dr has recommended solids for 4.5 month old due to reflux

[Molliemis]

Hello all,

My 4.5 month old has reflux and her ped has strongly recommended that we start rice cereal now. She is on medication and still has a hard time keeping formula down.  I gave her a couple of tblsps yesterday and it did seem to help. Trouble is I'm just starting the 4 hour EASY and now I need to add in solids. I dont know when to give a bottle and when cereal and how many hours apart etc. Can anyone post a daily routine so I will know when to give a bottle and when to give cereal and a bottle? Also, do you give cereal first or bottle first? if you give cereal do you cut the amount of the bottle? and by how much?  Sorry I'm at a loss here.

Thanks ahead of time for your help.

Mollie

[mmom]

We had to start early too for the same reason.  What we did was space the milk feed 4 hours apart and cereal was 1 hour later.  For example, our LO woke in the morning and we gave him a bottle, then 1 hour later we fed him cereal.  We then did this after the afternoon bottle for lunch (or maybe mid - morning?).  The only time it wasn't that way for us was for his "dinner" feeding.  There was more space, since he had a bottle at day care and then had his dinner with us and then his bottle before bed.

[Lolly]

We started at 17 weeks for the same reason too! As PP we stuck to the 4 hour routine and did cereal about 1 hour after. Our main difference is she takes most of her calories in the evening so feeds/ solids are closer together for us.

Don't reduce your bottles though as the milk is the most important source of nutrients until much closer to 1 year. Just offer small amounts of solids to make sure it doesn't replace any milk yet.

HTH!

Laura

[Molliemis]

Thanks so much Mmom and Laura for responding. Should it look like this?

7:30 Bottle

11:30 Bottle
12:30 cereal

3:30 Bottle

7:30 Bottle
8:30 cereal

or like this:

7:30  Bottle
8:30  cereal

11:30 bottle
12:30cereal

3:30 bottle

7:30 bottle

I'm just starting the 4 hour easy and having a tough time with that as well. 7:30 seems late for dinner but if you do dinner at 5:30 or 6 then it's not 4 hours between feeds. And my LO really wants to eat every 3 hours and I'm trying to change this. Is that right?  How do you guys handle "dinner" at this age?

Thanks so much!
Mollie

[mmom]

We only did 3 cereal feeds.  Think breakfast, lunch, and dinner.  So for us it was:
6am bottle
7 am cereal
10 am bottle
11 am cereal
2 bottle
4cereal
5/6 bottle
bed

[ark]

I personally would keep the cereal away from bedtime for now, until you are sure her tummy is OK with it.  Cereal caused nightime issues with my DS.

[Lolly]

I would do breakfast and lunch solids for now - even just breakfast for a bit to see how she reacts to the solids. We do tea around 5pm then bed bottle at 7pm.

You can increase time between feeds slowly if she is still wanting to feed 3 hourly - in fact little and often is often better for refluxers. I would try a 3.5 EASY and see how she goes with solids on that. It is hard fitting milk feeds and solids in when they are young but does seem to work itself out - are you doing a dreamfeed at all?

Have a look here  http://babywhispererforums.com/index.php?topic=68458.0 and here http://babywhispererforums.com/index.php?topic=61945.0 - although it is for babies a bit older than yours it should give some ideas how solids and milk fits into the 4 hour routine.

Laura

[Molliemis]

Thank you for all of the responses.

Laura, you asked if I do a dreamfeed. We have tried and tried but unfortunately she won't cooperate. If we can get the bottle nipple in her mouth (which is challenging with her), the most she eats is an ounce or two and not anymore. And she'll still wake up at midnight or 2 anyway. We've been putting her to bed at 8 after her bottle and she usually makes it until 2 or 3 when we have to give her about 3 oz then she goes down until 7:30 or 8. So the dreamfeed hasn't worked for us thusfar.

Re the solids, I gave her cereal twice today and she screamed through it both times.  She would eat it only after i put a spoonful in her mouth and then put my finger in her mouth and let her suck it down. I'm sure this is a sign that she's not ready for solids. But the reflux? I don't know what to do.

Mollie

[Lolly]

What formula is she on? Have you tried a reflux formula or a thickener for her formula? My DD (and DS before) is on Enfamil AR and it works really well, a few people on the boards have had success with it. It may be a better option than starting solids if she clearly isn't ready yet. You can get non food thickners like carobel which help keep it down, Is she on any meds at all?

Laura

[Molliemis]

Her formula is Enfamil Premium Lipil and her medication is Axid. I've asked her ped about changing formulas and he's against it. I'm not very clear why except I think he believes the Axid is controlling the symptoms we put her on it for, i.e., she would suck and scream while I fed her a bottle and which caused her to cut her feeds in half. She doesn't do that anymore so the Axid is working. He thinks the solids will help keep her satiated longer because she's upped her volume a great deal in the last 4 weeks - she was only eating about 16 oz a day and now she's well over 30 oz a day. The fact that she's upped her volume so much with the Axid and she's having trouble staying full (she really wants to eat every 2.5 hours) he thought solids was the way to go. I asked her about putting it in her bottle and he said he very rarely recommended that in not in her case.

I'm not sure what to do except to try to keep teaching her the spoon.