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Friday, December 13, 2013
Baby not eating
I am writing on befalf of my sister. She is having a hard time breast feeding her 8 week old baby. It seems he just turns his face away from the breasts and cries, whenever she tries to breast feed him. He has not gained enough wait too. The baby poops only once in 2 days. What can she do to improve his appetite?
This question has been forwarded by Newborn Care:
The problem is likely one of milk supply.
Sometimes the baby is unable to drain the breast adequately, which results in decreased milk production. The baby is then frustrated at the breast and refuses it.
This may be due to the shape of the baby's mouth such as high hard palate or tongue tie, or it could be that the mother's nipples are short or flat or both, or that the mother, for some medical reason like low thyroid function or blood loss or polycystic ovary syndrome, etc., is unable to make enough milk for her baby.
She and her baby should be seen by a breastfeeding medicine specialist, who should be able to sort this out with a complete history and physical examination of both mom and baby.
Meanwhile, the baby should be supplemented with pumped milk (mom should pump both breasts simultaneously every 3 hours) either at the breast with a Supplemental Nursing System or with a bottle, and possibly take a galactagogue such as Fenugreek or Reglan or Domperidone.
I am guessing that this baby needs at least 2.5 to 3 oz every 3 hours around the clock to grow. If there is not that much breast milk available, then a formula that the baby can tolerate can be used to make the difference until the mother's milk is equal to or greater than the baby's needs. His appetite and stool output should improve when his intake increases.
Please wish your sister the best of luck, and write again if need be.
Jeanne L Ballard, MD, FAAP, FABM
Professor Emeritus, Pediatrics, Obstetrics and Gynecology
College of Medicine
University of Cincinnati