Author Topic: Serious NW isues and HV wants me to double his food intake!  (Read 2417 times)

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Offline balmerhon

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Serious NW isues and HV wants me to double his food intake!
« on: October 24, 2008, 21:40:14 pm »
I've been making the rounds of various boards here but in brief, my son Jake, who is 7.5 months old, wakes at least every 2 hours for feeds. These feeds range from a few swallows to 4-5 oz. I started PU/PD back in Sept, then he got a cold. Then we thought maybe he had mild reflux. Then he got gastroenteritis. He's still not 100% recovered from that... but in the meantime, I spoke at length with my HV about the night feeding.

She agrees he may have some mild reflux which could account for some of the frequent feeding (alkaline milk). But she felt that in addition to just being used to being fed at night (a bit too much accidental parenting), he is not getting nearly enough complex food during the day. He's a BIG boy. He's probably pushing 25lb now and wears clothes for 18mo olds. We started him on solids at 4 months hoping that would help with he NW but it only had a small effect.

When I went to see the HV, Jake was having baby cereal with fruit in the morning (about 1/2 a baby-sized bowl), an adult size yogurt for lunch, and a jar of Stage 1 baby food for dinner. We'd tried some soft finger food but he choked too much so I tabled it for a bit.

The HV, however, now wants him on a full bowl of cereal with a drink for breakfast, a mid-morning finger food snack, two (yes, two!) servings of food (savoury and sweet) of the 7+ month size for lunch plus a drink in a sippy cup, another finger food snack mid-afternoon, and another double serving of food at dinner time. AND depending upon when he has that, a small bowl of cereal with his night bottle before bed! She thinks he should be on no more than 20oz of milk a day.

Now, I was floored. But I wonder if I should be? She said it is hard because the goal posts keep moving in terms of when weaning should start, which confuses people who have to do it earlier or later than recommended.

But he's not used to them. Getting him on that much food is going to be almost as fun as getting him off the night feeds. He's officially a grazer taking his full complement of calories on a 24 hour cycle. ::)

Anyone else had this issue come up? Does your baby eat that much?

I'm so confused!  :-[

Jacob William 12/3/08 & Samuel Craig 11/4/06

Offline Freya'sMum

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #1 on: October 25, 2008, 21:09:06 pm »
Hello!

Lots to think about there, no wonder you are confused! I would think Jake is too, especially as he's been poorly recently :(

Could you post your current routine?

Some other questions I have... what is Jake's appetite like? What happens if you deny him any nightfeeds - have you tried this? How much milk does he take on average within the whole 24 hours? Is he receiving any treatment for the reflux?

Sorry for the extra questions, need to have a longer think about it all!

Ax
Alison x






Offline *Vicki*

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #2 on: October 25, 2008, 21:26:06 pm »
Hiya  :)

goodness, how confusing!  ::)

looking forward to seeing a routine  :-*
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Offline Lex444

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #3 on: October 26, 2008, 08:58:32 am »
I'm no expert and I'm known for respectfully disagreeing with many on this board. Nonetheless, here's my perspective, with the caveat that it's not the majority view. I'm with your HV and believe it's good for kids to get a variety of food in the second half of the first year, supported by milk.

What your HV suggests is something like what I have my eight-month-old on, with three-four breastfeeds every 24 hours. And my son is a little skinny guy, whatever we feed him! Same as his parents.

The snacks for us are usually yoghurt, or a few crackers and cheese which my son feeds himself, or half a banana, or sometimes a half a crumpet with butter and fruity jam if I'm feeling like lashing out.

Today for lunch, for example, he had gnocci with a chicken and cheesy broccoli sauce, followed by half a mango. He has this with water from his sippy cup like your HV says. Then dinner was two egg yolks scrambled, with maybe a quarter of an avocado, and toast fingers with melted cheese, and some yoghurt to finish. Sippy cup again. A lot of it is a variation of what we eat - babies from seven months on can cope with family foods (without the salt and seasonings), mushed or minced up.

I've reduced his breastfeeds as he eats more food - used to be six, now it's four. And yes, it did help our night wakings, although this is not (as I said) the majority view. It actually did help us because my son was ready for more food.

In other words, your son might not be getting enough complex food for his intake requirements. Then again, it could be a reflux problem. Some babies are fine on more milk at this age, and some are not.

I think experimentation is the only way you're going to discover what gives.

The way I did it was to increase the main meals first little by little and see what happened, making sure I didn't offer the obvious things that irritate little stomachs. I know it sounds daunting but it just took a bit of practice. I learnt to watch my son, who lets me know if he wants more or not, and if he's full, I stop.
« Last Edit: October 26, 2008, 09:13:28 am by Lex444 »

Offline balmerhon

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #4 on: October 26, 2008, 22:25:39 pm »
Thanks for the replies.

I'm short on time so am going to be horrible and refer you to my previous posts as not much has changed since I first came to the BW forum. If anything NW is worse (2 hours or less sometimes) but I know some of that is due to the gastro bug. Additionally, I can't even try to implement the HV's suggestions as Jake is not showing any real interest in solids right now except for things he can chew on (toast, cheese, rusks). I think this is still part of the gastro issue though.

My original post about NW with our 'routine' (not much has changed):

http://babywhispererforums.com/index.php?topic=132076.msg1426677#msg1426677

My post about PU/PD:

http://babywhispererforums.com/index.php?topic=133322.msg1448488#msg1448488

My post about how much formula:

http://babywhispererforums.com/index.php?topic=133328.msg1446046#msg1446046

My post about reflux:

http://babywhispererforums.com/index.php?topic=134498.msg1469292#msg1469292

Hello!

Some other questions I have... what is Jake's appetite like? What happens if you deny him any nightfeeds - have you tried this? How much milk does he take on average within the whole 24 hours? Is he receiving any treatment for the reflux?

Ax


As I said, his appetite now isn't great. I'm chalking a lot of that up to the gastro bug but am worried I'm going to miss when he's ready for more food or that he'll become lazy and not take to going back to solids well.

My goal with PU/PD was to get him down to one night feed but we didn't get very far as he came down with a cold. All the gory details are in the post I linked above.

Milk total is probably about 42oz now but again, there's the tummy bug to factor in. He was quite poorly last weekend so I'm only one week clear.

He was on Gaviscon for several days with no real noticeable difference. I'm not entirely sure he has reflux tbh.  :-[

Lex, thanks for your input. My inclination is to agree with the HV to at least some degree - I'm just not sure Jake does!! This gastro bug has really messed things up!  :P

I'm looking forward to any more input - I'm starting to lose all hope here! I just want some sleep!



Jacob William 12/3/08 & Samuel Craig 11/4/06

Offline Lex444

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #5 on: October 27, 2008, 02:37:17 am »
OUCH to the gastro and the nightwakings. I just read your previous posts .... there's lots of stuff going on here and lots of different advice so no wonder you're feeling overwhelmed.

Mothering - in my experience, and it's more limited than yours, so bear with me, :-[ - is enough of a rollercoaster without being sleep deprived. And lady, I visit that parallel sleepless universe regularly. I find it incredibly hard.

(BTW despite all of the toll this is taking on you, your son sounds like he's obviously thriving with the weight and the great interaction with his brother and granny, etc. Also, your husband sounds like a fantastic support and help, and your son seems to really respond to him.)

The wakings you're having could easily be partly because of overtired if he's not sleeping enough during the day. Also, if he's not good at putting himself back to sleep, it's probably a prop issue too.

Reading all of your previous posts, it does sound like he's eating a hell of a lot of milk and using it to put himself back to sleep at night.

Although I see Bryony on the nightwakings board says he's eating too many solids?

I know. Conflicting advice everywhere, us, your HV, your mother-in-law. Sorry. It's really only opinions and I can only add mine to the pack.

I guess I'd ask first, what feels right to you? You're the closest one to him, so your gut instinct is probably right. Do you think he's eating enough solids or not? And at night, do you think he really needs to have the milk?

What I did about the nightwakings - and do again, when they recur, which they do! - is tackle it all at once and expect hell.

I waited until a weekend when my husband was free and then made a rule about when I was going to feed. The rule depended on his age.

(At the moment with my eight-month-old, I try to offer only one night feed between 7pm-7am. I say "try" because I mostly do it that way, but sometimes he wakes at 4am after being fed at 11pm and I crack, and then he starts waking every three hours again until I institute my rule and get tough. I know, everyone says "consistency consistency", but I find it blo^^^dy hard when it's 4am and I'm exhausted. When he was six months old I allowed for two feeds between 7pm-7am).

I couldn't use PU/PD as it made my son hysterical. He also hated sshh/pat when he was small.

So I used a kind of WI/WO technique, although I found I had to stay out a little longer than recommended, almost controlled crying, (I know, I know) as when I went back into the room it tended to make my touchy/textbook son wail louder.

I'd go in every two minutes or so, whenever the crying started to get intense. We had to do it for a good forty minutes the first night, each time he woke, which was three times perhaps? The next night it got less, and less again. Then we had a good patch. Then he got a cold and it all spiralled out of control again. Repeat.

I think with the solids, you just need to experiment and stick with an experiment for a week to ten days to see what the effect is.

Sorry, I know there are not a lot of real answers here. Just my take on it.
« Last Edit: October 27, 2008, 02:41:12 am by Lex444 »

Offline *Vicki*

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #6 on: October 27, 2008, 20:13:29 pm »
I will come back sweetie - bear with me  :-* Lex 444 has given u some great advice  :)
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Offline balmerhon

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #7 on: October 27, 2008, 20:40:39 pm »
Thanks, Lex - that's really good stuff. I'll need to have a good think about everything. And I'm looking forward to other opinions.

I'm just holding tight now waiting at least a few more days for a complete recovery from his tummy bug. Today he was more interested in food. Last night was odd though. I had a terrible time settling him and had to let him have a good cry which tired him out (I was next to him but he was very OT). He just couldn't seem to get comfortable and he was very *ahem* gassy. ;) Eventually I had to prop him up with pillows so he was at an angle and he went right to sleep and took less milk overnight. Today for his nap, he slept better, too, with the pillows. And I just put him down tonight with them and he fell asleep much faster. He's practically in a nest of them!

But the propped up bit lends more credence to the reflux theory...
Jacob William 12/3/08 & Samuel Craig 11/4/06

Offline lilysmommie

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #8 on: October 27, 2008, 20:43:39 pm »
To me, it appears that your LO is getting about double the amount of formula that a typical 8 month old would get. Like the pp said, he is likely using the bottle to put himself back to sleep at night. At 7-8 months, he doesn't need milk to get through the night.

I would suggest working on the NW first. I'm no expert at that so I'll let others give you good advice on that one. But once you have those tackled, then I would tackle the solids issue. I would imagine that once he isn't waking at night so much and drinking so much formula, his appetite will come in line and he will want more solids. Also, then you will be a much happier mommy as you are getting more sleep!!

The problem is right now, you have many things going on (nw, too much formula, not enough solids, only likes rusks etc, he is a bigger boy, maybe some teeth coming in) that it's hard to isolate the problem. So, that's why I say just work on one thing for now.

Hang in there, I know it's so tough!! You have so many people giving advice, it's hard to know what to do. But, as a pp said, always follow your gut instinct, you know your baby best!!

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Offline Freya'sMum

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #9 on: October 27, 2008, 22:15:46 pm »
Hello!

There's not much more I can add - I am usually in the 'prioritise milk' school of thought, but 42oz is an extreme volume, and whilst I think your HV's recommendation of no more than 20oz is a rather dramatic reduction, I do agree that a smaller volume can only increase solid food intake :) I think you can still prioritise milk in the diet with a lesser volume, and suspect that this current volume is not due to hunger!

I'm not convinced that increase in solid foods will decrease NWs, generally it doesn't (altho there are always exceptions ;)) and suspect that these are due to many factors not just calories. In my experience parenting is a delicate balance of listening and guidance, team work between you and your lo, however this is not an easy thing to do, especially in the first year - and during or shortly after illness, implementing any changes is especially difficult!

Wishing you all the best

Ax
Alison x






Offline *Nicola*

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #10 on: October 27, 2008, 23:15:47 pm »
Hiya

You've had great advice already so really just wanted to offer some ((Hugs)) and a couple of thoughts:

1) If there is a question mark above reflux I would try and answer this first and foremost.  Reflux issues can impact on sleep and feeding (solids and milk) so it is possible there are some reflux/pain issues going on here.  The propped up sleeping also makes me wonder about reflux.

2) Totally agree with Lilysmommie to work on one thing at a time.  There are lots of issues going on for you both making it difficult to see what is going on, what impacts on what, what has nothing to do with something else ... and so on and so on!

3) From a NW perspective I agree totally with Bryony that there are prop issues.  I don't think that increasing solids or decreasing milk will simply solve these NWs.  I don't think the link between the 2 is that direct.  Dealing with the NW issue (props/feeding etc) will help reduce those NWs and nightfeeds though :)

Big (((hugs))) x
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Offline balmerhon

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #11 on: October 28, 2008, 15:56:23 pm »
Thanks so much everyone.

I'm not sure what else to do about the reflux issue. There wasn't much difference with the Gaviscon and as I've posted before, he's clearly not got a rip roaring case of it if he even does have it. He is, in general, a very happy kid. To complicate matters, in just under 4 weeks, we're moving to the US (where I'm from). The boys will probably get medical care temporarily through Maryland as my husband's job doesn't start until 1 March. So I'm losing my good GP and the HV system.

*sigh*

I just don't know if I have the energy to go back to my modified PU/PD for every NW over the next few weeks when it could all go out the window after the move. What I am thinking about doing is going back to diluting his night feeds to see if that makes any difference. With that, I may also try PU/PD for the first NW. I know that's not the proper way to do it, but as Lex said, sometimes you're just too bloomin' tired to cope.

I dunno. Just thinking aloud right now.

Thanks again. It's gonna be a long road and I suspect most of it will have to be sorted out once we've moved.
Jacob William 12/3/08 & Samuel Craig 11/4/06

Offline Lex444

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #12 on: October 28, 2008, 23:22:43 pm »
My lord, you've got a lot on your plate. I'd wait until after the move as well, and just hang on in until then. I suspect you're right and the move will throw everything out as well.

Do you have anyone to help now, just so you can nap and stay sane?

Offline balmerhon

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #13 on: October 29, 2008, 10:01:54 am »
I'm afraid we don't do anything by half measures here!

My DH does help some but he's trying to finish his Phd by January! As we're with my inlaws, MIL helps a bit, just not at night. I'll have a bigger circle of family to help one we're in the US.

Jacob William 12/3/08 & Samuel Craig 11/4/06

Offline Lex444

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Re: Serious NW isues and HV wants me to double his food intake!
« Reply #14 on: October 29, 2008, 11:36:05 am »
Wow wow wow. But then, I'm all for full measures, bugger doing anything by halves.

Keep us posted when you arrive!