Is loss of appetite for breast milk in a newborn a cause for concern?

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Posted on Fri, 15 Nov 2019 in General Health
Question: Hi doctor, I had contacted you before regarding my baby. I am first time mother. After IVF My daughter was born at 38 weeks by c-section. Birth weight was 2.96kg. Today my daughter is 3 months + 2 weeks old.

Since beginning I had problem with her latching on breast for feeding. After many tries and advises from lactation specialist I had to start her giving breast milk by bottles after expressing by pump. Sometimes I had to give her formula.

Since last one month my baby is having strange problems with feeding. She sometimes finishes the bottle but most time she takes half and then refuse to take more. She will arch back while feeding, cry sometimes and take her mouth away from the bottle.

I struggle too much to feed her. This has affected me and my breast milk supply has reduced. I now have to give her most time formula and one or two times a day my breast milk.

She on average takes 600ml in one day. Before one month she used to take 600ml as well. She has not increase her intake.

At 3 months her weight was 4.520kg which proved lower gain than average.

I searched on internet and thought that most symptoms are related to silent reflux although my baby is not vomiting but other symptoms such as refusing feed, arching back, cry, not finish bottle, poor weight gain are associated with reflux.

I asked doctor and she gave renitidine to try for 4 weeks. We are in 4th week now but no improvements in her symptoms. Day before yesterday she had taken 700ml without much fuss but yesterday she and we struggled a lot to finish even 530ml. Sometimes she will take 120ml in one go and other times she will refuse after 40ml. We usually wait 3 hours between feeds but after 3-4 hours she will take as she pleases.

She sleeps well at night and we give her two feed during night when she is half awake. We noticed that when she is in little sleep she refuses less. When she is awake she will just jump around everywhere to go away from bottle.

Recent blood tests are ok and also urine infection was negative. Doctor's physical examination of tummy, chest hearing, hands, feet etc was ok.

I do not mind if she only takes 600ml in a day but what I think that she should take it easily whatever she wants.

We are Totally confused now if my baby has any major problem or not.

1> What do you think this could be?
2> Is her intake of 600ml a day is adequate?
3> Is her weight gain anything to worry?
4> Any tests or other suggestion to know what is wrong with her?
5> Anything you suggest to increase my breast milk supply? Currently I only get 100-150ml a DAY.
6> She sleeps well at night. Daytime plays well. Does not cry much. Seems happy baby but feeding time is so stressful. I feel that if I do not try enough then she will not even eat 400ml. I had to try harder and stay awake at night. I m going mental.

Please reply.
doctor
Answered by Dr. Sumanth Amperayani 49 minutes later
Brief Answer:
Suggestions on underweight of Infant

Detailed Answer:

Hi,

1. this could be a gastroesophageal Reflux and I suggest rather than Ranitidine, you go ahead with a combination of proton pump inhibitor like Lansoprazole and antiemetic medication like Domperidone. I am not suggesting a combination but two individual drugs. Both these are prescription medications and you will require a doctor's prescription for it. I would recommend you trying this for 6-8 weeks.

2. You told that two weeks back her weight was 4.52 kilos and for this weight a consumption of 600 ml is good, so do not worry about it.

3. Since birth she has been almost 21 grams per day which is less than the standard growth of at least 25 grams per day. So GER is a definite possibility there and I suggest that you go ahead with my first suggestion.

4. You can get a renal function testing done along with electrolytes and urine dipstick test and work up to rule out result tubular acidosis.

5. You can take Capsule Lactare one capsule three times a day to increase your breast milk production.

6. She is otherwise developmentally normal so I do not think your kid will have any serious problem.

Best regards - Dr Sumanth Amperayani
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8203 Questions

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