How to Drop the 1-2am Bottle if PU/PD is Too Stimulating

[sweetened.daisy]

Hello and thank you for your advice in advance. My son turns 7 months old today and has been waking up for a bottle at least once at night and recently has been fighting drinking more than 2oz 30 minutes after he wakes at 6am and my guess is because he will chug 5oz anytime between midnight and 2am. I can usually get him to drink another 2 if I give it 30 more minutes but he is upset drinking any more usually. I know that he is on the verge of not getting enough calories during the day because some days it's tough to get 20oz in him. Here is our schedule for the day.

6am - wake up and diaper change
6:30 - bottle (usually only drinks 2-3oz and gets upset if I offer more (via bottle))
7:00 - acts hungry - drinks 1-2 more oz
8am - nap
9:30/45 - wake up
10:30 - bottle (usually 5oz)
11 - a few bites of solids (stage 1)
12pm - nap
2pm - wake up
2:30 - bottle (5-6oz)
3 - a few bites of solids
4:45 - catnap
5:15/30 wake up
6pm - bath
6:30 - bottle (drinks anywhere from 4-7oz)
6:50 - stories
7pm - bedtime (usually asleep by 7:15)


Wakes anywhere between mightnight-2am and drinks 5oz then goes right back to sleep

We tried PU/PD to extend naps and he is much too stimulated by that so usually just going in, reassuring him and waiting in the hall and checking back in if he cries works best. However, in the middle of the night, I don't know what to do. He shares a room with his three year old big sis and she is usually ok if he cries but I know he genuinely might be hungry which has led me to feeding him. However, feeding him during the day is a battle now - he just isn't interested in drinking or eating unless he's extremely hungry, fed in a dark and quiet room. I know Hogg's advice is to up his ounces in his bottle but I can't make him drink more than 5 oz and sometimes that's pushing it. :/ What are some things I can try?

[jessmum46]

Just as a thought what size/flow teats are you using?  Perhaps he needs to go up a size to get a better flow and be more willing to take more?  Will be back later with more thoughts x

[sweetened.daisy]

I think he's on the normal ones - I know its not slow flow for sure. He just finished his second bottle of the day and refused more than 3oz

Should I go buy a "fast" flow nipple do you think? He really just pushes the bottle away and sometimes that means he's ready for a burp but lately if I try to offer it again after the burp he gets super grumpy at me and it will only make him resist more if I keep trying. He also isn't really wanting much in the way of solids so I'm not sure what to think about this little guy but I don't know how to drop that middle of the night feed if he refuses to eat enough during the day to carry him through.

He is on the every 4 hour schedule which has him eating (by bottle) 4 times a day. After bottle number two now, he's had a total of 7 oz for the day so far! Eee!

[sweetened.daisy]

I just got him to drink another 2.5 oz about 15 min after he stopped drinking before but then I could only get in about 5 min of activity before he was acting really tired.

[jessmum46]

Realistically until he can take more in the day I guess you can't really eliminate that night feeding, I can see how a night feed might affect the first feed of the day but shouldn't affect the later ones really.  You could always try offering 4oz instead of 5oz at night and see if that improves things first thing, but I would check what teats you are using to make sure they are a fast enough flow.  Other thoughts - is he growing appropriately?  He may just be smaller and need less than other babies, but I would hesitate to say reduce any feeds if growth is a concern.  Has he been checked for reflux?  Tongue tie?

[sweetened.daisy]

He has acid reflux so he takes a prescription for Zantac for that twice a day (first thing in the morning and I usually do before bath at night). Never been tested for a tongue tie but he can totally drink 7-8oz at a time if he wants to so I'm not sure what to think about that. I think that's a good idea to cap that 2am feeding to only 4oz and maybe see if that helps. He had dropped in weight from the 10%tile at 5 months to the 5%tile at his 6 month appointment so the doctor was concerned he wasn't eating enough. I started to pump exclusively just so we could monitor how much he was eating and at first that seemed to really help because he would eat 6-7 oz at a time and he even slept through from 7pm-6am 3 times, but that hasn't been repeated for about 3.5 weeks now.

The doctor wants to make sure he is drinking at least 20 oz a day and ideally even 25 oz or more to have proper growth and get back on "his" curve but I don't know how to do that if he won't drink... and I don't think backpeddling and offering him the bottle every 3 hours will help because he just won't drink if he's not hungry and I think we'd end up with a snacking situation on our hands.

[sweetened.daisy]

I should also add that he has always been fine taking a bottle and was getting too impatient for my 2nd and 3rd letdown during nursing which is why the doc said to just pump intead.

[sweetened.daisy]

I went and got fast flow nipples and it seems like now he's choking on it and will just let milk run out of his mouth.

[jessmum46]

Do you think he is having any reflux-related discomfort?  Has his Zantac been increased in line with weight?  Any teething right now?  If the faster-flow is making things worse though I'd go back to what you were doing before. 

It may just be he needs an overnight feed for a bit longer, I know that's probably not what you want to hear but if his reflux means taking large feeds isn't comfortable he needs to get the calories in somewhere.  You could try a slow wean if you wanted by reducing the amount in the night bottle an oz every 2-3 days and see if he adds it onto his morning bottle (ie shift the calories to the day) but if it overall drops his intake I wouldn't push it given your pedi has had worries about his weight.  Here it would not be considered abnormal to shift around from one centile to the next - more a sustained drop across 2 or more centiles - but I wouldn't want to advise against the advice you've already had x