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5 month old premature infant bottle feeding issues
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5 month old premature infant bottle feeding issues

My daughters were born at 33 weeks, stayed in the hospital for only 12 days.  One had a birth mark that grew very fast and we had a steroid injection given so that the growth would stop.  Three weeks after the steroid injection, she quit eating normally.  She went from eating 4 ounces every 3 hours to barely an ounce every three hours.  Now she will not eat when she is awake, only when she is sleeping and not thinking about it but at that, she stops eating after 2 ounces per feeding.  She is now five months old and only 12.6 pounds.  Her twin is eating normally and 16.8 pounds.  She is on Prevacid for reflux but that does not help us with her not eating while she is awake.  She just plays with the nipple and spits the formula back out.  Can you help us?  She has only gained a pound in three months!


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433383_tn?1204128429
Hmmm, I think you should CALL YOUR PEDIATRICIAN.    
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Avatar_n_tn
I have and they seem to have not seen anything like this before.  Thanks for your help.
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Avatar_f_tn
I have 2 kids and they are exactly what you describe, but mine were both full terms.  I don't have an answer for you since my older one (now 3 years old) got to a point where he was taking a bottle ONLY in his sleep.   Now I have a 3 months old who is acting the same way.  It was very frustrating. He was eating fine at about month and a half, but now at 3 months has no interest in eating, fusses if I give him a bottle even if he hasn't had a bottle throughout the night and only wants to sleep when I try to feed him.  He doesn't sleep much during the day and wakes up soon after he finishes eating.  

I don't want my 3 months old to end up like my 3 year old who ended up taking a bottle only in his sleep.  Noone seems to have seen kids like this, but I have, so you are not alone.  I would love to know what can be done to get them to take a bottle willingly while awake.  The Pediatrician couldn't help much.  My 3-month old is on Prevacid also(just started him on it).  have to wait and see what happens. My 3 year old did not have a milk allergy (had him tested), so that wasn't the cause with him, didn't test the younger one for allergy.

Anyone has any solution in mind???  
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Avatar_f_tn
Just wanted to add that mine did not have steroids, still have the same problem with feeding.  After eating normally, then went to eating only 1 or 2 ounces at a time to now not wanting to eat at all while awake.  If he is kept upright and I rock and sing to him, he eats a little better.
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171768_tn?1324233699
i just wrote a long response about my preemie daughter's feeding problems, but she just toddled over as a healthy, plump 12 month old and turned off my computer as i was typing. so i'll skip the details and give you the end... if you respond then i'll tell you more of the specifics so you can compare.

recommendations-
~try different nipples. we tried EVERY bottle system out there, and finally found one that worked- the size small medium flow gerber Nuk. try different flows, different sizes, shapes, etc...
~ask your ped for a referral to a feeding specialist
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Avatar_f_tn
Please do give me more specifics....I would love to compare...

I have been feeding my 3-month old with a Nuk nipple since he was 3 weeks old when I started giving him a bottle.  He was fine on it until maybe a month ago when he stopped having interest in the bottle while awake.  When he was eating okay with Nuk, I gave him Playtex standard nipple, but did not seem to like it much.  I cut all his nipples now to make the hole bigger because he takes formula with cereal in it because of his reflux.  I started giving him Avent bottles from yesterday in some of his feedings.  Not sure if I should offer it in all his feedings.  So far no  improvements, but its only the second day.  Also I'm not sure how long I should wait to see if that is improving his feeding.

This past Saturday, I started my 3 months old on Prevacid.  From the next day (sunday), he isn't sucking as well as he used to even in his sleep.  He is having about 3 ounces in his sleep.  Not sure if he is too deep into his sleep...and not sucking hard enough to get much.  

When my older son (now 3 years) stopped eating while awake, we had feeding specialists come in our house but was not much help.  He was close to 5 months old at the time.  Its not that he could not suck the bottle (he did it fine in his sleep and before when he was younger while awake).  

I noticed that my 3-month old has white stuff on his tongue.  Wonder if it is thrush and if that could be contributing to his loss of interest in his bottle??? I don't remember my older one having a thrush.  This morning he ate 2 and a half ounces (he started eating while awake and then fell asleep with a Avent bottle) and threw up all of it while burping him.  Maybe he gulped too much air while eating????

Any suggestion will be greatly appreciated.
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171768_tn?1324233699
(i sent this in a pm too. posting because maybe it can help someone in the future
)
my daughter was born 4 weeks early. she had coordination problems- she couldn't coordinate her suck, swallow, breathe pattern. as a result, she was very very difficult to feed. she would pause to breathe, but had to release her latch on the nipple, so she would dribble about 1/3 of the feed (i actually weighed it once). a lactation consultant who observed her bottle feeding determined this. in addition, her suck wasn't very strong. the nuk worked for her because of it's solid base- it was easier for her to quickly reseal her lips around it than other nipples. in addition, since the hole was on top, when she paused to breathe the milk didn't just shoot into her throat making her choke like other bottles. We suspect she had some swallowing difficulties as well, based on the fact that she did choke on every other nipple. BUT, since her suck wasn't very hard, we discovered that the slow flow nuk just wasn't cutting it for her. She needed a small nuk with the hole on top to prevent the choking, but a medium flow. I happened to have one in a bag of different nipples someone gave me, and it made a huge difference. i was so excited and relieved, i ran straight to the store, only to discover that they were discontinued 4 years prior. after hours/days/weeks of searching we found them.

now that may all seem a bit irrelevent, but it's just background info. She was a very slow eater from the start. it would take her up to an hour to finish 3 ounces, but she did it. as she approached 2 months of age, her feeding got WORSE. i couldn't understand why. the only feeds that were tolerable were the ones where she was sleeping. they seemed to go so much more smoothly. at that point i was still seeing a lactation consultant in hopes of breastfeeding. she explained to me that as she got older, she was more aware. she was becoming aware of all of her underlying feeding issues, and they were starting to bother her. that's why she ate smoothly while asleep. for the next month and a half her feeding continue to get worse, and we began to suspect swallowing problems. the LC agreed that it was probably time for a feeding evaluation. we went to the ped and got the referral. we never followed through because when we got home from the ped, literally the very next feed went a bit better. we had been using the new nipples for a few days, and it seemed to actually be helping. we decided to wait a few more days, and she just continue to improve. i think it was a combination of her maturing (better feeding in general) and the new nipples.

i'm not sure what kind of feeding specialists came to your house, but the kind i was referred to would not have been able to do the evals in the home. you would need a swallowing study to determine if there is dysfagia, and if so, what is causing it.

white stuff is a sign of thrush. i'd call the ped. while there, discuss your feeding concerns with him and see if he'll give you a referral.

as for bottles, i would choose one and stick to it instead of going back and forth. i did not like avent, even though there were times when it worked for her. (that was something that was weird in the beginning too- she'd do great on avent for a couple of weeks, so we stuck to that. then, all of a sudden, she'd dribble most of the avent, so we'd switch to nuk and she'd do great for a couple of weeks. like i said, in the end, it was the medium flow nuk that saved us.)

one other trick i thought of that helped when she was at her worst- she used to take a pacifier. if we gave her the pacifier for a few minutes and then quickly switched to the bottle, she did seem to feed better. make sure the paci and the bottle nipple are the same. for example, we used the nuk paci because we were on the nuk bottles.
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Avatar_f_tn
Thank you for the response!!  Your child sounds so much like 2 boys.  I think I do need to get my 3-month-old evaluated by a feeding specialist.  Will call his Ped soon.  His feeding seems to be getting worse everyday.  He is not, however, losing weight since he is getting what he needs in his sleep.  I'm afraid to stop feeding him in his sleep in fear that he won't get his food requirements met and won't grow properly.
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171768_tn?1324233699
we did what you did- most of her feeds while she was sleeping. obviously some had to be while she was awake, but we had to draw straws to see who was going to go through that he!l
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