How to manage feeding issues in my 4-month-old baby?

Question

Hi doctor,

I have a 4-month-baby exclusively on breastfeeding. But for the past more than a month, she refuses to breastfeed when in an active mood. She only drinks when she is sleepy (after a nap), not before the nap also. After the birth, she has lactated correctly without any issues for three months. In the past few days, her refusing frequency has increased. She takes only if I feed with a bottle or bowl.

What could be the issue with her?

Answer 1

Hi,

Welcome to icliniq.com.

For normal babies, what we usually prescribe is - breastfeeds ‘on-demand.’ That is, feed the baby only when the baby cries with hunger or cries for milk. Do not attempt to feed by the clock.

Normally, babies of this age feed once every two hours, but that does not mean you try feeding at 6-8-10-12 o'clock. If the baby is active and playful, it only means that she is content and not hungry. Do not attempt feeding at that time. Wait till she asks for food. If it is practically possible, avoid all other feeds for two more months. Exclusively breastfeed for the first six months.

If the baby is not taking breastfeeds but is taking from a bottle or bowl, the reasons could be -

Breast milk is not adequate for the baby (to confirm this, you always have to try bottle or bowl feeds only after giving breastfeeds).
Baby has got used to the sweet taste of formula or whatever milk you are giving, and now, breast milk is bland and tasteless.
Feeding on a bottle or spoon is effortless compared to active sucking of the breast, which means, baby needs not to do any work to be content with food. Believe me. Babies get used to this very quickly.

The second thing - is the weight you have mentioned correct? If it is correct, then the baby should be quite robust and healthy. It only means she is refusing feeds for the right reasons. So there is no need for you to get worried.

If you wish to follow up, please let me know the birth weight of the baby, height, and head circumference.

I hope this helps. Thank you for contacting icliniq.