How much / when to reduce milk for 6m old

[violagal]

Hi ladies,
DS2 is 6m old (27weeks). This morning I got him weighed and he is 10.4kg. Before solids he was taking 5 x 10oz of formula. Due to this and some other readiness signs we started him on purées at 20weeks. It had the desired effect of reducing his milk to 4 x 10oz feeds once he got to 3 meals a day at 24weeks. The HV this morning said that I need to reduce his milk quite rapidly now as he should only be taking 500-600ml. Given that he currently takes 1200ml and he is a big boy I can't see him taking too kindly to that sort of cut! So I was hoping for some advice on how and when I couid do this gradually.

His milk feeds are now at 7am, 11am, 3pm and 630pm. His solids are 1.5hrs after each milk feed and he has toast fingers and cows milk baby cereal for breakfast, veg purées with now added cheese/fish etc for lunch and baby rice with fruit puree for dinner.

Nap wise it is a bit messy as we have hit the 3-2 transition but if we get a good day often the 11/3 milk feeds can be as late as 1145/345. If we have a short morning nap then he's too tired to eat lunch pre nap so then lunch will be around 1pm.

Any thoughts on what I can tweak?
Thanks!

[MasynSpencerElliotte]

500 - 600 ml per day for a 6 month old??? Sorry but I think she either has outdated info or made a mistake as that is so low. Here the recs are 750-1080 ml per day from 5-7 months and they only drop to 540 mls as a minimum after 9 months. I wouldn't even try to cut back tbh! If he is happy and well in and of hmself I would carry on as you are. Formula or breastmilk is supposed to form the bulk of their nutrition until 12 months as no solids are a nutritionally dense.

Eta...my 16 months old takes 500 mls of formula a day still plus 3 meals and two snacks, at that age she would not have been a happy camper on only that much.

[creations]

The guides in the UK are indeed to ensure baby is getting 1 pint (500-600ml) milk per day. It may seem very low for some babies (meanwhile mine never managed that much). Whilst some babies will take, and need, more than this, it is the guide (based on WHO) so it is very normal for a HV to quote this figure.

Having said that the HV should take into account how much baby is taking, how big he is, and what his true needs might be rather than just fire off a number and expect you to just deal with it!

If there is a significant weight/health issue then I would plan a course of action with the guidance of a health professional, not a HV, a paediatric dietitian or nutritionist, ask your GP for a referral rather than tackling this alone.  However most babies do not over eat so until you have further direction from a paediatrician I would continue as you are, feeding your baby to his need.  Chances are he is not overweight and in need of significant cut of his milk but rather he is just big.  What centile is he on for weight and height?

In my experience HVs comments can send mums into a panic that they are not doing the right thing, and then leave them to tackle the issue alone. I would at least get a second opinion from your GP (and if it was me, a paediatrician at the hospital) before deciding what to do next.  It *may* be that a paediatrician or dietician suggests switching the 11 and 3 milks to a solids snack with a drink of water, he is very much on the young side for this so it's not something I'd recommend doing without professional guidance, but this route would quite easily reduce his milk intake to the 500-600 guidance without him 'going hungry'.

Things which would be quite easy for you to change without actively cutting his milk would be
- increase protein, at 6 months he can take meat and eggs, beans are also a good source of protein and may be more filling for him
- if there is no family history of nut allergy you can introduce ground nuts and nut butters (smooth peanut butter). Not whole nuts.
- ensure you offer water at meal times so he isn't taking milk through thirst alone but through hunger and the need for milk (if he isn't proficient with a sippy cup yet consider a straw or even a bottle of water to ensure he is able to get the amount of water he needs/wants)
- think about switching the baby rice for another food, baby rice may fill him initially but may not sustain him (for instance if he likes eggs a half or whole boiled egg or omelet would provide protein and good fats which will sustain him longer than baby rice, he may naturally decrease his milk intake once he is eating more proteins and fats)

Try not to worry, if you do need to reduce the milk I'm sure we can help you find a way so as not to turn your DS isn't a hungry grouch.
Let us know how you go with the GP/paed.  They may just set your mind to rest and say to continue as you are.

[violagal]

Thanks for the replies. Masy indeed I did say that was half his current intake and that I didn't think it would go down well!
Creations yes to be fair she did measure length - they don't normally but as he is so heavy they did. Weight wise he is now between the 98th and 99.6th percentile which is good as last two times he was weighed he was creeping over the 99.6th hence the worry when he was taking 50oz milk. Length wise he is 71cm which is 91st percentile which HV said was fine. Essentially she is worried that as his solids increase if he keeps that milk intake he will drop off the top of the scale...
Those suggestions sound great - his big brother has cashew and almond butter on toast so can start that. Eggs of course might do an omelette for tea then instead of baby rice. Beans as well I will introduce.
I'm pretty sure my GP won't advise any rash action as she has 'admired' his size during a couple of recent trips for checking on a cough and indeed said he was tall as well as big so am happy to just tweak the diet and assume he will stop drinking so much.
As I give 4oz milk with cereal I was thinking I couid cut the morning bottle to 5oz and that might lead to a bigger breakfast and then less at the 11am milk and so on...that should be too drastic!?

[creations]

He sounds fine
It's fine for the weight and height to be 2 centiles apart. IMO it's also fine to go over the 99.6 centile, I mean yes that's the top of the chart but someone has to hit the 100 mark don't they? TBH on length/height there must be a percentage go off the chart because the top centile has a prediction of 6' 3" (the adult height predicted) and lets face it, there are many men taller than that.

On the flip side, I have a teeny boy, some of his clothes are 18 month or 2-3 yo size and he turns 4yo this weekend. He took half the recommended amount of milk and wouldn't take a drop more but he always grew.
It sounds like the HV may be jumping the gun a bit but it also sounds like you are confident he is fine

[violagal]

Yes ds1 is on the small side as well; never took more than 6/7oz feeds so this is totally new!
What I am struggling with is what to prioritise. For example his milks used to be pretty much bang on 7/11/3/630 but now with solids they often stretch if he has a long nap. So yesterday afternoon he had a long nap from 2-4 so then I had 2.5 hours to fit in 20oz milk and dinner which just seems overkill. If he is naturally stretching his times between milk due to the solids should I continue to offer the same 10oz milk or should I judge at the time and offer say 6/7oz in order that he will still take some solids at 430/5? I guess I don't know whether I should be preserving the milk feeds or slotting in varying solids around them or now prioritising the solids and fitting in the milk feeds around the solids if that makes sense?

[creations]

Fitting the feeds around naps is totally normal, LOs start to stretch to 5 hrs between milk feeds due to nap times and some people do split lunches so there's half a meal before nap and half after (this can be at varying ages depending on routine, how they take to solids etc).
As he's taking so much milk and the times are a squeeze for you I'd think it would be ok to reduce one of his bottles as you've suggested but if you're making up formula I'd suggest making the usual amount and splitting between bottles just in case he is not satisfied with the 6-7oz you offer and you need to give him more (perhaps you split across bottles anyway with the feed being big?).

At this age priority would normally be given to the milk but so long as he doesn't drop below the 600 (which he isn't going to do) I think you'll be ok to to reduce some milk and offer more solids.  I would imagine he is going to show less interest in the milk once he is getting more substantial solids meals though, veg and fruit puree might not fill him much but meat, fish, beans, eggs are going to make a difference.

[violagal]

Hmmm two bottles is a good idea actually - the volume is not an issue, this boy can down the 10oz with no burp in 7-8 minutes now  so yes if I make a 7oz bottle but have 3oz on standby that will feel 'safer'!
He definitely has been stretching the afternoon feed now after a week of having fish added to his veg at lunch so I think I'll try cutting that and see how we get on.
Thanks for all the help - I always feel a tad guilty now saying that I'm having problems because this baby is such a good eater...! Must be grateful for that

[creations]

Hope it works out for you

[violagal]

Hi all,
DS2 is now 7.5m (34 weeks) and we are still having trouble with his milk intake! I have been adding fish, meat, eggs etc to his diet which is he loving but he seems to be eating less solids than we he was a month ago. For example this morning he had his usual milk at wakeup, then some toast fingers 45 mins later but then was not interested in his porridge. He also does this at lunchtime - he has a bottle around 1030-11 but often not interested in lunch until 1pm.  He is currently taking 4 bottles at 7ish (7oz) / 1030ish (7oz) / 230ish (7oz) / 630ish (10oz) so about 950ml in total. His meals were about an hour after each milk but he is definitely losing interest in them.

Time to cut the milk??

I haven't had him weighed since he was 6 months, might do that tomorrow.
Thanks...
Emma

[creations]

It's worth remembering that LOs have growth spurts. I know we can all get very used to the amount out LOs eat during a GS and have an expectation for this amount to continue as the norm. The GS ends, LO eats less and we go into a panic about them living off air.
Then also take into account most babies would have toast OR porridge for breakfast, very many babies do not increase to 3 solids meals until 8 months.  You've reduced his milk from 1200ml to 950ml per day plus whatever dairy he gets in his solids.
So, what am I saying? I suppose I'm saying he sounds fine. He has a healthy interest in milk and a healthy interest in solids, he is not refusing either, he is not taking more than he needs on either.  Another couple of weeks from now he could be in another GS and eating your fridge empty.

I think you'd be perfectly fine to continue as you are.
If you prefer to reduce the milk you could see how he goes swapping his mid morning bottle of milk to a solid snack and a sippy cup of milk or water, this may help to bring lunch earlier if that's what you need to happen (to fit meals around naps). You could also experiment with breakfast, he may be refusing the porridge because it is another milk source, by cutting his porridge out he has naturally reduced his milk intake, maybe he'd like some fruit with his toast instead of porridge.  It would be just as fine to serve porridge instead of toast though, yk?
Try not to worry. I know we all do seem to worry about food at some point but I don't think he is going to waste away and neither do I think he is eating too much. If anything this is evidence of self regulation which LOs tend to do pretty well and can continue to do if we don't start with the "just one more bite" or "finish your plate" rules.

[violagal]

Thanks Creations...and of course very good point about him not wanting the porridge as its just more milk!
I think I'm struggling with trying to balance it all - should he be having a milk feed that is big/small enough that he wants solids an hour later? Or, as what is happening now, he has all the milk he wants but then isn't hungry for solids for a couple of hours?

[creations]

Well, most of the routines I see on BW people give solids 1 hr after milk, but Tracy's weaning guide suggests 2hrs gap between milk and solids, so really either is fine. Depending what suits you and LO.
Weaning Guidelines from Secrets of the Baby Whisperer

Often meals are not all the same size either. Many eat more for breakfast, less at lunch, even less at dinner, that's fine. Mine had such a huge mid morning snack (when we dropped the mid morning bottle, he was older than your LO) it was more like a lunch really but it was at 10.30am. It had initially been at 11am which had been his milk time but the mum and baby groups we attended often had a snack which at 10.30am so because of this DS would expect his huge snack at that time, other babies had a bit of bread stick or a slice of fruit and mine tucked into bean and vegi fritters and large portions of fruit which I carried with me. Then lunch probably at 12 and probably not such a big meal.

Sorry that I'm not able to give you one definitive answer. It's just that all LOs are so different in taking solids.
One thing, if you are concerned about his food groups being uneven (lets say because he has lots of toast but then not so hungry for vegetables at lunch time) there is no rule about what to give at which meal time. It's fine for vegetables or protein to be given at breakfast even if it doesn't appear to be culturally traditional breakfast food.

[violagal]

That's definitely great reassurance thanks! I got him weighed this morning and he's 11.26kg so maintaining his position just under the 99.6th percentile. HV not worried as he's not jumped over it. Interesting what you say re feeding times as DS1 who is nearly 2.5 is a bit like that, he likes milk and banana when he wakes but then nothing for an hour or two then will eat a mountain of toast around 10! So I think I need to relax a bit and observe his patterns rather than trying to fit in 4 bottles and 3 meals an hour after the bottle! As let's face it, he's clearly not going to waste away!

[creations]

Glad you feel reassured and that his weight is stable too.
No, I don't think he will waste away