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Early weaning for infant who appears in pain during breastfeeding

In the past month or so, my 4-and-a-half-months boy has really been struggling to nurse. After no more than 5 minutes at each breast, he begins to grunt so terribly that you'd think he's in terrible pain. He sometimes also stretches out completely (like a plank), or brings his knees in towards his tummy, perhaps because of cramps. In either case, he at that point drops the nipple and will just look at me, smiling.

Our pediatrician (having just heard my description, rather than seen him) opined that this is just a manifestation of the gastrocolic reflex. But to me my baby's continuing torments at the breast suggest he's not getting enough nourishment. Indeed, my breasts feel both less "productive" (due to the decreased demand) and less "emptied" than before. Even though he still looks happy and healthy, he's gaining less and less weight: while at the 75th weight-distribution percentile at 3 months of age (6.2 kg), with 7.1 kg now he`s only at the 50th percentile.

Also, he has wet diapers regularly, though less than before. But dirty diapers only come once every other day or so, sometimes rarer, albeit with large "output". All of this wouldn’t worry me had it not been for all the moaning, and the reduced weight-gain.

I wonder if he'd be more accepting of formula milk instead of (or in addition to) my breastmilk. But he's been breastfeed from the very beginning, and I don't know if mixing at this stage is a good idea. It occurred to me these struggles might be a sign he is actually ready to have solids gradually introduced; but with this frequent reflux and intense gas, I worry weaning him so early will make his situation worse.

Ideally I'd like to know what the medical literature says about mixing breast- and formula-milk at 4.5 months, or about early weaning in response to restless breastfeeding (even if we accept this is just a sign of a normal gastrocolic reflex). But any anecdotal wisdom is welcome also! Thanks in advance :-)
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Avatar universal
Well, I'd say, don't worry! If he smiles, it means he is happy! If he grunts and strtches, he is content. Just like a cat, who stretches and purrs in the sun after a good meal. Breast milk is the best you can give your baby. Formula milk is not so good, can cause allergies and is more prone to cause digestive problems. When he will be 6 months old, you may start to introduce other foods. Also every baby eats just as much as he/she wants, not more and no actions taken to change that are good for that baby. Also pooping irregularly is normal, when breast fed. If on formula, pooping less than once in 5 days is considered real constipation. Everything else is just some light variations in frequency. No child is the same, so those percentiles are just statistics. If you still feel you child is malnourished or underfed, you could ask pediatrician or a midwife of your trust for an advice. Have a nice day and don't worry too much. Worry can also reduce the amount and quality of breast milk.
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