6 1/2 Month Old Infant Refusing Bottle Even When Hungry

K.,

Have you tried different bottles or even a sippy cup? Maybe it is the bottle she doesn't like. I have seen rare cases where some babies just do not like bottles, but do well with sippy cups or even cups. Have you tried different formulas? Enfamil, Similac and Carnation Good Start are three of the major standard formulas, but stores even have their own brands.

If all else fails, you might want to see a dietitian to get a recipe to fortify the formula. I am a pediatric dietitian at Children's and we fortify formulas all the way up to 30 calories per ounce (regular formulas are 20 calories/ounce) so we can maximize the amount that the babies are taking.

I hope that helps,
A., RD/LD

Hi! I know this must be so frustrating and worrisome for you. I have 2 that refused their bottles for just a short period of time (like a day)and even that was exasperating. I am a pediatric occupational therapist. I don't want to overly concern you, because this could just be a phase for sure. The fact that she is taking her bottle at night is somewhat telling for me. Are the lights on or off? I know that sounds weird, but just wondering. Please know that I am not a doctor or even able to diagnose anything really. But, have Isabelle's eyes been checked or even looked at? To me it sound like it's a possibility that she has double vision. Sometimes when the eyes cross or are not aligned properly (strabismus), it causes images to be seen in double. When the bottle or spoon, etc is coming to her mouth it becomes disorienting and it causes her to cry, scream and give up on the food even when she's hungry because she doesn't know which image to focus on and where to put her mouth. So in the dark it would makes sense that she takes the bottle fine because her vision is occluded anyway and she just goes by 'feel.' Try turning lights off and feeding her in the dark possibly during the day and see if that makes a difference. If it does then perhaps you could talk to her physician about the possibility of her vision playing a role in the feeding difficulty. Even if her eyes don't physically look misaligned, there could still be the start of a muscular eye issue. Please know that I am in no way saying Isabelle has this, I am just saying it's a possibility,and a stretch at that. I was just using 'for instance'for the purposes of this e-mail. Hope things get better very soon! Write me back if you have any questions.

Is your daughter teething? Usually you can tell from little white "buds" on the gumline. As children make the sucking action, the pressure causes much pain and they simply refuse to eat. My son has been growing his bottom teeth (he's now 7 mts 1 wk) and has the exact same problem. We give him children's liquid Ibuprofen to reduce swelling and pain, and minutes later he begins to suck his bottle with no problem; otherwise, he will shove the bottle away or begin to suck and cry.

So I'd suggest a mild pain reliever, or even some form of distraction. We also put on a children's learning DVD that he loves, which draws his attention away from any pain during feeding.

Hi K.,
L. the lactation consultant here. With her pursed lips, and behavior, your baby is communicating to you in the only way she knows how that she does not want the bottle (for wahtever reason). Maybe her gums hurt, maybe she has reflux, maybe her ears hurt, maybe someone forced the bottle into her mouth, maybe she just doesn't feel like eating. She's showing you she's not receptive to the bottle or its contents for some reason.
As you said in your post, it's best not to force the bottle into her mouth - that can create an oral aversion. Do some detective work and ask yourself, "Has anything in her life changed significantly in the past few weeks?" If she's receiving formula, have you changed brands, are you mixing it with the same water as before, have you stopped heating it (if you were in the past), did someone else force the bottle into her mouth? Have you tried a sippy cup?

You've received some great advice from others and it is true that weight gain slows significantly in the second six months of life. The "typical" baby has a weight gain of 4-7 ounces a week during the first month; an average of 1-2 pounds per month for the first six months; and an average of one pound per month from six months to one year.
Solid foods are generally started around the time baby is six months old.

Teething could be an issue, as could an ear infection, GERD, or other medical conditions.

Check in again with your pediatrician, explaining how difficult giving the bottle is for you and your baby. Or consider getting an opinion from a different pedi. In the mean time, do what works. A thorough medical evaluation is in order, in my estimation.

Please keep us posted on her progress.

Whoa! K., I would ask about GERD (Reflux). There is one type that involves a lot of acid coming up, but it goes back down, it's called silent reflux. It's the hardest to diagnose, but refusal to feed when you KNOW they're hungry is a sign. Check out these websites for more info/helpful products:

http://www.infantrefluxdisease.com/

http://www.askdrsears.com/html/10/T106000.asp

http://www.reflux.org/

http://www.pollywogbaby.com/ccp51/cgi-bin/cp-app.cgi?usr=...=

http://www.acidrefluxpillow.com/Toddler.htm

Hopefully these can help you decide if you should be insistent w/your dr. My ped said it wasn't the problem. Well, after seeing a specialist on my own and having an endoscopy and ph probe, guess what? It was! So, my advice is to stay at it if you think you have a suspicion as to her uncomfortability!!!

If it is reflux and you have ques/concerns, feel free to email me. We see Dr. Ogunmola at Cook Children's GI Clinic in FTW.

Good luck!
R.

Has the ped. checked her ears? I know that sometimes ear infections or just fluid in the inner ear can cause discomfort to a baby while sucking on a bottle. The pain might be so uncomfortable that she will only eat unless she is absolutely starving. Just a thought??

I also agree with the other post, that she may have an ear infection, this happened with my son, he had several ear infections as an infant, up until he was 1/2 to 2 years. He did not want to eat because he was in such pain. You should take her to the peditrican to figure out if this is problem or something else that is causing it. They will put her on antibotics and she will start feeling better.

She is old enough to start feeding rice cereal or oatmeal. Try to give her the bottle, and if she refuses, then mix it into the baby food and offer that to her. My baby started drinking water from a sippy cup with the grip handles at this age (I would recline him and he could hold it himself as long as he was laying down.) I had to do this b/c he refused the bottle from everyone, so this was a last resort for grandparents who babysat. I would bring it up with your pedi., but encourage a more active response this time since it has been ongoing now. The rice cereal should be a good start, she may even like it, and pretty soon she can start on veggies and fruit.

Scary! I'm not a qualified person to be giving medical advice and I don't want to scare you, but as a mom of two (two girls-2 months and 12 years), I have some ideas that might help. I hope this is not a big deal and is some phase she is going through that will soon pass, but if she is lethargic/out of it most of the time and not her usual energetic/alert self then I would be concerned (and definitely concerned about her weight). I personally think you should get a second opinion from another pediatrician - one who is a little more concerned! From what I have been told by my pedi, it is very important that they grow at a good rate. Is she eating anything else (baby food, cereal)? If not, maybe you could try cereal mixed with formula to help her gain some weight(I'm assuming you are not pumping your breastmilk..if you are, check how you are storing it or the foods you are eating). Also, check the formula you are giving to make sure it is not spoiled or foul tasting and maybe even try a different type of formula and try several different nipple types..she may just dislike the taste/feel of her current bottle nipples. You might try giving her a couple of ounces at a time every hour/hour and a half or so. I'm not big on strict eating schedules, but they have to eat! Again, I'm not qualified in the medical field and I think most importantly you should get a second opinion from a pediatrician. Good luck!

She may have gas and feels full or her tummy hurts. Talk to pharm. about otc drops to help ease gas pain. You may also want to check the size of the nipple on the bottle - it may be time for a different type or size. The formula may have made her constipated which of course translates into an upset tummy. Does she have regular BMs? If your ped. is not taking you seriously after the extreme drop on the growth/weight charts - find another BETTER doctor!!

Babies do slow down in growth a lot between 6 months and a year, and new found mobility might cause a tiny weight loss, but it shouldn't be very much. If this is consistent, I would definitely get her ears checked, and ask the pediatrician about reflux. Tell them that ou are worried about her weight loss. If your doctor blows you off, find a new one.
Also, the symptoms for teething and ear infections are very similar (refuse the bottle, runny nose, fussy, sleep problems, low fever, etc.) Does she have any teeth? You might see if a dose of ibuprofen would do the trick. The pediatrician's office can tell you the proper dose for her age and weight. Give it to her when she first wakes up, or about a half hour or so before a meal.
Also, have you offered a sippy cup? For both teething and ear infection, it's the sucking action that is painful. I'd use a plain, old-fashioned sippy (like the tupperware kind - I think First Years makes a cup with a lid that has a plain spout, without the stopper). The kind with a stopper or valve still require sucking.
Good luck! I hope you get some answers soon!

It could be something as simple as Isabelle not liking the nipple on the bottle you're using. At night, she is half asleep so she's much more agreeable. My son didn't seem to like the Dr Brown or Avent nipples much. When I tried the Playtex nurser bottle, he accepted the bottle just as he does my breast. Something about the shape and flow is very similar to a breast nipple. Maybe the flow of the bottle nipple you're using is coming out too fast...or too slow. If you're currently using a slow flow nipple, try a fast flow(or vice versa). If that doesn't make her happy, then switch bottle brands.

I would try a few things before you go back and get her medical attention. If she is not breastfeeding(I am only really familiar with bottle fed infants), try to cut out her night time bottle. At her age, she should be able to go a full 8-10 hours at night without food. It might be a struggle(i.e. lots of tears, sleepless nights), but if you just leave her alone when she wakes at night, she may go back to sleep, not without a fight, but tough love can really make her transition easier for her in the long run. In order for that, however, she has to get at least 25 ounces(and even more if she has not started solids) during the day to last her thru the night. If she has started solids, cut back on her portions and make sure to give her the bottle first, so you know she is getting enough nutrients. Try to keep the same routine with her feeding schedule, as well as the activity of feeding her because she will learn to expect food by the actions you make. I wouldn't force her to eat. If she turns her head, try to coax her but don't push it. If she fusses and still refuses, put her down and give her time, she will eat if she gets hungry enough. I would try this for a week or two and if nothing changes, call your doc right away. Lack of weight gain can be the best indicator that something might be wrong that needs medical attention. Good Luck!

Hi K.,
I would also recommend you talk to the pediatrician about this and have them explore if it is medical. Once a medical concern is ruled out, or if it continues to affect her growth and developmewnt, uou can also contact your local ECI program to have a free evaluation to see if there is something they can do to help. To find your local ECI you can call 800-628-5115. Keep us informed.
J.