequency fine?
also how far should we keep the mobile, laptop, tablet instruments away from him?
Thanks,
XXXX
Brief Answer:
Direct interaction with people rather than videos.
Detailed Answer:
Hi XXXXXXX
Thank you for getting back.
Babies usually start responding to their names by the age of about 5 months. Use his name frequently while talking to him so that he will connect to you by the name.
Cartoon videos are not required at this age and I suggest you not to show any programs on laptop.
The American Academy of Pediatrics (AAP) cautions that the children need more real face time than screen time, more laps than apps.
Encourage the child special senses by providing toys, by conversation, and by personal interaction from parents and family members to improve the inherent capabilities and interaction of the child.
Video or television screen should be at least at a distance of 6 feet from the child.
You can put clothes (pants or shorts) to cover the child legs, arms, and body. Cloth diapers are not sufficient to cover his legs.
Putting kajol is not safe and I suggest you to stop putting kajol to his eyes to prevent eye infections. It is not safe and there is a chance of kajol going into mouth because of habit of putting hands into mouth.
You can weigh the child regularly, but weighing the child on daily is not required. You can check his weight weekly once on a routine basis. But during any illness, you can weigh him daily to assess his nutrition and hydration.
It is better to keep mobiles, laptop, and tablet away from the child. Try to maintain as much distance as possible from the child.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Direct interaction with people rather than videos.
Detailed Answer:
Hi XXXXXXX
Thank you for getting back.
Babies usually start responding to their names by the age of about 5 months. Use his name frequently while talking to him so that he will connect to you by the name.
Cartoon videos are not required at this age and I suggest you not to show any programs on laptop.
The American Academy of Pediatrics (AAP) cautions that the children need more real face time than screen time, more laps than apps.
Encourage the child special senses by providing toys, by conversation, and by personal interaction from parents and family members to improve the inherent capabilities and interaction of the child.
Video or television screen should be at least at a distance of 6 feet from the child.
You can put clothes (pants or shorts) to cover the child legs, arms, and body. Cloth diapers are not sufficient to cover his legs.
Putting kajol is not safe and I suggest you to stop putting kajol to his eyes to prevent eye infections. It is not safe and there is a chance of kajol going into mouth because of habit of putting hands into mouth.
You can weigh the child regularly, but weighing the child on daily is not required. You can check his weight weekly once on a routine basis. But during any illness, you can weigh him daily to assess his nutrition and hydration.
It is better to keep mobiles, laptop, and tablet away from the child. Try to maintain as much distance as possible from the child.
Hope I have answered your query, if you have any clarification please let me know.
Regards.
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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