Night time calorie catch up.

[Pipa]

My lo has problems eating.  He seems so hungry at night but doesn't take much per feeding.  He's on a three hour EASY right now and is 12w, 13 or so lbs.  He is primarily given bottles of bm.  Through the day we're thrilled he gets four oz in one feeding.  Usually its more like three.  That means that come night time he's really hungry and goes into eating overdrive.  From the time we put him down at 7:30 or 8:00 he starts taking little naps and then eating.


6:15 ate 2 oz (while sitter was here)
7:45 ate 4 oz (seemed to still be hungry no surprise since would only eat two earlier).
Slept for thirty minutes
9:00 ate 4 oz (?)
Stayed up for quite awhile and then slept an hour?
11:30 ate 2 more oz I think.  (can't remember, very tired by that point)
Had to be helped to stay asleep for next hour (swaddling, paci, etc.  he hates swaddling but bats his face with arms and knocks paci out)
4:30 (Hallelujah!, blessed sleep if only a little) Ate 3oz while asleep
8:00 - 3 oz

I know he should probably be eating more than this but can't seem to get him to.  He has bad reflux so sometimes he is choking and other times he just pushes the bottle away.  It's the same way when I nurse him and it doesn't change when he's given formula (supplemental).  We started Zantac a week ago for reflux but we'll see if it helps.  How much should he be eating?  How can I get him to eat more so that he doesn't do this at night?   

[*Mona*]

hi

can you post your daily routine for us with exact amounts of milk he's taking for each feed?
I'm not an expert re reflux but surely he shouldn't be waking up this much at night.
good you started him on meds though.

thanks

[Pipa]

Sure, I'll post what happened yesterday, which was a little better than usual (daytime quantity-wise), perhaps b/c of the meds?
8:00 Wakeup and eat 3oz - Zantac
9:15 Naptime
10:15 Wokeup and wouldn't go back down (usually has 1.5-2 hr nap)
11:00 Eat, 4 oz, then A
12:00 Nap 2 hr (not usually this long and has longer A but think he made up for earlier)
2:00 Eat 3 oz, A
3:30 Nap, 1 hr
5:00 Eat 4 oz, A
5:30 Nap 30 min
7:30 Eat 4.5 oz!! Yippee, Zantac, then Change and wd
8:00 Bedtime, slept for one and half hour
9:30 Woke and ate three oz stayed up for about one hour (refused to go back down)
10:30 - sleep - 1 hr
11:30 - woke and ate 3oz
2:00 - woke and ate 3oz
4:30 woke upset so swaddled and paci
6:00  - woke and ate 2 oz (didn't want to rob morning feeding)
6:30 - paci
7:00 - swaddle and paci
8:00 - woke and ate 3 oz

So there it is.  I've tried to do cluster feedings starting earlier in the evening but it seems to aggravate his reflux and he still does the clusters later at night of his own accord so I dropped yesterday to get him to do more at one time. It is VERY tiring!  I think he's very hungry at night and that why he really needs the paci b/c he sucks pretty hard on it.  Of course now he can grab it and yank it out of his mouth (accidentally) so we have to wake up when he does that and re-paci and try to swaddle which he HATES.  Please help!

[*Mona*]

hmmm
I added up the amounts of milk he takes during the day and it's about 18,5oz so yes, he can be hungry at night

like I've said I'm no good for reflux problems so I'll let other mods know about your post so that they can help you better than me

monika

[Mama2boys]

Hi Pipa,

I am no expert but my lo who soon turns 1 also suffered form reflux, and once we had him on meds he got much better, but he too was a tiny and frequent eater. It has gotton better now, but he still eats smaller amounts and frequently,

Not sure how much you can fight it because eating small and frequent is the advise given to adults as well in case there are digestive or acidity problems.

My only word to you is hang in there, it will pass by and the lo will grow out of it. Do talk to the doctor about starting baby rice/cereal a bit Early, we were advised to start at about 4.5/5 months and that did help a bit.

But please do follow the doctor's advise.

hang in there it will get better
Mukta

[Grace's Mom]

Hmmm..my lo had reflux and was an extremely small eater but for some reason it didn't effect her night so I might not be of the best help. 
 
When he's waking at night do you think it's for hunger each time?  Do you think he might be able to eat more during the day if the feeds were spaced out just a tad?  When reflux babies have meals too close together (like your lo is doing at night) it can actually aggravate the reflux. 

Just a thought.

Melissa

[Pipa]

Grace's Mom, it's funny you mention that.  We are actually starting to do that.  We were feeding him every three hours, period.  Now (starting yesterday evening) we are waiting for hunger cues to begin.  We thought that the other way he would get more.  But I noticed yesterday that getting rid of feedings where he wasn't cuing, allowed him to get more in a single feeding which will hopefully increase his ability to take more at one time.  I would like to have him on a four hour EASY which he is ready for feeding wise I think but not activity and sleep wise.  Not sure how to deal with that.

[Grace's Mom]

Yeah, it's tricky.    Some lo's are ready for a 4 hour EASY in regards to the E but not the other parts.  You just kind of have to create your own unique EASY to make it work for the time being until your lo is able to stay awake for the 2 hours which normally doesn't happen until closer to 4-5 months.

[em_here]

Big hugs to you, must be very very tiring, my lo used to want to snack in the night too, nightmare. As pp said maybe spacing the feeds a bit will help so 3.5 hrs rather than 3 hrs, or as you said following the hungry cues..... A DF and 1 night feed would be the "norm" at this age I would think, so hopefully the feed spacing will help him take bigger volumes and thus wake up less

Big hugs!

[grahamsmama]

If the Zantac hasn't started working after a week, I might consider calling your doctor.  It's possible you might need a different medication.  Do you have a recheck scheduled for the reflux? 

[Pipa]

After a week of 1 ml and no change, doc increased to 1 ml 2x daily (this Mon) and we're going in Friday for recheck.  May have seen some change yesterday, he at more yesterday!  Still had the usual nighttime routine but at least he got more food!  Maybe it will just take time for this to even out.

[Grace's Mom]

Glad they uped the dosage.  Hoping it helps. 

Yes, with any change it always takes a few days for things to even out in their little systems.

Thanks for the updates.

Melissa

[grahamsmama]

Good!  I hope that was the problem. 

[donna_issabella]

Hi there,

Great to hear that your doctor increased the dose of Zantac.

It sounds like a combination of little things to me. I also found with Henry that eating 4 hours made him take more. Also, if LO's with reflux do not have the acidity in control, when they sleep and lie down, the acid travels up their oesophagus, causing them to sleep poorly and wake up to feed. They feed to sooth their sore throats. Then because they kept snacking at night, they aren't hungry in the daytime, causing the vicious cycle to self perpetuate.

Life with reflux is tough, but seems like you are doing a GREAT job!! Keep in mind, Zantac is super weight sensitive. SO as he gains weight, his symptoms may come back. The other thing is that zantac works best if given 15-30 minutes prior to eating. As they get older, it is easier to do. I always saw anything longer than 10 minutes as a bonus.

Good luck and keep us posted! I hope Tuck gets better soon and you both get some well deserved rest!

xx
DI

[Mama2boys]

Another trick the doctor told me wa sto slightly incline the mattress. SO I put in a slim pillow  under the mattress so that further helped preven the acid from going up the throat etc.

Mukta