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What causes reduced milk intake after starting on vegetable diet for infant?

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Posted on Fri, 29 May 2015
Question: Dear doctor,

Details: Our daughter 'Shanaya' is 7 months old. Born in Kuwait but now we are back to XXXXXXX last month. As per Pediatrician in Kuwait - we started Shanaya on boiled vegetables (mashed) post her 6 months completion and then added mashed rice with pulses for lunch and now added mashed fruits (apple, pears, papaya & banana) for dinner. Shanaya feeds on breast feed approx 80ml a day. We recently visited an XXXXXXX pediatrician who advised us to feed (food) the baby a bit more as Shanaya's weight is 6.34 kgs, which is less on completion of 7 months.
We have changed Shanaya's kuwait formula milk from 'Aptamil 2' brand to XXXXXXX 'Nanpro 2' just 3 days back. Also we have increased her intake of mashed food meals.

Main Issue: Shanaya intake of formula milk has decreased for the last 3-4 days - it is not more than 200 ml a day compared to atleast 350ml 5 days back - now is this because we have increased her food feed or is it because she is not liking the new formula milk taste ???
She is perfectly active and her growth is also good as per the pediatrician.

If it is because of the milk then what brand (tastier) do u suggest? and if something else then ...?

Please advise doctor.
thanks a lot
doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
It may be due to the increase in the food feed

Detailed Answer:
Hello XXXXXXX

Thanks for the query


At age of 7 month weight should be somewhere between 7-8 kgs assuming she was born full term with normal weight.The weight of your baby is slightly lagging behind.
I always prefer to give home made foods instead of formula feeds if feasible.The reason is you can give variety of foods and this increases the oral acceptance.
At this age there should be at least 3 large serving(each serving consists of one katori of around 100 ml volume). In between there should be 2-3 small servings(fruits or nan pro).Continue the breast feed in between.
The food should be such that it contain protein,fat,carbohydrate,minerals and vitamins.The proportion of fat requirement is much higher in this age to meet the nutritional requirement for proper growth.
The large serving should consist of mashed rice with pulses,mashed roti with pulses or milk or any cereal porridge cooked in milk.Add ghee/oil in food generously to make it calorie dense.You can also give XXXXXXX or suji ka halwa.

You can give mashed boiled potato also.Give banana,papaya,cheeko XXXXXXX to meet the vitamin's requirement.Change the menu daily.

The choice of formula feed varies according to the individual baby.All the companies make their formula in such a way that it should taste better.
So I would suggest you to continue the same.
As you will increase the amount of home made feed the intake of formula feed gradually decreases.In you case it is the more likely cause.
I would suggest you to follow age and sex specific growth chart recommended by XXXXXXX academy of pediatrics for monitoring the growth.

I shall be glad to answer if you have any more doubts.
Wish your child good health.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar Jain (8 hours later)
Doc, I am sorry to say but I am totally confused now.

1. I have met 3 pediatricians in the past who have told us that the baby's weight should be 6.9 kgs at the end of 1 year, however you have mentioned that it should be 7-8 kgs on completion of 7 months.

2. You have mentioned that we should give more of mashed food and then formula milk and fruits on intervals, however the other doctors have advised of more milk and substantial food diet also considering fruits as one of the main meals not as a interval meal as mentioned by you.

3. How do we serve roti and pulse mashed? the roti will become small heap of atta which will be a problem for a baby to swallow with no teeth to bite.

4. Also FYI, the baby was born pre-mature (on completion of 8 months) at birth weight of 2.35 kgs. Baby was kept in incubator for 48 hours. Found healthy so discharged with a clean chit.

5. I am still not clear if we need to change the formula milk brand or do we continue with nan pro. And if we change then which one do you advise we change to.

6. Actually getting a different prescription from every pediatrician makes it very difficult for parents like us to understand the technicalities of taking good care of a baby.

Requesting your advice on the above mentioned questions as to be XXXXXXX I am not very satisfied with your first review answers as they are completely contradictory to what i have learnt till now.

thanks

XXXX XXXXXXX

doctor
Answered by Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Following recommendations is a better idea

Detailed Answer:
Thanks for the follow up XXXXXXX

I am sorry that like other doctor I could not be able to convince you.
Very few doctors follow the recommendations and use their personal experience to treat the patient.There are recommendations and guidelines based on large studies which should be followed to avoid confusion and also for better results.
This is the reason people are choosing online consultation and spend their time to gather the information from internet.

Hereby I am providing you the links of recommendation by XXXXXXX academy of pediatrics and XXXXXXX academy of pediatrics(two top research academies in world)and request you to read that to avoid confusion.

http://www.indianpediatrics.net/dec2010/dec-995-1004.htm(Under heading of complementary feeding)
http://www.healthychildren.org/English/healthy-living/growing-healthy/Pages/assessment.aspx

http://www.indianpediatrics.net/mar2007/mar-187-197.htm(figure 3)

Regarding your third query
You can give well mashed roti with pulses to the baby.It is not necessary to develop all the teeth fully to start these feeds.Babies of this age can have these mashed food items very well.Just be sure that you have mashed it well.

Regarding your fifth query
Don't get too much confused and keep trying to feed her.It does not matter which formula you are giving.

I hope after going through these articles you would be better able to handle the feeding problems.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2063 Questions

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What causes reduced milk intake after starting on vegetable diet for infant?

Brief Answer: It may be due to the increase in the food feed Detailed Answer: Hello XXXXXXX Thanks for the query At age of 7 month weight should be somewhere between 7-8 kgs assuming she was born full term with normal weight.The weight of your baby is slightly lagging behind. I always prefer to give home made foods instead of formula feeds if feasible.The reason is you can give variety of foods and this increases the oral acceptance. At this age there should be at least 3 large serving(each serving consists of one katori of around 100 ml volume). In between there should be 2-3 small servings(fruits or nan pro).Continue the breast feed in between. The food should be such that it contain protein,fat,carbohydrate,minerals and vitamins.The proportion of fat requirement is much higher in this age to meet the nutritional requirement for proper growth. The large serving should consist of mashed rice with pulses,mashed roti with pulses or milk or any cereal porridge cooked in milk.Add ghee/oil in food generously to make it calorie dense.You can also give XXXXXXX or suji ka halwa. You can give mashed boiled potato also.Give banana,papaya,cheeko XXXXXXX to meet the vitamin's requirement.Change the menu daily. The choice of formula feed varies according to the individual baby.All the companies make their formula in such a way that it should taste better. So I would suggest you to continue the same. As you will increase the amount of home made feed the intake of formula feed gradually decreases.In you case it is the more likely cause. I would suggest you to follow age and sex specific growth chart recommended by XXXXXXX academy of pediatrics for monitoring the growth. I shall be glad to answer if you have any more doubts. Wish your child good health. Regards