DD won't eat more than 2-3 oz - ideas??

Our daughter is 16 weeks actual (4 months), 9 weeks adjusted and currently weighs 9 lbs., 12 oz.

She was born at 33 weeks, and 1 day and was on an ng tube for quite a while because she wasn't taking enough by bottle. She was on oxygen, and reflux and thrush complicated the issue.

I am having problems getting her to take the volume that she needs to take. She is currently on 24-calorie formula and is gaining well on that. But the ped wants her to increase her volume so we can move her down to 22 or 20 calories. She takes between 2-3 oz. a feeding every three hours, but needs to take between 3-4 oz.

She was on an ng tube until September 15th. She has improved since then, but not fast enough to decrease the formula calories.

She does have reflux, but it seems pretty well controlled on Prevacid (15 mg once daily.)

Most times she starts out great, but then falls asleep. Once or twice a day she is really fussy. There is really no pattern that I can figure out.

She had a swallow study yesterday and did well. She still has a little bit of an immature suck-swallow-breathe reflux, but has improved. She doesn't need to have her formula thickened, and doesn't need to have another study done unless something else pops up.

Maybe it is just a matter of time because she has improved. But has anyone else experienced this? Have you been able to do anything to increase the amount that your LO eats?

Edited October 29, 2010 at 11:02 am

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my lo is about 4 mths old (almost) and almost 2 mths adj. She takes about 2-3 oz as well and my ped said that as long as she gets 18-24 oz in a 24 hour period that is fine. My low weighs 11lbs now but mainly due to high calories because she takes karo syrup with all her feeds and that is a lot of cals. I would just maintain her and as long as she is gaining weight steadily it sounds like she is doing well!

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How many ounces does she take daily? My daughter is 4months corrected /5 actual and she only takes 4 once bottles still... But she eats frequently...sometimes there lil tummys get full and that just might be her max right now...If she is getting her total volume in to gain weight which inthinknis anywhere from 16-30ounces depending on weight, then she should be fine...I don't think there is anything you can do to make a baby eat more...butaybe she is to comfy when you feed her, so maybe you can make it a lil cool for her because warmth makes them so sleepy, or hold her away frm you while feeding because mommys warmth can also make them to sleepy, that's what I had to do....I hope I could help, but I'm sure in no time she will come around...but at least she's gaining and her reflux is under control...that's great news....

Francesca

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I agree with Jia's mom and Francesca. My dd is 14 mo old and she still only drinks 5 oz at a sitting. I have also read other posts on this site that would suggest that if you were to swtich from 24 to 22 cal formula, you baby would automatically increase her intake (either oz per sitting or more frequent feeds) to get the calories she needs.

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Thanks so much for your replies!!

I was going to suggest to my ped to try the 22 calorie version. The OT who did the swallow study wants her to stay on the 24 calorie for a month because it is a little thicker and will give her time to develop her suck-swallow-breathe reflux a bit more. But I think I will suggest trying the 22 calorie for a week to see how she does.

Is it that big of a deal if she stays on the 24 calorie for a while? Does it hurt them?

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I have recently heard that a good guage of how many ounces they should be eating is to take their weight and double that. So if they are 9 lbs they should be eating about 18 oz a day.

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FYI = a non preemie babie only drinks 24-30 oz a day at 4 months

regular formula or breast milk that is which is 20 Cal. or 480 to 600 cal. a day.

Infant babies fromBirth to six months only require or the EAR for boys is 545-690 kcal (calories) per day, and for girls, 515-645 kcal per day, the figures rising as the babies grow and become more active as they approach their first half year.

From seven to 12 months, the EAR for boys is 825 to 920 kcal per day, and for girls 765 to 865 kcal per day.

So if your daughter is eating 8 x 2.7 oz bottles a day at 24 calories she is getting the right amount for the minimum calories for a Baby Girl under the guidelines.

Calculating feeds is based on 20 cal formula. The formula for formula is 2.5 oz per pound divided by the number of feeds. IE = 9.75 lbs x 2.5 = 24.375/8 feeds = 3.045 oz. or 61 Calories per feed.

I hope this helps.

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As I am sure you are aware, reflux babies need to take smaller amounts since larger amounts reflux more. Whether it is chicken or the egg, I don't know, but the end result is that an active refluxer rebels against folling up her stomach - and if the stomach is less full, less reflux will occur.

Also, another thing to consider is that a weak suck tires a kid out. My son had a weak suck until 3 months adjusted. We were ricing his feeds for the reflux and he simply could not suck unground rice cereal through the Y cut Dr. Brown's nipple (which is MADE specifically for this purpose!). We ground his rice cereal in a coffee grinder - and he sucked through the Y nipple. At 3 months, suddenly, his suck came in and we went down to a Size 3 because he was drowning with the flow. As he became stronger, we moved to a Size 2 because he was again sputtering under the flow. The weak suck tremendously affected him ... and he only drank minimal amounts at that time too. So it is all too possible that your daughter is pooped with 2-3 ounces.

Last, and perhaps best of all, there is no harm in having your daughter on 24 calorie formula. None. It IS thicker (helps with reflux, the gag reflex, the feedback feel on the tongue and through the swallowing motions, etc.). But it is also efficient for her -- fewer ounces to drink to get her calories. With a suck issue, this is key. I would be asking myself if the pediatrician has a good reason for wanting to wean her down to 22 or 20 calories. I am a firm believer in the concept of "don't fix it if it works". Your pediatrician may have a good reason -- but it also may simply be he doesn't get preemies. My son was the only early preemie his pediatrician had as a client (when he started there - now there's another). So every feeding decision was referred to the pediatric gastroenterologist or the NICU followup clinic, because he had such little experience. As you know, research changes protocols on a constant basis. Some pediatricians simply don't keep up with preemie protocols -- they are generalists. It took a pediatric GI, in fact, to tell me my kid had Failure to Thrive based on weights alone -- all the pediatrician had to do was check out his growth curve and see how it flattened. But when I looked at his growth chart, it isn't even on a preemie form! So ... maybe your daughter's pediatrician is simply trying to make her like his other patients, so he/she doesn't have to learn new amounts, new protocols, etc. And if that is the reason, I would resist. I say go with 24 calorie until she is ready developmentally to drink more ounces (and wants to drink more ounces) -- it can't hurt and can only help.

Good luck!

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Just wanted to say how much I agree with Leapingly as far as my experience with my son goes. I also wanted to add that my son never had the recommended daily amount of formula, but that he's doing OK sizewise anyway. For 6 months or so, he stayed under all the curves on the growth chart (under 0.4th centile), but when he started on solid food, his weight took off. He's now almost 17 months adjusted and was just weighed - I was stunned to discover that he is almost 75th centile for weight. The formula didn't do it for him - probably a suck-swallow co-ordination issue (he's still not that keen on drinking nor on milk) - but the solids certainly did. I know that solids are a long way in the future for you yet, but I just wanted to reassure you that even if your daughter doesn't have as much formula now, she may well make up for it later when you start her on solids.

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Thank you so much for your replies! She has made a lot of progress, and this has been a good reminder that she needs to progress at her own pace. Especially since she is doing OK with her weight. I will see the pediatrician on Wednesday, and will ask her what is the reasoning if she pushes the 20 or 22 calorie.

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