Tips for feeding a poor eater?

nicolejoy

nicolejoy

Registered User
My four month old recently came home from hospital. She's spent most of her life being fed by an NG tube and in addition, she has a cleft palate. She's a really poor feeder. It takes an hour (and usually a bunch of tears) to get her to drink 100mL. I sometimes will change her diaper mid feed and find that it sometimes helps her to more actively suck. She's being fed with a haberman feeder so much of the feed, I have to squeeze into her mouth and just encourage her to swallow (so she's not really sucking). I also try to burp her frequently as she seems to get a lot of gas...

I'm getting pretty tired and stressed with needing to very actively feed her for seven hours a day - but if I DON'T force feed her, she'll end up back with the NG tube and I'm sure we both don't want that!!

Any other tips for me to try so this won't be so painful for us both??
 
I'm sorry to hear about the stress in feeding. I'm wondering would it be best to feed her more frequently say 50 ml each time until she gets the hang of it? She's using too much effort to suck and is probably just tired of it.

I'm not sure if the Haberman Feeding nipple is the same as other nipples, perhaps a faster flow might work so that she doesn't require too much work sucking from the nipple?
 
I'm already feeding her every three hours - one hour on, two hours off. If I fed her more frequently, she'd have no change to get a nap or anything...

She can't effectively suck at all, the Haberman allows you to squirt the milk into the mouth instead. We've tried a bunch of different nipples and the Haberman is the only one that she can get more than 40mL in an hour.

I'm sure it'll get better though, just gotta hang in there. If it doesn't improve, I think I'll have to start waking her at night to get in an extra feed that way. The day time is already too intense!!
 
nicolejoy, do the hopsital have any ideas about what to do...as if your baby has a cleft palate they may have some suggestions....also does your baby seems to cough ect when drinking as that could be a problem too....sorry I can't help here but keep up the great work, I can tell it's exhausting and stressful for you, you are your child's angel.
 
Hi Nicole
Delighted to hear that Madeline is now home with you - but the joy must be mixed with a lot of pain and stress. You're doing a wonderful job, and having read your blog, I know you're strong enough to continue.

I can't really offer any advice about the cleft palate - I assume you've done an internet search? Maybe there are some online support groups/forums, where you can ask advice of other mums. Here's a link to a fact sheet which suggests keeping feeds to 20-30 minutes (to avoid overtiring the baby). So maybe more frequent feeds of lesser amounts might be the answer.

http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=8453

Best of luck!
 
More frequent feeds is what advise. Sucking for so long maybe tiring her (And you) so she gets more slow as the minutes go ticking. Feed her in the night as well. How did the nurses feed her in the hospital and how much?
Have you asked the doctors in Australia (Not HK) how much milk should she be drinking in a day? She is a special baby so her nutritional requirements maybe different??
 
The nurses were feeding her 6 times a day (every four hours around the clock) and I thought that more frequent feeds might help her - so I asked if they could do that instead. They then started feeding her every three hours during the day time and every four hours at night (seven feeds a day, got one extra one in at least!). They would keep each feed to at most an hour long and when she came home, they advised that I feed her six times a day (skip one of the night feeds, but feed her around every three hours during the day time). I'm trying to keep a similar-ish schedule to what she was doing at the hospital. I'm afraid that if I start feeding her more frequently, in the end we'll end up feeding overall for longer. One thing that I have tried is to feed her more than 100mL per feed if she is doing "ok", so that way if she has one or two poor feeds when she can only take 50mL or so, she can still take 600mL in the day... I'm currently meant to be giving her 600mL per day. If she can't take more than 400, she needs the NG tube back in. She is taking around 550 and getting it higher than that is a struggle. She's been losing a little weight - but she has a bit of weight that she can afford to lose while we figure this out...

The doctors are following the "guideline" which says that babies need at least 100mL per kg of body weight - so as she is 5.5kg, she should take at least 550mL.

I haven't had a chance to really do an internet search for tips, hubby's been working from home this week so he can be around if I need a hand - so he's been on the computer a lot. I know it's not an uncommon problem, particularly after NG tubes, so I probably should see what I can find online. I just thought I'd ask here first :)

Tomorrow we'll be back at the hospital all day (she should be officially discharged then, she's currently just on home leave) so I will talk to them up there and see if they have any more tips for me...
 
Nic, I've been told (at the last appt.) that my little miss isn't getting enough so while she's a wonderful sleeper, we have to wake her up at least once to ensure that she consumes enough. So perhaps you might have to do that too if that is your choice method of feeding. For example, today, since 7 a.m. she's only had 3 bottles - 120-150ml each. So we have to wake her at 11:30 to ensure that she gets another bottle. She was feeding every 3 hours during the day and has only just changed her pattern to longer stretches. She was taking just 90-110ml per feed. So until recently, we were feeding every 3-4 hours and because of her spewing, we took an hour to finish a bottle most of the time. We changed the teat (which I know isn't an option with Madeline) to encourage her to drink more. Would the Medela feeding spoon help? We have one at home if you'd like to try.

I'm absolutely knackered as I'm not sleeping well (to stay up for little miss and get up for the other one at 6ish to get his morning organised) but I've turned to sleeping with her during her morning nap when the older Little Man is at school. Maybe you could do that too when L is at school?

Hang in there. She's get better!
 
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Just thought I'd update...

Yesterday I tried something new - just feeding her more "on demand" and not force-feeding her if she wasn't wanting any more... but I DID offer the milk more frequently (every 2-2.5 hours instead of every 3-4 hours). It worked a LOT better and she actually drank the same amount as her best day previously! I'm going to keep trying this approach for a few days and see how it goes... So far I'm probably spending a similar amount of time feeding her and preparing bottles etc, but at least it's with less of a fight so it's a lot less stressful for us both... For her I think that 8x75mL (average) works a lot better than 6x100mL!!
 
That's great news!! I actually think force feeding can be traumatizing to a baby and they may be scared of the bottle and refuse to feed. My son has always been tiny and I would get very stressful trying to feed him so that he meets his quota. After a couple of episodes of force feeding, he started to refuse his bottles. He would actually cry when he saw the bottles. I eventually had to purchase a whole new line of bottles so that he would drink again.
 
I think that if I'd continued to force feed her, it would have led to bigger issues - she was already starting to show signs of aversion. And I don't have the option of changing to a different type of teat!! In a few days if she continues eating as well as she has been, I'm going to stop setting my alarm at 6am and see if she can get enough in the day without me needing to wake her then to squeeze in that extra feed. Hopefully it works - I'll get a bit extra sleep that way :) :)
 
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