Bottle / feeding refusal

[mtemte]

My daughter is 15 weeks old. At 13 weeks she had lip surgery. Prior to surgery, she was breastfed with up to 3 bottles of thickened formula to help with her reflux throughout the day. She is also on Inexium for her reflux. Immediately after the surgery, she fed both bottle and breast but had some problems with bottle due to breathing issues (secretions after surgery causing blocked nose plus wears a nose implant). However since last Thursday week (over two weeks) she is point blank refusing the bottle and cries when she sees it coming near her mouth but she is also not increasing her breastfeeding to compensate for the bottle feeds she is missing out on and is also breastfeeding less. She is having wet nappies but much less wet than before and a dirty nappy every third day (as opposed to every day beforehand).
I have spoken to the surgeon who does not think it is linked to the surgery as she was feeding OK leaving the hospital (8 days after the surgery) and paediatrician has checked her over and she does not have any ear/throat infections etc. Paed simply thinks she needs reassurance after the stress of the surgery.
I have tried giving paracetamol in case she may still be in pain or in case it may be teething and have also changed teat size but it makes no difference. My husband has also tried to feed her when I am out of the house but she still refuses the bottle. She has now started to lose weight.
I now think she has a negative association with the bottle (pain or fear of pain - although breastfeeding is supposed to be harder work). She will not let us touch her lip or nose and gets very upset if we try.
I started her on solids today as she is only feeding 2-3 minutes per feed on the breast and apart from that, is taking nothing else. HOW can I increase her feeding again as she is now starting to lose weight

[Lolly]

How often are you trying to feed her - she could be getting enough from the breast.

How is her reflux - is she on a good dose of the meds? Bottle/feeding refusal can be linked to reflux not being under control.

I would stop any solids though - she is too little and by giving solids she is less likely to take more milk, solids won't make up for the milk she isn't taking from a nutritional point of view and could make things worse.

Have you tried feeding when she is sleepy? So either just as she is dropping off or before she fully wakes after a nap - that may help. What about syringe feeding?

What is the nose implant she has?

{{Hugs}} it must be very stressful for all of you.

Laura

[mtemte]

Tnx Lolly. In my opinion, her reflux is under control. She is on a good dose of medication and although I know it can flare up in stressful situations and we have bad days from time to time, all symptoms have gone. My older daughter had sever reflux too so unfortunately it's something I'm very familiar with. I'm not saying it's definitely not that but I would be very surprised.
I am breastfeeding her every 2-3 hours but she will only feed for a few minutes a lot a time. I have a heavy let down but I still don't think she is getting enough due to the amount of and quality of her wet nappies. Also she used to have a dirty nappy once a day - now it's perhaps every 3-4 days and very little.
I had planned on going on solids from next week anyway 17 weeks) as this is highly recommended for reflux babies. The solids I have started are highly loaded with milk so that is one way of increasing her milk intake.
I tried dreamfeeding from the first day it started as this worked well with my first daughter but as soon as the bottle reaches her lips, she moves away in her sleep and if I keep trying, she wakes screaming. I have tried just when she's sleepy and when waking but she refuses point blank!
Easter Sunday I resorted to syringe feeding, as she had one wet nappy that day   I syringe on bad days now but she will only take up to 40mls of either formula or breastmilk this way. 
The nose implant is something she has to wear for three months in order to keep the shape of her nostrils after the operation, as they cut muscle from around her nose. It restricts her breathing when she is feeding so I remove it when she is eating.
I have basically tried to eliminate all possibilities - I don't think it's pain wrt her lip or teething as paracetamol makes no difference, I have tried different types of milk, I have changed to several types if bottle and teats... Apart from negative association, I cannot figure out what it could be (while in hospital, she was incubated, had nasal and throat aspirations twice a day for four days, had several types of mediation syringed into her mouth and all that on top of the pain linked to the actual operation) . And if it IS negative association, what can I do to make it better