Author Topic: Some advice on dropping a bottle please  (Read 5003 times)

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Offline Lolly

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Re: Some advice on dropping a bottle please
« Reply #15 on: August 28, 2011, 20:17:04 pm »
I think you should get the Dr to put him on a decent dose of ranitidine (at least 2mg per kg, better still 3mg or the full 4mg) for a 3 or 4 weeks and see if that makes a difference. If it doesn't make a difference then you can drop back down and no harm done but I think you will notice a difference The feeds he is taking are really small, he should be able to take at least 6oz (180ml) at this age, more is more usual. Taking feeds that are smaller than you would expect for age and weight is fairly typical of a refluxer - they take enough to take the edge off their hunger but much more hurts so they get good at controlling what they take.

Laura


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Re: Some advice on dropping a bottle please
« Reply #16 on: August 28, 2011, 20:58:58 pm »
OK, thanks.  I thought the smaller feeds were because of his solids.  He did take feeds of 150 - 180 (and in a growth spurt up to 270 in one go, it didn't even fit in the bottle!) prior to starting solids so I assumed he cut back because he eats a truck load of solid food 3 times per day.  Will speak to the doc.
Thanks


Offline Lolly

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Re: Some advice on dropping a bottle please
« Reply #17 on: August 28, 2011, 21:10:39 pm »
Even on solids they should still be taking a good amount of milk, I'm assuming you are doing milk first and then solids an hour or so later?  My refluxers for example at this age would take 7-8oz at wake up, maybe 5-6oz bottles in the day and then 7-8oz at bedtime. We moved DD to 3 bottles in order to increase her intake as she really wasn't interested in milk in the day so I was then making 3 8oz bottles a day and she was having at least 20oz out of those three bottles.

If you think solids are having an impact on his milk then scale them back a bit. I know he is BLW but most of his calories need to be from milk, so if you are giving milk first then he should still be taking decent size bottles and then eating his solids an hour later so even on a 4 hour bottle routine he has a good 2 hours+ to get hungry again for his milk.

Laura


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Re: Some advice on dropping a bottle please
« Reply #18 on: August 29, 2011, 07:31:04 am »
Laura, I think you're right about the meds.
I've been thinking about it and although I thought the reflux was getting better, on second thoughts he is probably not taking as much due to the reflux.  I think he holds out for the solids.  Yes I'm doing milk first and solids an hour later (evening meal is often a bit more than an hour later but I do try not to get too close to the BT bottle) but within only a couple of days of starting solids he cut his milk right back as though he knew the solids were coming and he'd rather have those.
I worried I was giving too much solids and if I should cut back but I posted for info about portion size for a LO to see if I was over feeding on solids.  He only just reaches his minimum amount of milk and sometimes doesn't reach it (I do give some yogurt and cheese and he gets vitamin drops every day), but I think you're really right about his reflux.
last night he woke within an hour of going to bed with a sudden cough and cried out sort of spluttering.  He hadn't been sick though so I think it was acid that went back down.  The more I think about it the more I think his meds are too low.  I know other babies can take a really good milk feed, my LO should be able to too.
I do think he is taking just enough milk to take the edge off his hunger and then holding out for solids which he eats with great enthusiasm (hardly know how I'm keeping up with the shop bill!).
I'll get his meds increased.
Thanks


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Re: Some advice on dropping a bottle please
« Reply #19 on: August 30, 2011, 19:34:13 pm »
Laura, just wanted to let you know that DS's ranitadine dose has now been upped to 2ml twice per day (which I think you said was the max for his weight so it sounds good).
I feel silly and guilty for not having had it increased before.  I feel I've really let the little man down.  The whole thing of him taking lots of solids put me on the wrong track, then the reflux getting worse at the same time as teething.  I feel I should have been more clued up...and then again when I did ask the GP about increasing the dose he said the dose was fine (grrrrrr to him!!) and I should have known better.
As it's been bank holiday weekend the earliest I could speak to the paediatrician's secretary was today and by then I felt that the situation had become urgent.  DS and I were up almost the whole of last night and I am positive he was disturbed by the reflux, and eventually went into melt down because he was so tired.  In the end, after trying everything else to help him, all I could do was tell him I'm sorry and hold him close to me as he screamed himself back to sleep.  It was truly horrible and I feel like a terrible mum.
Thank you so much for helping me with this.  I'll let DS know it was you that worked out what the problem was xx


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Re: Some advice on dropping a bottle please
« Reply #20 on: August 30, 2011, 19:40:00 pm »
{{HUGS}} don't be so hard on yourself, you are in no way a terrible mum! I've been there too, DS was on gaviscon for way longer than he should have been when he needed more. I've been dealing with reflux for nearly 5 years and with 2 children - I made lots of "mistakes" with DS, let Drs brush me off etc, etc. I learn from him and got DD treated earlier.

Hopefully the increased dose should kick in quite quickly and he (and you) will get some relief.

Remember too that he won't remember any of this, he just knows he has a lovely mum who loves him to bits and is doing the best she can for him :-*

Laura


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Re: Some advice on dropping a bottle please
« Reply #21 on: September 08, 2011, 09:46:03 am »
Thanks for sharing this useful information to help babies drop a bottle. Also, you can try to drop one bottle feeding and replace it with a cup. Give your baby a few days to adjust before dropping a second bottle feeding.

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Re: Some advice on dropping a bottle please
« Reply #22 on: September 08, 2011, 12:22:27 pm »
I'm back again.
about 9 days on the new dose of ranitadine now.  So far I have continued with the 4 bottles per day plus DF to see how things went with the meds increase.  He does seem more settled but milk continues to go down plus I used to get more into him almost every day by giving cereal for breakfast (an hour after bottle).  I have 4 different types of baby cereal so there is a bit of variety for him, he now usually refuses it and would prefer I took him out of the highchair and forget breakfast, there is no encouraging him and I don't want to make food a big issue by forcing it esp as he does so well with solids and with the lack of milk he really needs a good relationship with solids to get his nutrients, I end up giving fruit and toast instead, or eggy bread, fruit pancakes etc.  I think he will now agree to cereal maybe once or twice per week so I can't rely on this as milk intake.

We are now at about 300-350ml per day and he will be 8 months in a couple of days.
He is also often skipping the 11am by napping through it (slightly increased A time with age plus some better wake up times in the morning making A start later).  I've offered milk on wake up (maybe 12.15pm) and after 10-20ml he refuses more.  As solids lunch is usually around 12.30 I have moved on to that thinking he isn't hungry, but he starts shouting for food the second he realises we are going towards the highchair.  He eats very well at lunch.

So, I think he's dropping or dropped the 11am bottle.  But he is also only taking 60 - 120ml at 3.00/3.30pm
I've had a look at the sample EASYs for his age and the FAQ on bottle times.

How does this look for timings?
7am milk
8am solid breakfast
12.30 solid lunch
3.30 milk
5.00 solid dinner (he eats less at this meal)
6.30 BT milk

Also, should I try flavouring the milk with vanilla or banana (something sugar free) or is that going down a really bad track - I'm in two minds really wouldn't want to but really want him to get his nutrients yk?


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Re: Some advice on dropping a bottle please
« Reply #23 on: September 08, 2011, 18:58:33 pm »
Today only taken 180ml total, possibly 200ml if I count what he had in a sippy cup with his breakfast and lunch.
I had totally planned to drop the DF before any of the day bottles but it just doesn't seem possible when I know it is one of the few times he will take some more milk.  He will likely take 90 at the DF tonight.

I think I need to speak to the paed again.  Don't know if I should cut all his solids to get him to drink milk, but kind of doubt he would take it, I mean from day 1 of solids he was asking for food all day but cutting back on milk. Or maybe I need to get a calcium supplement and just let him cut his milk down. sigh!


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Re: Some advice on dropping a bottle please
« Reply #24 on: September 08, 2011, 21:29:13 pm »
Are you able to get much dairy into his solids? His minimum 20oz intake does include the dairy in food, so if he isn't drinking the milk then you really need to increase the dairy in his food.

I would speak to his paed, if reducing his solids isn't going to get him to drink more you do need his advice. Maybe you could get in to see a dietician who could give you better advice.

Laura


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Re: Some advice on dropping a bottle please
« Reply #25 on: September 08, 2011, 22:58:23 pm »
Hey Creations!  Long time no talk, hun!

I think I would try the suggestion of cutting solids for a while to see if he ups his milk intake.  Be prepared to give it a couple of days though... I have had to do this with DD when she started to prefer solids to milk... a couple days of no solids made her realize that milk came first...

We went to 3 bottles at 8 months and DD's milk intake stabilized... She is really distracted and the queen of stopping after a couple of ounces.. I have found that giving her all of her bottles in her bedroom with minimal lighting really helps... so I get her bottle and then go to her in the morning so she has that bottle before she leaves her bedroom.  Her afternoon bottle is part of her wind down for her PM nap (works two fold - she finishes it easily and it really helps her settle for that PM nap which can be a bit of a struggle some days now)... her last bottle is part of her bedtime routine - I am lucky in that she rarely falls asleep eating... if she does, it's because she is really knackered at BT!  She does STTN so the occasional feed to sleep is no big deal here at all.

This is our current day -

wake at 6/615 - bottle at 620ish and out of her room for the day
solids breakkie at 8/815am
Small top up bottle (teething has made that first bottle/solids dodgy, it will be phased out soon) - 3 oz and nap at 930am
solids lunch at 12/1215
bottle 8ozs and nap at 245pm
solids dinner at 530pm
bottle at 745, BT 8pm.



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Re: Some advice on dropping a bottle please
« Reply #26 on: September 09, 2011, 11:49:13 am »
Thanks.  I'm going to talk to the paed again, as you say Laura perhaps a dietitian/nutritionist is needed for advice on this, I was having that thought too.  Whenever I speak to his health visitor they only say to up the diary in his solids but it seems I'd need to give him LOTS.  I mean I don't know how much cheese is equivalent to ounces in formula but the salt level needs to be watched because of his age.

Yogurt makes him more refluxy because it's quite acidic so although he loves it I do have to watch how much and how often he eats it.  I've just bought some creme freche, mascarpone and single cream to see how we go with those in things.

Thanks for the info Kara.  DS won't take more than 10ml on waking, he has to be awake for a little while before he will entertain a bottle!


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Re: Some advice on dropping a bottle please
« Reply #27 on: September 09, 2011, 12:10:16 pm »
sorry for the abrupt ending there - he's awake from his nap! xx


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Re: Some advice on dropping a bottle please
« Reply #28 on: September 09, 2011, 17:40:37 pm »
LOL No worries!  I know what it's like when they abruptly wake during momma's internet time :)

DD used to refuse a bottle first thing too, but keeping her in her room for it changed that completely!



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Re: Some advice on dropping a bottle please
« Reply #29 on: September 14, 2011, 21:39:30 pm »
Thought I'd send an update.
Spoke to paed's secretary couple of days back and she will be calling me back tomorrow with advice or appointment etc (his paed isn't in until tomorrow so it's as fast a response as I can expect).

Gave some thought to feeding in the bedroom, Kara, but in the morning he now generally has a poo straight off so I have to take him to get cleaned up prior to his feed and if I left him in the bedroom to go get a bottle he would go crazy shouting and crying.  He still sleeps in the same room as me so for sure he would know i was leaving him instead of getting him up.  His afternoon feed is almost always out of the house so there wouldn't be an option for that one to be in the bedroom.

He had his first swim class at the weekend.  That turned out to be a high milk day (490ml).  Waking him to take him out meant he got his 11am bottle instead of missing it and half an hour of swimming made him ravenous for the milk I gave directly after.  But I can't realistically take him swimming every day and although it would increase his milk intake he'd be expending more calories too so it evens back up.

Starting to mull over a theory that the more dairy I offer in his solids the LESS milk he takes, as though he knows he's had enough dairy?  Just a hunch, would need some exploring.

Two nights ago went cold turkey on the DF.  I know I know, I kept saying I couldn't do this, but he took only 2 or 3oz at it, so really what's stopping him having that in the day?  Nothing but habit.  He's 8 months old, he used to drink 180ml in about 10-15 mins so he really shouldn't need 5 bottles every day and only be taking little sips from them.

Night 1:  At 2.30am I was wishing I hadn't gone cold turkey :) in the dark hours I thought he must be really hungry so fed him - duh!  He took about 60ml.  He woke again at 3.30am and we had a hell of a time of it, lots of cuddles, lots of screaming, he was totally MAD that he was awake.  Eventually back to sleep at 6am (he's usually up about 6 or 6.30!)
In the broad light of day, with a more clear head I mulled it over and decided he hadn't been hungry at all.

Night 2:  NW at about 3.30am.  Didn't feed but did eventually offer some water which he had a bit of.  I suspect that this waking was down to lost lovey which I think has happened a couple of times recently (muslin square, he is back arching and accidentally pulling it underneath himself then laying on it, so when he is transitioning between cycles he must be searching for it in his sleep and then wakes when he can't find it).  Eventually back to sleep around 4.30am and slept until 7.45am.  By the time he woke, did his poo, started his alert to wake me, nappy change, prepare feed etc it was 8.15 meaning he went almost 14 hrs between feeds and yet he was still in a very pleasant mood, no crying for his bottle (more like polite requests).  He took 130ml which is the most he's taken in one feed for AGES (apart from the swimming day) although I thought he might have more considering he'd gone 14 hrs!
As the morning feed was better I decided not to give the 11/11.30 milk which he keeps skipping anyway due to napping, but I've been offering it when he wakes which is close to solids lunch.  This meant his second milk was at 3.30pm, 110ml.  And his third milk was at BT, only 80ml.  Day's total still only 320ml  but it feels a bit more structured than all those tiny bottles and he hasn't been asking for anything so clearly doesn't feel like he's missed out.
Now on night 3 of no DF.  I hope for a better night.