should I stop bottle for my 10 month LO?

[Rongrong]

breastfeeding for 9 months, couldn't get her to drink formula or bottle until 1 week ago, I was so glad that she could drink 120ML/time from sip cup, but it only lasts for one week.

for now, she only drink 30~60ML/time, 4 feeds/day, so total is only around 150ML/day, why all of sudden she doesn't want to drink formula again? does it mean I have to stop bottle for her? what change should I make to her solid food so she gets enough dairy?

 ???thanks.

[MumAnzy]

Hello and congrats on breastfeeding so long! I reCently took my almost 11 month old for a health visitor check up and she mentioned that now that LO is full on solid meals I should drop the "snack bottles" and that he only needs the wake up (7am) and night 7pm) bottles.  She also mentioned that they need a maximum of 500ml a day but that there is no minimum.  My LO loves his bottles and will drink it all but if I put milk in sippy cup he might only drink 40-60 mil instead of usual145 ml.  I have been told not to worry that he is fine with whatever he drinks.   Not sure if this helps but just thought I'd share just in case!  It seems they now need most of their nutrients from the food as the milk doesn't have enough iron amongst other things they need.   Suggestions for dairy is sprinkling cheese on food,  yogurt as desert, cream on meals, butter.

Good luck! 

[Rongrong]

Thank you for the post, the reason I am so concerned about her dairy intake is comparing with other babies, her formula intake is way less, as guideline posted here: Sample Routines for Bottle Feeding (based on number of feeds per day)
‘Bear in mind that you do want to keep your focus on formula/EBM as the main source of nutrition until a year of age.  There are more calories/fast/nutrients in milk than the majority of solids ounce for ounce.  Moving to solids too soon can often result in worsened sleep from an active tummy or LO waking for the nutritional benefit of milk. ’
‘** once LO is 10 months of age, it's fine to drop down to 20ozs a day．．．．．’

20ozs, but my lo only takes 120ML/day which is only 4ozs/day!!it’s even less than other baby’s one time intake.

What’s your opinion of the guideline? Should I take it easy and tell myself ‘every baby is different’? or what should I do?

And not just dairy, her total intake is less than others, when other parents use TBSP measuring solid foods, my lo is still eating with TSP, just don’t know why she eat so less.

I am so frustrated.

[creations]

Hello.

In general a 10 month old baby really does need adequate milk intake. Their primary food until 12 months old is milk, it has the nutrients and vitamins needed and Rongrong, you are correct in your understanding that milk is higher nutrition and calories than solids at this stage. Babies tummies are very small at this age and the amount of solids they can fit in there just doesn't offer the same level of nutrition as milk.

Rongrong can you post your LOs feed times and how much milk and solids you are giving at each feed?
Has she continued to gain weight?  Is she healthy?  Any sign of teething or a virus or ear infection etc?
Do you give bottle or sippy cup or straw cup for the milk?
Have you tried different temperatures for the milk (cold, warm, very warm)?

My LO continued to thrive on lower than guidance milk intake, however he is a petite boy, his health was good, he continued to grow and gain weight and his solid intake was good (good amount and very varied) - but even with his low milk intake he was taking more than your LO, 120ml per day is very very low.  There may be a way to increase it with a change of routine but I would be looking for some professional advice and a health check with your doctor if this is a long term issue or can't be resolved quite quickly.

hugs I can see how it must be worrying and frustrating for you x

[Rongrong]

Thank you for the detail questions, change the temperature of the milk? I never think of that, it’s worthy to try.

Last time she had her weight measured was 2 months ago, she did gain weight, probably at that moment she was still having breast milk, thank you for reminding me this, I got to take her to health center and see if she is gaining  weight.

Because she was BF, she refused bottle, and I tried very hard to help her get use to sip cup, and I made it(so not bottle, not straw, just sip cup), I was so so glad to see that she took 100~120ML/time, but don’t know what happened, after one week, the intake dropped down to 120ML/day,  every time she only drank 30ML!! and I saw the guideline on this forum, thinking maybe she just doesn’t want milk anymore as the guideline says that if ‘the baby is refusing feeds, not finishing feeds’, might need to consider dropping bottle feed. Fortunately I didn’t give up, I keep offering her milk, and change her solid food recipe, add milk, cheese to all her food as much as possible, yesterday, she started to drink a little bit more, today, with food intake, total dairy intake is 540ML/day. Although it’s still lower than guideline, I am happy to see the increase.

Her last teething happened while she was still on BF, I don’t see any other infection for now, she looks pretty healthy, active, except her bad appetizer. She is really not a good eater. Her appetizer changes often, sometimes she eats normal, sometimes she could even skip one meal (just doesn’t want to eat anything), so probably same thing happens to her dairy intake. I just don’t want to image one day down the road, she refuses to drink milk again, it breaks my heart. And I just don’t know what I can do to stabilized her intake/appetizer.

Below is her E.A.S.Y, I am using toady as an example as today her dairy intake is the best:
6:00   wake up, formula, 30~60, go back to sleep after
8:00   wake up ,1.5TBSP cereal + fruit + 60ML formula
11:00   60~150ML formula
11:30   1st nap for 30mins ~ 1hour
1:00   lunch, 3 TBSP home make dough mix with fruit+meat
3:30   stream egg or egg custard + 90ML formula
4:00   60ML formula
4:30   2nd nap for 30mins ~ 1hour
6:30   1TBSP cereal with 30ML formula (sometimes we have to skip this meal as she hates it)
7:30   bath and 90ML formula
8:00   Bed

Couple problems in her E.A.S.Y:
1.   her A time is longer than standard which is 4~4.5 hours, and I have been working hard on this,  a little bit progress, morning A time sometimes cuts down to 3:15 hours, but afternoon one is still need to be at least 4 hours;

2.   for some unknown reason (I haven’t figured it out), she doesn’t want to eat anything after 2nd nap, she cries and screams when you try to put her on high chair.  I know people would say that’s because her nap is too late, but what can I do? I have to do Pu/Pd for her every nap, otherwise her A time will be even longer. And it looks like her afternoon eating is more frequent than morning, that’s because if I don’t feed her before 2nd nap, sometimes she will just go to bed without supper.

3.   Sometimes if she drinks more formula, let’s say 150ML, the meal after that will be hard to feed, she will eat less just like the milk takes up the space in her stomach even though she drank the milk 1 or 2 hours ago.

I know, too much information here, appreciate anyone who can read through them and provide any recommendation, even question is great.

Thanks again.

[creations]

With your EASY you might find her mood better in the afternoon if she has one long nap and one cat nap. I see both naps are 30 - 60 mins which is ok for some LOs but mostly one restorative sleep is needed, so 1.5hrs long rather than 1hr.  I did a long morning nap then an afternoon cat nap, but you can do it the other way around too depending what suits her.  You might find that the A times work out better and that you don't have to PUPD for sleep. Also at this age some LOs need more than 4hrs A time, mine had a very long morning A time (or wouldn't nap well) but shorter A in the afternoon and a short A to bed.

I think you've done well to get her taking the formula, I see posts with difficulty getting baby to take any other milk after bf.  Looks like the intake has gone up now so perhaps it was a short term thing?

Other things you might consider
- if she has a lot of protein (solids) she might be too full for milk.  If she has meat for lunch plus egg custard for afternoon snack, how much meat and egg is she taking?  If you reduce this, perhaps offer vegetables instead, might it help with the milk intake?
- usually if milk intake is low it is advised to increase dairy solids, custard, milky puddings, cheese, yoghurt etc which I see you are doing.  I found with mine that the more dairy solids I gave him the less formula he would drink as though he was able to self regulate just how much dairy he needed.  I tried for a couple of weeks with increased dairy solids and he took less formula.  Then I tired cutting right back on dairy solids, no more milky puddings etc and his formula increased almost immediately.  I preferred him to have milk for the calcium and also because formula has added vitamins and nutrients which are not in the solid food.  Might be worth an experiment.
- Sometimes people find LO takes more milk if the milk feeds are dropped to 3 per day instead of 4.  They take more at each feed and more over all.  Again something to think about if you wanted to try it.
- the evening meal, it is common for babies not to eat solids well in the evening.  I never fed solids later than 5.15pm.  The meals don't need to be spread out evenly across the day, often they can take more calories from solid food in the morning hours and up to lunch time and more of milk calories in the afternoon and before bed.  You might find with a long nap and a short nap she has more energy for the evening meal or than you can offer it at an earlier time.
- one more thing, sometimes we can base what we think they need based on what they take during a growth spurt when they eat huge amounts.  Just try to remember that during a growth spurt they take in extra food and the intake will drop afterwards. It can look like such a small amount but might be exactly what they need.

Sorry, no answers, just things you might think about x

[Rongrong]

Thank you for reading through my posts and reply to me promptly, her dairy intake is still a problem , it is not temporary. the day I posted here saying that her intake was 540ML, it was the best  day, after that, it drops down to 300ml/day and 400ml/day, and for these 2 days ,most intakes are from food, not sip cup. 

About her naps, doing pu/pd for her every nap is not the only problem, I have to stay with her for her every nap (I barely have my own time), she normally moves after 20~30mins nap, when that happens, I either have to pat her , or put my hand on her back/chest until it passes 45mins, otherwise she will just wake up.  and short/cat (or skipping ) morning nap  doesn't mean longer and better afternoon nap, regardless, she still only sleeps 1hour in the afternoon which makes her total sleep time for a day shorter. So you can tell that it's hard (or I should say no way) to extend her nap, I already try my best.

As I said, she is not a good eater, there are so many things she doesn't eat, yogurt, cheese, fruit, I have to mix them with cereal or flour. And compare to other babies, she doesn't eat too much solid food either, below is baby feeding guide from Nestle, every time I look at it, it drives me nuts. My lo’s solid food intake is probably only 2/5 of the guide. I just don't understand how come other babies can drink 5Oz's formula/time and also eat 5~6 TBSP cereal/time, but for my lo, 2 TBSP is much and she still doesn't want formula. For egg custard, just formula + one yolk, for lunch, not too much meat either, and it's also the only chance she eats meat, I just want to keep the nutrition balance. So I don't think reducing solid food intake will help, but appreciate your recommendation.

http://www.nestle-baby.ca/en/mommytools/docs/nestlebaby_feeding_guide.pdf

Dropping 3 a day instead of 4 might be a good idea, it's amazing that you have so many ideas on how to increase babies dairy intake, although not each one fits my lo, it's still wealthy to try, again, thank you for all your great input, it looks like all I can do is trying my best, and it's up to her if she wants to drink or not.

[creations]

it looks like all I can do is trying my best, and it's up to her if she wants to drink or not.

This is true. We can provide for our children but cannot force them to eat.  If weight gain is fine then it's really down to accepting a small appetite and trusting that she knows her needs. I would get her checked if you are concerned. There is help (occupational therapy, nutritionists, dieticians) for LOs who have problems feeding, but I wouldn't be able to say if you needed to go that route or not.

Not sure where you are, here in the UK it is advised babies have daily vitamin drops. Might be something to consider or ask your doctor about.

It's also worth remembering that any feed guide is based on a very wide variety of children.  Those who are petite are obviously going to need fewer calories than those who are a bigger build, so long as the baby follows her own growth line reasonably well then the vast difference in how much smaller/larger babies eat is normal.

Sorry I haven't been able to help more xx