1 month old baby not feeding well

Feeding Your 1- to 3-Month-Old (for Parents)

During your baby's first 3 months, breast milk or formula will provide all the nutrition needed. Doctors recommend waiting until your baby is about 6 months old to start solid foods. Some babies may be ready for solids sooner than 6 months, but wait until your baby is at least 4 months old.

What Changes Should I Expect?

As your infant grows, feeding will change. Babies will start drinking more milk during each feeding, so they won't need to feed as often and will sleep longer at night.

Your baby's appetite will increase during growth spurts. Continue to feed on demand and increase the number of feedings as needed.

Your infant also will become more alert as the weeks go by, cooing and smiling. So there will be more interaction between you and your baby during feedings.

The following are general guidelines, and your baby may be hungrier more or less often than this. That's why it's important to pay attention to your baby's signals of being hungry or full. A baby who is getting enough might slow down, stop, or turn away from the breast or bottle.

Breastfeeding: How Much and How Often?

As babies get older, they will start to breastfeed less often and sleep for longer periods at night. Your infant probably is eating enough if he or she:

  • seems alert, content, and active
  • is steadily gaining weight and growing
  • feeds six to eight times per day
  • is wetting and soiling diapers on a regular basis

Babies might not be eating enough if they:

  • don't appear satisfied
  • cry constantly
  • are irritable, even after feeding
  • are not making wet diapers

Call your doctor if you're concerned your baby isn't eating enough.

A few weeks after birth, breastfed babies tend to have fewer bowel movements (BMs, or poop) than they did before. At around 2 months of age, your baby may not poop after each feeding, or even every day. During growth spurts, you may notice that your little one wants to feed more often. This frequent nursing sends a signal to make more milk. Within a couple of days, supply and demand will get into balance.

Babies who get breast milk only should get vitamin D supplements within the first few days of life. Other supplements, water, juice, and solid foods aren't usually needed.

Formula Feeding: How Much and How Often?

Babies digest formula more slowly than breast milk, so if you're bottle-feeding, your baby may have fewer feedings than a breastfed infant.

As babies grow, they can eat more at each feeding and may go for longer stretches between feedings. You'll also notice that your baby is starting to sleep longer at night.

During the second month, infants may take about 4 or 5 ounces at each feeding. By the end of 3 months, your baby may need an additional ounce at each feeding.

It's easy to overfeed a baby when using a bottle because it easier to drink from a bottle than from a breast. Make sure that the hole on the bottle's nipple is the right size. The liquid should drip slowly from the hole and not pour out. Also, resist the urge to finish the bottle when your baby shows signs of being full.

Never prop a bottle. Propping a bottle might cause choking and it increases the chances of getting ear infections and tooth decay.

Should I Worry About Spitting Up?

It's normal for infants to "spit up" after eating or during burping. Spitting up a small amount — usually less than 1 ounce (30 ml) — shouldn't be a concern as long as it happens within an hour of feeding and doesn't bother your baby.

You can reduce spitting up in these early months by:

  • feeding before your baby gets very hungry
  • keeping your baby in a semi-upright position during the feeding and for an hour after
  • burping your baby regularly
  • avoiding overfeeding
  • not jostling or playing vigorously with your baby right after a feeding

If your baby seems to be spitting up large amounts, is spitting up forcefully, is irritable during or after feedings, or seems to be losing weight or is not gaining weight as expected, call your doctor. And if your child has a fever or shows any signs of dehydration (such as not wetting diapers), call the doctor right away.

Call your doctor if you have any questions or concerns about feeding your infant.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 2021

Causes, Emergency Care, and Treatments

“Poor feeding in infants” is a term used to describe an infant with little interest in feeding. It can also refer to an infant who is not feeding enough to receive the necessary nutrition required for adequate growth.

Poor growth associated with lack of feeding can lead to a separate condition called failure to thrive.

Poor feeding is caused by a variety of factors. It differs from picky eating, in which a baby may reject one form of milk for another or a toddler may refuse certain foods.

No matter the precise cause of poor feeding, undernutrition is a top concern. In fact, the World Health Organization (WHO) estimates that 45 percent of child deaths are related to undernutrition.

It is important not to dismiss poor feeding as something that will improve over time. This is a critical point in your child’s life, and missing key nutrients can lead to physical and cognitive concerns.

One of the most common causes of poor feeding is premature birth. Premature babies are typically poor feeders because they often have not yet developed the skills needed to suck and swallow milk.

Still, feeding usually increases as baby grows. If your little one was born prematurely and still has feeding trouble after leaving the hospital, it’s important to continue following up closely with your pediatrician, particularly if feeding concerns worsen or do not improve.

Other causes include congenital conditions such as jaundice and infections such as viral gastroenteritis. Once these conditions are treated, poor feeding usually subsides.

Serious conditions

Poor feeding can also be caused by serious conditions, such as Beckwith-Wiedemann syndrome. This is an overgrowth syndrome that causes infants to be particularly large and grow at a considerably fast pace. It affects an estimated 1 in 13,700 newborns worldwide.

Other serious conditions include:

  • congenital hypothyroidism, which occurs when the thyroid fails to develop or function properly
  • other genetic conditions, including Down syndrome
  • hypoplastic left heart, a rare condition that occurs when the left side of the heart fails to develop properly and is unable to pump blood to the body
  • other heart defects

Less serious conditions

Other causes of poor feeding aren’t related to a congenital condition at all. Temporary illnesses can make feeding uncomfortable (and even painful) for infants.

Common ailments that get in the way of feeding include:

  • diarrhea
  • ear infections
  • coughs and colds
  • teething

When in doubt, it’s always best to double-check with a pediatrician. You don’t want to assume a minor illness when in fact there could be a serious underlying condition.

Feeding difficulty is a serious matter. When accompanied by other symptoms, emergency care may be required. Seek immediate medical attention if your baby is showing any of the following signs:

  • has a fever of over 100°F (37.8°C), an emergency in babies 3 months old and younger
  • is vomiting after every feeding
  • is vomiting blood
  • has a cough with breathing difficulties
  • is crying constantly
  • has bloody stool
  • is wheezing
  • is becoming unresponsive to touch

Poor feeding that is caused by an infection will usually stop when the infection is resolved.

Treatment of poor feeding depends on the cause. This can involve changing the feeding schedule to consist of smaller, more frequent meals. If a milk-based intolerance is suspected, your doctor will work closely with you to find a formula and feeding plan that suits your baby.

While serious cases of poor feeding require prompt medical care, other causes can be resolved at home with the advice of a pediatrician.

If your baby is breastfeeding or chestfeeding, try to avoid:

  • certain medications that can enter breast milk
  • applying lotions and other skin products to your breasts
  • high levels of stress — this may also make your milk taste differently

Other considerations may concern formula feeding as well as infants who have started solid foods.

Formula feeding

While breastfeeding is the method of feeding for infants recommended by health agencies such as WHO, it is a fact that not all babies are successful with this method — and not all nursing parents may want or be able to breastfeed.

If your baby doesn’t seem to latch on despite repeated attempts, you may consider talking with your doctor about formula feeding. You may still be able to try breastfeeding or chestfeeding, even when supplementing with formula, if you’d like.

The key is that your baby gets adequate nutrition. A lactation consultant may be helpful, if available to you.

“Picky eating”

After baby reaches 6 months of age, your pediatrician may encourage you to introduce solids to their diet. While solids shouldn’t replace breast milk at this phase of your child’s life, most infants require additional nutrients around the 6-month mark.

Examples include:

  • rice cereal
  • pureed fruits and vegetables
  • pureed or soft meats

Introducing solid foods can be exciting for both caregiver and child. However, some infants don’t take to solids as readily as other babies.

This can be alarming, but the issue may be solved by:

  • mixing cereal with solid foods
  • offering solids in small increments
  • only giving solids two to three times per day
  • starting with one food at a time, then introducing others as your baby gets used to solids

When an infant doesn’t like solids, it’s easy to jump to the conclusion that they are a “picky eater.” However, this phase doesn’t usually start until your baby becomes a toddler.

Stress management

When your baby is eating poorly, it’s easy to get stressed out. This is especially true for new parents who may not yet know the distinctions between serious conditions and minor feeding concerns.

Remember that stress can worsen feeding concerns. It may interfere with attempts at feeding if your infant senses something is wrong.

Managing your stress won’t treat all causes of poor feeding, but it can help in many cases.

It’s difficult to find time for yourself during this busy stage of your life — even a few minutes a day can help. When you feel stress coming on during feedings, take a moment for some deep breathing.

Poor feeding in infants can lead to serious issues, such as malnutrition and stunted growth. It is essential that babies consume and digest the necessary nutrients to thrive and develop.

Any infant who is feeding poorly should be taken to a pediatrician for evaluation. After a proper diagnosis, treatment may be necessary.

In other cases, poor feeding can be resolved through refined techniques and perseverance at home. If you suspect feeding difficulties may be causing other concerns, call a doctor right away.

Poor appetite in a newborn

Newborns and infants almost immediately after birth acquire a sucking reflex and, accordingly, feeling hungry, require it to be satisfied. Mother's breast milk is the most useful and necessary food for the growth and development of the baby. Therefore, if a baby suddenly loses appetite, does not gain weight, refuses to breast or a bottle, there are a number of reasons for this, which you need to figure out and understand what is wrong. If the refusal of food occurred once, there is no need to sound the alarm. But in the case of a regular repetition of the situation, it is better to turn to pediatrician who can help a little person and mother to improve nutrition.

So, what are the causes of poor appetite in a newborn? Why is he not gaining weight and with crying he throws his mother's breast or a bottle?

  • Special structure of the mother's nipple. Because of the inverted or flat nipple, feeding is difficult for the baby, he needs to make a lot of effort to get milk. If the baby does not eat for this very reason, then his smacking of his lips, anxiety and crying as soon as he is at the mother's breast will be indicative. In such a situation, the mother will have to express milk or feed in a certain position that is comfortable for the baby so that the baby can get enough milk. nine0014
  • Intestinal colic . Such cramping pains in the tummy most often occur in the first weeks after birth, when the not yet fully formed gastrointestinal tract can not cope with the incoming milk or mixture. As a result, the child suffers from increased gas formation, and his appetite is sharply reduced. If the baby twists his legs during feeding, pulls them up to his stomach, starts crying abruptly and interrupts feeding, most likely it is colic.
  • Dysbacteriosis. Does the baby spit up often, he develops skin rashes , does he gain weight poorly and eats very little for feeding? Most likely, this is a dysbacteriosis that causes a loss of the baby's appetite. Probiotics and a diet for the mother, prescribed by a pediatric specialist, will help in this case and normalize the process in the child's gastrointestinal tract.
  • Lactase deficiency. Lactose intolerance, which is contained in milk, may cause a newborn to refuse food. No need to be upset if the child does not eat due to the lack of the necessary enzyme in the body. Lactase deficiency is treated, and this is not at all a reason to wean a child from the breast. A good pediatrician will prescribe treatment for the baby and help to cope with such difficulties. nine0014
  • Runny nose . If the baby has a stuffy nose, most likely he does not eat well or refuses to eat at all. Eliminating congestion of the respiratory tract, you normalize the process of feeding.
  • Thrush and/or inflammation in the mouth is a common ailment in infants. Small white sores, plaque and redness of the mucosa indicate an inflammatory process in the oral cavity that prevents the baby from receiving milk normally.
  • Teething . If the baby's first teeth began to cut, then this painful and unpleasant moment can greatly affect the child's appetite.
  • Taste of mother's milk . If a nursing mother ate some kind of spicy or strong-smelling product, then this immediately affects the taste of milk. Garlic, various spices can change the taste of food familiar to the child and lead to loss of appetite in the baby.
  • Lactational mastitis in a nursing mother. Inflammation of the mammary gland, pain and induration, fever can be symptoms of this disease. The child in this case loses its appetite and refuses to breastfeed. At the first symptoms of mastitis, the mother should definitely consult a doctor. nine0014
  • Hypothyroidism in newborns. Reduced thyroid function in infants leads to mental and physical retardation, as well as loss of appetite. Pediatric endocrinologist will be able to determine the presence or absence of this disease in the baby.
  • Otitis. If the baby starts to eat, and immediately throws a bottle or breast with crying, raises his hands to his ears, turns his head - this may indicate inflammation in the ears, in which it is painful for the child to swallow. Otitis media must be treated in pediatric ENT doctor .

It is rather difficult to spontaneously get an appointment with a pediatric specialist in St. Petersburg. If you urgently need to show your baby to a doctor, you can make an appointment with a pediatrician at the Medicenter Medical Center, where in a calm and friendly atmosphere the baby will be carefully examined and the mother will be asked in detail by a sensitive pediatric specialist with many years of experience working with children. If necessary, he can send the baby for additional examinations, tests and cultures, which can also be taken at our center or call the children's specialists of our center at home. nine0007

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    What to do if the baby began to eat little

    — Anastasia Ivanovna, how to understand that the child is malnourished and does not have enough breast milk or formula?

    - Mom will know everything right away - it will be screaming, crying or not gaining weight (in the first year of life, the baby is weighed and measured every month). As soon as the mother sees that the behavior of the baby changes and the weight does not increase, she can conclude that the baby has begun to eat less, he does not have enough breast milk or formula. nine0007

    — At what age does food refusal most often begin?

    - Babies start eating little and sleeping a lot around six months. 4-6 months is the main period, because at this time the child's teeth begin to erupt, sleep and wakefulness patterns change, food interest and a need for a product of a different consistency appear. The child sees adults at the table: how mom and dad eat, knock on plates, and, naturally, he has the same need, he can refuse to breast at this moment. In addition, on artificial feeding, in addition, the mixture may not be suitable for age. nine0007

    — What are the dangers of early childhood malnutrition?

    - Mom and the doctor will immediately see that the child is malnourished, due to the lack of body weight. With malnutrition, there are not enough kilocalories that the child absorbs from food for energy. A lack of vitamins and minerals can cause a malfunction of the whole organism: underdevelopment of internal organs, malnutrition and brain supply (cognitive disorders) will occur.

    — Are babies really more likely to refuse breast milk than formula? nine0116

    — There are several factors that influence a baby's refusal to breastfeed. One of them is that a nursing mother has changed her diet. If the composition of food changes in macronutrients (proteins, fats, carbohydrates), it is possible that breast milk will become more fatty, and a small amount of food will be enough for the baby to get enough. Therefore, the mother must definitely keep track of what she eats and in what quantity. The best way is to keep a food diary, by which it will be possible to judge why the child begins to refuse to eat or eat less in volume. nine0007

    Bottle-fed formula is easier for a baby to suckle and uses less energy to eat, so it is natural for him to need less food. Everything is interconnected.

    - Will the use of special nipple covers help a mother?

    — Each case will have its own recommendations. Nipple shields are needed by a very small percentage of women whose breasts are not physiologically adapted for suckling. When breastfeeding, it is important to properly express and attach the baby to the breast - and this work begins in the hospital. The task of the mother is to help the child grasp the nipple correctly, and nature will do the rest. nine0007

    — Another common problematic question of young parents is why the baby began to eat less on complementary foods. What could be the reasons for this?

    — With the introduction of complementary foods, the acidity of the products may not be the same. In addition, acidity can be reduced in the gastrointestinal tract of the child himself - then the food is not digested. In such a situation, you need to take medical tests. And it is better not to engage in self-diagnosis and self-treatment, but purposefully, together with the doctor, find out the causes of the failure. nine0007

    But there is another extreme - overeating associated with leptin resistance. When the hormone leptin does not work in the body, the child does not receive information to the brain that he is full, and continues to eat-eat-eat. This is a very rare occurrence, but mom will immediately understand that you need to see a doctor.

    — Anastasia Ivanovna, what to do if the child eats little? How to restore the child's appetite?

    — The simplest thing is to create conditions for the baby to get hungry faster, which means that he spends more energy, play outdoor games, walk more and more often in the fresh air, go to the pool if possible. All this greatly affects digestion, and if the child spends energy, he will replenish it by eating more breast milk or formula. nine0007

    - Can a lack of interest in food go away naturally?

    - The active phase of food interest falls on four to six months (everyone is different). And during this period it is better to have time to give the first complementary foods, because later the food interest begins to decline. If a child completely refuses any products, it is advisable not to force him to eat by pushing a spoon into his mouth or persuading him to swallow another spoon, because it is after such persuasion that babies most often appear. A child without conviction should understand that he is hungry and it is time to sit down and eat, not play. nine0007

    — What can force-feeding turn into and is it possible to restore a child's interest in food without psychological pressure?

    — From practice, I can say that the mother puts psychological pressure on the child, realizing that he must now eat, but the child is picky instead of eating, he has no appetite. The mother begins to panic that the child is hungry. In fact, a hungry child will let everyone around know about himself and will definitely eat. At the same time, he will eat a portion of food according to his needs, based on his energy costs. Mom just needs to calm down and remember the so-called intuitive baby food, when the child eats as often and in as much quantity as he needs. If he runs and jumps more, he will eat more, and if he sleeps off after vaccination, when the body is recovering, then perhaps you should not load him with food. nine0007

    — If the baby refuses breast milk, will formula help?

    - Mix is ​​one of the alternative feeding options. If the child refuses breast milk, you need to choose something else, taking into account the age of the child and the situation in the family. After 6-7 months, often the rejection of breast milk comes with the start of the introduction of complementary foods, which the baby likes more. There are also cases when a mother carries a second pregnancy: the quality of milk changes - and the baby does not want to eat it. The inclusion of formula in a child's diet is always an individual decision to be made with your doctor. nine0007

    - How to choose infant formula if the baby refuses breast milk?

    - When choosing a mixture, you need to understand what the mother wants from the mixture - either this is the main food or supplementary food. It is important for yourself to decide which mixture you need, read the compositions of different types of food from manufacturers. There can be many recommendations - both by weight, and by the age of the child, and by filling with minerals. Tasks can also be different. If the child refused one mixture, a new milk or sour-milk mixture is selected. In case of an allergic reaction, you need to look for a therapeutic mixture without components that provoke allergies. There are times when a child does not like the taste, color, smell or texture of food. And if the child rejects food for the second or third feeding, then the diet should be reviewed and other options should be looked for, but after consulting a doctor. nine0007

    - Can MAMAKO ® Premium formulas be used to replace breast milk? What is special about baby food based on goat milk?

    - Goat and cow milk proteins are slightly different. It is generally accepted that cow's milk protein is coarser and larger, while goat's milk is softer and its protein molecules are smaller, therefore, they are easier to digest and assimilate, so digestion will be more comfortable.

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