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1222635 tn?1366399886

need some help on ariana's feedings

we started ariana out on rice cereal with the approval of her pediatrician at 6 weeks for her reflux. she was crying an hour after eating and so we were feeding her far too much and she was over eating. what ended up happening is we put rice in her bottle and made it really thick and cut big holes in the top of her nipples. she was eating this EVERY feeding. i know thats a lot, and i made her pediatrician aware how much she was eating, and he said it was fine for the moment as long as it was keeping her happy and helping with her reflux/sleeping. at her 4 month appointment 2 weeks ago, she weighed 14 lbs. 12 oz and was 25.5 inches long. he said she was thriving and growing great, but that she was in the 95th percentile for weight and 90th for length. i found that a bit confusing because other people who had 4 month olds said their's weighed about what she weighed and their pediatrician said they were in the 60 something percentile. anyway, he said she was doing great but that its time to wean her off of the cereal and only feed it to her in the morning and evening. he doesn't want her to have excess calories / weight and be overweight going into her early childhood. and he also wants me to start spoon feeding her when she shows interest and then once she gets the hang of eating from a spoon she can have baby food. and obviously cereal during the day and baby food morning and night is far too much.

well what i did is i bought a formula with rice starch in it. my plan was to feed her that during the day until the can was gone, and then use regular formula. i figured the formula with rice starch was a good in between of what she has been eating and plain formula, and it would help ween her off of rice all together. she was doing great! she wasn't very fussy and was still eating every 4 hours. (her pediatrician said to continue feeding her every 4 hours) well the past few days she has been SO fussy. she SCREAMED bloody murder on friday and i just assumed something else was wrong because it wasn't time for her to eat. finally i decided to try feeding her after i exhausted all other options and that was clearly what she wanted. i was a bit surprised because she hadn't gotten hungry early until then, despite being on less rice. i thought maybe it was just a one time thing and continued following the doctor's advice of formula every 4 hours, and her fussiness and wanting to eat more often hasn't ceased.

last night she was screaming bloody murder for a bottle after 3 hours. we have increased her dosage of zantac. she is now on 1.5 mL morning and evening. part of the reason i think she is getting hungry early is because she's spitting up an uncanny amount. it at least LOOKS to be half of what she eats. i mentioned this to the doctor and he wasn't concerned.

i guess my question is this: should i continue with the formula during the day and just feed her every 3 hours, despite the doctor's orders to continue feeding at 4 hours? OR should i put her back on the thick rice every feeding and feed her every 4 hours? i do not want her gaining excess weight...i am not going to be so selfish as to cause her to have weight problems as a child. only thing is, the regular formula shes eating now really isn't regular at all. it has rice starch in it. when i buy a can of normal formula with no rice starch, i am afraid she is going to scream for a bottle at 2 hours and then what do i do?

a friend of mine has a 4 month old, and he weighed 14 lbs 11 oz at his 4 month checkup, and was told to be in the 60 something percentile i believe. she was only one more ounce and she had been eating cereal every feeding, he was just on normal formula. so with that comparison it doesn't seem to be causing her to gain excess, she seems to be on track with all other babies eating just formula. or maybe boys are supposed to have different weights? UGH this is all so confusing. any advise is very much appreciated because once again i feel at a loss for what to do for her.
5 Responses
1330108 tn?1333680904
Boys and girls have different weight tracks. Maybe get a second opinion from another ped or tell your ped this is NOT working and he needs to come up with a new plan. I'd say until then feed her when she's hungry and hopefully either a new ped or your current ped can come up with a new plan in the next week as to what to do. You can also look online for a growth chart to double check her height and weight to see what percentile she is. Also if you and or your hubby were in the higher percentiles at her age than it is likely that she will too bc it's just the way genetics go :). Another week of this isn't going to doom her for childhood obesity so stick to what works till a dr gives you something better is my suggestion but of course I'm not a medical dr I'm nearly a psych dr ;)
171768 tn?1324233699
Honestly, I don't feel it is good advice from the pediatrician to feed her every 4 hours. It is well known (almost ANY site about reflux will confirm this) that babies with reflux need smaller, more frequent meals to help control the reflux. Every 4 hours was OK when she was on the rice/formula mix, but if he wants her off it (which sounds like she should start coming off it), then he should have warned you to do smaller more frequent feeds. It sounds like that is what she needs, and what your instincts are telling you to do anyways. If you do choose to go to regular formula like he would like, then you should definitely try to do the smaller, more frequent feeds. See how that goes. If it works and she is happier, then you will know you are doing the right thing. However, if she is looking for more frequent feeds and continues to take the very large feeds, then she is over-eating because of the reflux. My little one over-ate because of terrible reflux. We actually didn't get it under control until she was 8 months old. Zantac alone wasn't enough. Prevacid and Zantac together did the trick, but the ped had never heard of a baby needing both. So, we were sent to a gastro who we saw around 6 months old. She also did not like prolonged use of both zantac and prevacid, and she doubled the prevacid dose to 2 solutabs a day. That did the trick and by 8 months I felt like we finally had the reflux under control.

If these problems persist, ask your ped for a referral to a gastro. She will evaluate your baby's medications and give appropriate feeding recommendations. Pediatricians, especially older ones, are not very knowledgeable about reflux meds because it is relatively recent that these meds started to be used widely. In the past, these babies were given cereal as the primary solution and labeled as "colicky." So many people I know whose kids are in their teens and twenties describe their babies going through this and not getting any help. And what peds DO know about these meds is based on what the drug reps present to them (as admitted by my own ped- which is why he decided that he couldn't control her reflux). We are lucky that these poor babies CAN be helped with medications that are considered to be safe as long as you seen the right professionals.

As for percentiles, the huge difference in percentages, especially in height, can be the matter of a pound or 1/2 inch. Also, my ped often reminds us that the height measurements can very easily be off because of the imprecise way they take it. Since her height and weight match, you don't need to worry about her being overweight. In fact, her percentiles are pretty much the same as my second child.

Reflux is a very difficult thing to manage, and it is absolutely heartbreaking to watch your baby suffer. I feel for you. I still get upset thinking about what my little one went through. Even now, at 13 months, she has occasional flair-ups. Just last night we gave her a dose of meds. she weaned 2 months ago, but the gastro was able to give us appropriate dosage for OTC heartburn meds incase something aggrevated it.
171768 tn?1324233699
and if you haven't, check out the MarciKids website. It is tremendously helpful for parents dealing with reflux.
1222635 tn?1366399886
i think thats what im going to try first; smaller more frequent meals. hopefully it'll work for her. she has been taking 5 oz. now i'll lower it to 3 oz and just see when she gets hungry next as she usually sets her own schedule and is consistent to it. hopefully we can go 3 oz every 3 hours, that would be ideal.
1035252 tn?1427231433
Hey girl I responded on the other forum...what percentile has she been all along? I explained on the infant forum about percentiles and their importance when it comes to predicting weight problems...i hope that helps ease your mind! I do want to say that the percentiles don't have to match EACH OTHER (like height and weight don't have to BOTh be 90, or 95/92) but it's important that they're consistent to previous measurements...I think this is a common  misconception. If a baby was born in the 40% for weight and 60% for height, for instance...as long as they stay in similar percentiles as they grow it's fine...they don't need to match for height/weight. make sense? it usually is a better sign though like tired said when the height is a higher percentile because a baby with a higher weight isn't going to have the same issues if they're taller than a shorter baby with the same weight...but the percentiles don't HAVE to match between the two variables, just to previous measurements.
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