Unsure how much to give him - LO recovering from faltering weight

[Hedgehog17]

Hi ladies,

My LO was EBF until 5.5mo when I had to introduce hydrolysed protein formula (Aptamil Pepti, as he's MPI) because he began to lose weight  I just wasn't producing enough milk  This was partly due to DS having a poor latch and also because he has silent reflux, which wasn't under control until recently, and he was fighting so much at the breast  Until then he'd been very slow to gain weight and was under the 0.4th centile on the chart, having started just below the 50th centile then dropping down through the curves from 4 weeks onward.

He is doing a lot of catch-up growth and has averaged a gain of 250g (8.8oz) per week while mixed feeding him for the last 4 weeks  He is now just under the 2nd centile 

Anyway, I'm about to stop BF and go solely with formula, but am not sure how much to give him as the instructions on the tin go by weight AND age and DS's weight is lower than it 'should be' for his age... he's currently 6.3kg (13lb 14oz) and 6 months 2 weeks old.

The tin says: At age 2mo & 5kg (11lb) they get 5 feeds per day of 6 scoops.

At 4mo & 6.5kg (14.5lb) they get 5 feeds per day of 7 scoops.

At 6mo & 7.5kg (16.6lb) thet get 4 feeds per day of 8 scoops.

After that 7-12mo there's nothing about weight but they suggest 3 feeds per day of 7 scoops (presumably factoring in solids).

He has started solids but we're doing BLW as he's not keen on mush OR being fed  He's not really digesting anything yet so I can't factor solids in as part of his nutrition at this stage!

He's currently taking 4 feeds of 5-6 scoops and 1 feed of 3 scoops (the DF) but we're increasing the daytime feeds as his tummy gets used to it. He used to take a 6oz DF but for the last 3 weeks has been taking less and less so I'm guessing that he's ready to drop it and just take 4 daytime feeds.

So should I be aiming for 4 feeds of 8 scoops by the time he gets to the end of 6mo? He won't be at the recommended weight by then..

Thank you in advance for any advice, I'm very new to formula feeding!

[Lolly]

To be honest I wouldn't worry about what the tin says and feed to his appetite. My DD who has been on the 91st centile (and a silent refluxer) VERY rarely took over 25oz in a day when the tin and her weight suggested she should be taking 32oz+ a day but she has stuck like glue to that centile.

I would follow his cues, make sure that milk is the priority over solids (easy enough with BLW at this age ) and when he is draining his current size bottles add another oz. There should be enough in the bottles so he can stop when he is full and not because the bottle is empty, so there should be a bit left in the bottle at the end of a feed. Also they do tend to not take the same amount at each feed, some can be a lot less than others.

You may get more luck with the DF by doing it a little earlier or later to catch him in a different part of his sleep cycle. As he needs to catch up a bit I would keep that for a while until he is more firmly established on solids. I'm sure he will wake in the night if he isn't getting enough though!

Which teat size are you using now, swapping to a faster one may help increase his intake if you haven't already tried that.

I guess that 4 x 8oz bottles is what many 6 month olds will be doing, but in my experience however much you want them to do what they are *supposed* to they will self regulate and do their own thing .

HTH! Any more questions ask away!

Laura

[Hedgehog17]

Thank you Laura 

I was feeling a bit lost! Glad to know that they can be so variable with feeds  I tried DS with a fast flow teat today and he didn't seem any different with it - up until now I'd been using slow flow so as not to put him off the breast - so we'll get a few more of those.

I do have one more question - when you make up a bottle, say you put in 6 scoops to 6oz of water, does this count as 6oz when it actually makes up to 7oz in the bottle?

Many thanks again!

[Lolly]

This is a good question! My HV said that it counts as a 6oz feed because there is 6oz of water and 6oz worth of calories and nutrition. It only creeps up the bottle a bit because of the space the powder takes up. I always counted bottles by the initial water volume and if they drained it it was a little bit of a bonus!

Laura

[Hedgehog17]

Thanks again Laura 

DS is sleeping better today, I think because he's getting a good fill from the bottles  I'm still BF twice a day but only just to ease discomfort and only after giving him a bottle, so next week should be down to once a day then finish.

He's still being a wriggly distractible monkey however I feed him but I think that's just his age!