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Dr. Andrew Rynne

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What causes lack of appetite in an infant?

Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3635 Questions

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Posted on Wed, 25 Apr 2018 in Child Health
Question: My new born baby is 8 days old and her mother did not got milk for first 5 days and after that she is getting small amounts only till then baby is on glucose water as per child doctor suggestion. We have stopped glucose from 2 days. Now the baby is sleeping for long time and not waking up for feeding also. Now Baby is being feeded with little mother milk and infant formula.
a. My concern is baby sleepign too long and not waking up for feeding
b. baby was on pohoto theraphy till yesterday morning
c. If we try to wake baby up she is not taking milk even if she takes its only small quantity and then falls to sleep immediately
d. Baby falls sleep very very soon after feeding even very little milk

What to do?
doctor
Answered by Dr. Diptanshu Das 1 hour later
Brief Answer:
Exclusive breast feeding needs to be given

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your query and understand your concerns. 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. Moreover they 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.

For a baby of this age, it is normal to sleep 20 hours a day. So, it is not bothersome if the baby seems to sleep more. You need not bother about the amount of feed do long as the baby passes urine at a frequency of more than 6 times in 24 hours, and 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 take the child to a doctor without delay.

Observe the child for increase in yellowish discoloration.

Let me know if I could help further.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Diptanshu Das 1 hour later
Thanks for understanding my concern. More doubts:

a) baby is fed with ~20ml mother milk and 30-40ml formula milk per day and baby is sleeping for most of other time and any further feed she is sucking outside
b) Baby urine currently is 3 times/day
c) no motion from past 2 days
d) mothers milk we are sucking into bottle exactly at time of fedding due to mothers nipples being inside currently.
e) For first 2-3 days urine and motion (black) are good and once we started photo therapy from 4th day her motion is ok as she is given motion tablet
f) mother milk is only 2-3 spoons till 5/6th day
doctor
Answered by Dr. Diptanshu Das 1 hour later
Brief Answer:
Please confirm whether it is thrice in 24 hours

Detailed Answer:
a) 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. Breast milk is produced on demand. Switching back to exclusive breast feeding will be all you need. Just monitor the urinary output.

b) 3 times in the day or 3 times in 24 hours? Please confirm.

C and e) For a baby of this age, it is normal to pass stool several times a day or even after each feed. Alternatively the child may pass stool once in 10 days and that is normal too. Unless the stool is hard and pellet like, you need not grow concerned. It is also normal to pass green stool or a combination of yellow stool.

d) flat nipple would hardly matter. Proper technique (putting the entire areola in the mouth) as well as the use of silicone nipple shields should help in resolving the problem. You can scissor your index and middle finger on either side of the nipple while the baby is sucking, and use it to control the flow of milk. Regulating the flow if needed would help in overcoming the problem of choking.

f) Giving external feeds will automatically suppress breast milk production.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Diptanshu Das 2 hours later
She had her motion now with only mother milk and with formula and results are:

a) Mother milk: Yellow and black with medium loose

b) Formula: Only yellow with small white particles and medium loose. In this case she had it immediately after feeding
doctor
Answered by Dr. Diptanshu Das 1 minute later
Brief Answer:
That is absolutely fine. No need to worry.

Detailed Answer:
That is absolutely fine. No need to worry.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Diptanshu Das 15 hours later
a) Baby had 4-5 times motion&urine from today early morning with yellow loose-medium hard stool, is it ok?

b) Even if baby is sleeping shall we wake her up and feed as she goes to deep sleep for long time

c) Baby lips gets dehydrated very often, what shall we do? she gets her tongue in and out as we do is it ok or its sign of hungry?
doctor
Answered by Dr. Diptanshu Das 1 hour later
Brief Answer:
Wake the child and feed if interval more than 3.5 to 4 hours

Detailed Answer:
a) Ok. No issues.
b) If sleeping for more than 3.5 to 4 hours, you should wake the baby and feed. Variations acceptable for night hours.
c) You can try breast feeding the baby at those times.

You have not confirmed if the baby is passing urine 3 times in 24 hours.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Diptanshu Das 20 minutes later
Yes it's 3 times in 24 hours
doctor
Answered by Dr. Diptanshu Das 59 minutes later
Brief Answer:
Seek medical attention at the earliest

Detailed Answer:
I do not suppose that is correct. In any case, if that is really the case, it is definitely a cause for concern and you should see the treating pediatrician at the earliest. If the information is correct, the child is supposedly in a state of dehydration and fluid electrolyte replenishment should be urgently required.

I would insist you not to ignore it.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Diptanshu Das 46 minutes later
to clarify 3times/24hrs was 2 days back and after we started formula and mothers milk simultaneously urination and motion happened yesterday.

We stooped formula from today onwards as mothers milk is coming but we are not sure how much quantity baby needs daily. she urinated 5-6 times today and motion of 4 times. But my concern is if baby is fed with mothers milk baby is taking little amount of milk and falls sleep is it normal. we force her to suck for some more time.

with only on mothers milk how many times a baby goes for urine and motion same for formula also. We stopped formula is it ok also even if mothers milk is less shall we just feed her mother milk only? stopping formula is gud?

do you suggest for immediate doctor attention?

One more thing baby was in sleep for 20hrs after phototheraphy and with no mother milk only glucose 2 days back when we came back to our home so we thought she was in sleep because of it.
doctor
Answered by Dr. Diptanshu Das 4 hours later
Brief Answer:
No need to worry

Detailed Answer:
If she has passed urine 5-6 times today it is not a cause for concern.

I am quite certain that the feeding technique is improper. The very fact that breast milk flow has increased and she is passing urine 5-6 times, is reassuring. The urine frequency indicates that breast milk is sufficient. Stopping formula is a very good decision. Unless the urine frequency drops again, it would not call for urgent medical attention. You do not need to give glucose to the child.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Diptanshu Das 8 hours later
did not get you on improper feeding technique?

After you suggestion we tried only mother milk one complete day yesterday and from yesterday evening 6PM to till now baby had 5-6 times urine and 2 times motion. does this indicates baby had sufficient mothers milk.

why i am asking is from today early 12am to 6:30am we have been feeding baby with only mother milk as she is crying and feeling hungry. baby had no sleep at this time awake and crying for milk. Even after feeding her for so many times she is still crying and looks hungry. We had given little amount of formula and waiting for mother to gain some energy & milk. what shall we do in this situations. How do we know mothers milk baby had is sufficient. Is it ok to fall back to formula when mother is too strain and no milk is generated for some times. Can we mix formula and mother milk and feed it. Also we are taking mother milk into bottle when baby is not sucking is it ok to have MM in bottle and also can we store it for few hours.

doctor
Answered by Dr. Diptanshu Das 2 hours later
Brief Answer:
Formula feeds should best be left out altogether

Detailed Answer:
Yes, it indicates that the child has received sufficient amount of milk. Please continue on this path. I would insist on refraining from formula entirely. You need not bother about whether the child is getting enough feeds. The mother's milk is produced on demand. If the child is hungry, it will suck more and more milk will be produced. On the contrary, if you give formula to boost the child, the hunger will be reduced and the child will suck less and will get less than adequate feeds. So, giving formula will have a disruptive effect.

It is ok to express breast milk but that will not serve the purpose. If expressed, it can be stored for upto 24 hours on the door of a refrigerator. It should be brought out and let the temperature come to normal room temperature. It can be thawed under tap water but should not be heated. I had mentioned that I suspected feeding technique not to be proper. Proper technique will ensure that the child feeds comfortably from the mother's breast. You can use a nipple shield (silicone) if needed.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
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