hi there,
i have been reading your blogs for months just to make sense of things but i am still struggling with my 6 month old daughter. in brief- she was born at a normal weight (7 1/2 lbs full term) and i was breast feeding her. at about 2 weeks she started screaming on the breast and coming off. the lactation consultant couldn't figure it out and just said she was limiting her amount for some reason.(i ended up stopping breastfeeding and just giving alimentum at about 2 months.)
at 6 weeks we started zantac and noticed she was not gaining.
fast forward to speed up the story-she was on zantac for a couple of months and then switched to prevacid. now she is on nexium. she does not scream, spit up, or vomit. she just stops drinking at around 2 oz. some weeks we will have some luck and she will drink 3-4 but the norm is about 2 oz. and we end up getting around 20 oz a day. she doesn't really whine for food. she wakes up every hour at night screaming. finally went to GI 3 months ago and ended up doing a scope to test for allergy, since we had not tried neocate. the GI doctor doesn't know what to do-everything on the scope was normal. we DID do a barium swallow 4 months ago documenting reflux and we can hear the milk come up and get swallowed back down but honestly that's about all we have to go on. she just doesnt want to drink! we used to have better luck when she was sleepy or sleeping but even that's out the window. does anyone out there have a similar experience where they limit their feedings but we don't really have a good reason? i guess we just wait for her to grow out of this? as far as the sleeping, we just couldn't take it anymore so we are doing sleep training. i think her eating habits consumed us and we deveopled very bad habits going to soothe her every time she cried but it really never helped so we ended up giving her formula which she probably didn't even want.
Hello!
Wow-you have been working very hard for six months on feeding. Two ounces per feeding means you are feeding her 10 times in 24 hours?
I wonder if your daughter had any choking, coughing or fear of eating? She just takes 2 ounces and then she just stops? I wonder if she has been evaluated by a feeding therapist or speech language pathologist with a background in feeding? Does she have a delay in her speech development? Before taking steps toward sleep training, I would want to make sure there isn't a physical reason for the feeding pattern. If she is in the habit of eating over 24 hours, it might help to decrease and then eliminate the night feedings and this would hopefully boost her intake during the day. I can tell you if there is some reflux, pain, discomfort or feeding aversion, this can be a very long and slow process. I eventually weaned my comfort feeder from night feeds but it was very painful for both of us. When the feeding is providing comfort for night waking due to pain, it is equivalent to taking away the medicine.
Let me know a bit more and we can talk some more.
Jan
hi, thanks for the response. sorry i did not mention that before GI we went to a feeding clinic and she was evaluated by a speech therapist, occupational therapist, and pediatrician. the pediatrician concluded she had reflux and that she was purposely limiting her intake to avoid throwing up. are babies that intuitive? when she was younger (0-3 months) she would make gagging and choking noises while drinking but never to the point where we were ready to take her to the ER. she doesn't make those anymore. what has been constant is hiccups. one thing that was interesting is when we advanced the nipple to 6 months, the first few times she drank 3-4 oz in 1 gulp and then DID spit it up. then after that she went back to her stopping at 2 oz. so maybe that does go with learned behavior -protecting herself from throwing up? i completely agree with you that before sleep training make sure it's not a physical reason. but i guess we just don't know what else to do since the doctors can't find anything. do you think it's too early to start taking away one of her night feedings? we were just trying to get the volume up. since she has had such poor weight gain we fortify her formula. and yes some days we really do feed her 10 times a day, sometimes 12. it's ridiculous. we tried to get her on a schedule every 3 hours-seemed to work for a few days because she drank 2-3 oz at a time and sometimes even 4 but then she reverted. she can go 5-6 hours during the day without food. or when she wakes up in the morning and it's been 4-5 hours she will still onlydrink 2 oz sometimes. she definitely has a fear of eating-we are trying baby food and thought she'd love it since she grabs at our plate and glass all the time but she doesn't really take to it. the one thing she loves is water from a glass. sorry this is so long.
Hello!
Thanks for the additional information. It really does help me to know more details. I wonder if she had a swallow study done as part of the feeding evaluation. It is often done with a speech language pathologist or laryngologist present to watch the barium pass during a swallow. It is possible for young babies and toddlers to intuitively "fix" their feeding problem by limiting intake. I also wonder if she has had a pH probe to measure the acid before, during and after a meal.
With her precarious weight situation and need to maintain her weight/intake, it seems like weaning from the night feeds will need to be done with medical supervision. It doesn't seem like removing one night feeding will necessarily cause her to take more by day.
As a parent, I would want to know if there is an underlying medical problem (swallowing/dysphagia, other feeding disorder, reflux, allergy, combination, other) and/or a feeding aversion (learned behavior from past pain). If these issues are identified and addressed, there may be no sleep issue. For my daughter, she was waking and nursing all night long but she was in pain and I was her medicine. I got a second opinion from another gi doctor and she was placed on a high dose of reflux medication and her "sleep problem" resolved itself pretty fast. At the same time, I had been slowly decreasing her night feeds (length was shortened) but it was slow going because the underlying pain was preventing much progress. Once the pain issue was resolved, the behavioral issues were easier to deal with.
Do you have a sleep coach or trained professional willing to help with the sleep training? It is certainly ok to give it a try for a short period of time to see if you can address any behavioral issues that have developed. I would just want to be extra careful with the possibility that she had a medical reason for the night waking.
Jan
No, we did not do a swallow study or the PH probe. we did do the barium upper GI- i wish we had done it all at the same time. i will ask our pediatrician next week about these things + a sleep coach/professional. i completely agree these things need to be addressed. my husband and i are so at the end of our rope-we are resigned that there was definitely a medical problem that made her develop behavioral problems and that we may never find out what the medical problem is. i think the pediatrician and GI doctor are at dead ends now and just think it will get better eventually. that's hard to hear when your kid only gains a few ounces every month! i would rather not try the neocate since it is a shot in the dark and she is used to the alimentum now. thanks so much for the advice and support-it's so hard for people to relate to feeding problems unless they've experienced them personally.