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3 month baby not feeding enough


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

Why Is Baby Not Drinking Enough Milk? – Baby Care Advice

It’s obvious when a bottle-fed baby is not drinking as much milk as expected. But does this mean she’s not drinking enough? Maybe ‘yes’. Maybe ‘no’. This article explains how to tell if your baby is underfeeding and the various reasons why babies don’t drink enough milk.

How to tell if baby is underfeeding 

Are you worried that your baby is not drinking enough because she’s not drinking as much as you have been told she needs? Or because her weight gain is low?

The fact that a baby doesn’t eat as much or gain as much as expected is not proof that she’s not eating enough. It could be that her milk needs have been overestimated or that expectations about her growth are unrealistic given her circumstances.  

The first step toward solving this puzzle is to identify if your baby is underfeeding. Underfeeding means a baby is not ingesting enough milk to meet her growth and energy needs.

So how can you tell if your baby is underfeeding? There are physical signs and behavior that indicate if a baby’s nutritional needs are met or not. These are listed in the table below.

Signs of a baby’s nutritional status 

Growth is not a reliable indicator of a baby’s current nutritional state. A baby’s prior growth could be poor but the problem having caused this may be resolved. So, while a baby might be underweight, she could still be well fed at present. Or it could be that baby’s growth is perceived as being poor when in reality it’s not. There are a number of reasons why a thriving baby’s weight gains can appear to be poor. (See Growth false alarms and Variations of normal growth. )

If you have now confirmed that your baby is not drinking enough milk to meet her nutritional needs, the next step is to identify the cause.

Reasons for baby not drinking enough

There are a number of reasons why a baby might not drink enough to meet her needs; these include:

  1. Baby chooses to avoid feeding.
  2. Baby is too tired to feed effectively.
  3. Baby has poor appetite.
  4. Baby is prevented from effectively accessing the food (something is making it difficult for her to drink enough).
  5. Baby has impaired ability to suck.
  6. Baby is not offered enough milk (breastmilk or infant formula).

1. Baby chooses to avoid feeding

Why would a hungry baby choose to avoid feeding? If she finds the experience of feeding to be unpleasant, stressful, or painful she might. Reasons a baby may prefer to go hungry than to eat include:

  • Feeding aversion
  • Sensory processing disorder

Feeding aversion

A feeding aversion is one of the most common reasons for physically well babies and children to reject bottle/ breast or solids and consume less than they need. An unresolved feeding aversion can cause poor growth 

Babies can become averse to one, two or all three feeding methods, i.e., breastfeeding, bottle-feeding or eating solids. Typically, a baby who has developed a feeding aversion willingly eats only when ravenous, and then only a little. She’s tense and upset at feeding times. She might scream at the sight of the bottle, when placed into a feeding position, or at some point during the feed, for example after being burped. She stops sucking and turns away or arches her back in an upset manner. Some babies, who have become averse to feeding will feed better in a sleepy state because they’re then less aware that they’re feeding.

Because a feeding aversion means a baby tries to avoid eating and doesn’t willingly eat enough for healthy growth, parents understandably feel they have no option other than to continue to pressure their baby to eat. But this makes the situation worse. More often than not the reason babies and children don’t want to eat is because they’re repeatedly pressured to eat.   

Sensory processing disorder

Babies can develop an oral aversion due to a sensory processing disorder. Babies who have a sensory processing disorder perceive sensations differently to others and become upset by situations and things that don’t trouble most other babies. They may find a particular smell, taste, or feel of certain foods or feel of the nipple of a feeding bottle and other objects in their mouth objectionable. Or they may be less aware or hypersensitive to the sensation of hunger.

Oral aversion is not the same as a feeding aversion. 

A baby may be mistakenly diagnosed as having an oral aversion when in reality she has a feeding aversion. It’s important to make the distinction between oral and feeding aversion because the treatment for each is very different.

In the case of an oral aversion, a baby typically objects to anything in her mouth including the nipple of a feeding bottle. Whereas in the case of a feeding aversion, baby is happy to have things in her mouth just so long as it’s not the nipple of a bottle (or breast or spoon or food in the case of these types of feeding aversions). 

A feeding aversion is often mistaken as an oral aversion. A feeding aversion is FAR more common than oral aversion. Therefore, it’s important that a feeding aversion is ruled out before assuming an oral aversion is the cause.

2. Baby is too tired to feed effectively

A baby could become too tired to feed effectively or too exhausted to wake for night feeds for the following reasons.

  • If her tired signs are overlooked.
  • If she has learned to rely on sleep associations that cannot be maintained.
  • If she is given sedative medications. 

Overlooking tired signs

Overlooking or mistaking baby’s tiredness cues as hunger or boredom means baby might not get the opportunity to sleep when tired and is then at risk of becoming distressed due  to overtiredness, which may then be mistakenly attributed to pain. (See Baby tired signs and How much sleep do babies need?)

Sleep association problem 

Babies often learn to rely on sleep associations (i.e., props and/or something the parent does) as a way to fall asleep. Learning to rely on sleep associations that cannot be maintained throughout baby’s entire sleep can result in broken sleep. Baby may wake prematurely from sleep still tired and cranky as a result of insufficient sleep. (See Sleep associations for more.)

Sedative medications

A baby could be too sleepy to feed due to receiving sedative medications prescribed to treat colic, such as antihistamines, antispasmodics, or others. (See Colic medications for more.) 

3. Baby has poor appetite

There’s nothing more effective than a hungry tummy to motivate a baby to want to eat. Without hunger a baby has little incentive to eat. The reasons a baby might have a poor appetite for milk feeds include:

  • Illness
  • Strict feeding schedules
  • Solids

Illness

Any illness can negatively affect a baby’s appetite. Loss of appetite can be one of the earliest signs of illness before other symptoms become apparent. Weight loss can occur depending on the severity and longevity of the illness. However, once baby has recovered her appetite will return and she may then experience catch-up growth.

Typically, an ill baby will reject feeds in a passive manner compared to strongly oppositional refusal that occurs when a baby has developed an  aversion to feeding.

Strict feeding schedules

While many babies thrive on a feeding schedule, not all do. Ignoring a baby’s hunger cues while trying to make her feed at predetermined times can result in underfeeding and poor growth.

You have probably experienced times when you felt pangs of hunger and may have been prevented from eating or chose to ignore these, perhaps because you were dieting. And then found the discomfort disappeared. This is because in the absence of food your body will convert glycogen stores and body fat into energy and so the desire to eat, though still present becomes less urgent. This would undoubtedly occur when babies are kept waiting too long for food when hungry.

Another problem with strict feeding schedules is that a ravenous baby can become distressed and disorganized, reject feeds or feed poorly. If she was also prevented from sleeping due to hunger this will add to her disorganized state.

Solids

Milk (breastmilk or infant formula) is the most important food for a baby during the first year of life. While solids are important to complement a baby’s diet, starting from 4 to 6 months of age, solids are a poor substitute for milk. Starting solids before the age of 4 months or giving solids at the wrong time in relation to milk feeds can result in a baby not drinking enough milk when offered. (See Starting solids for more).

4. Baby is not able to access food

A baby could be physically capable of feeding, have a healthy appetite, and be willing to feed, but she could be prevented from feeding effectively because of the following reasons.

  • Poor positioning
  • Equipment problems
  • Latch problems

Poor positioning

Baby could be held in a position that makes it difficult for her to feed. For example, her neck could be twisted and her head is facing to the side, or her head could be flexed or extended in a way that makes it difficult for her to suck or swallow. 

Equipment problems

A bottle-fed baby could experience difficulty feeding because of inappropriate or faulty feeding equipment. The hole at the end of the nipple might be blocked; or the nipple may be too short for her to get a proper seal and maintain suction; or the nipple could be too slow for her causing her to wear out before eating enough; or the nipple ring of a non-vented bottle may be screwed on too tightly slowing the flow rate or causing the nipple to collapse; or the venting system of a vented bottle or nipple might be faulty, also affecting flow rate.

Latch problems

A breastfed baby could have a problem latching to the breast. For example, her mother might have flat or inverted nipples, or her mother might not provide the support she needs to effectively latch. Or she may be held in a position that makes it difficult to latch or remain latched.

5. Baby has impaired ability to suck

A tiny percentage of babies have physical impairments that affect their ability to suck. These fall into two categories.

  • Structural problems
  • Functional problems

Structural problems

A structural problem means baby has a physical abnormality affecting her ability to feed effectively, for example cleft palate, tongue-tie, or underdeveloped sucking pads (the fat pads in baby’s cheeks, which is usually only problematic for scrawny newborns).

Functional problems 

Even though there may be no observable physical abnormality, baby might not be able to suck effectively due to a neurological impairment, an absence of sucking reflex, or due to nerve compression or damage occurring during birth.

Both structural and functional problems will be evident soon after baby’s birth. If your baby fed well and thrived after birth, you can probably rule out these problems.

6. Baby is not offered enough

Not offering baby enough to eat is frequently believed to be the cause when a baby doesn’t gain as much weight as expected. While this is a common cause of poor growth in third world countries where food is scarce or expensive, it’s rarely the reason for babies in developed countries to underfeed or display poor growth. In general, parents in developed countries offer their babies as much milk as their baby is willing to take. The problem is that baby is not taking enough either because she’s not willing to or because she’s prevented from doing so.

Health professionals often advise parents to make sure their baby drinks a minimum specified amount at each feed. However, to make sure a baby drinks the recommended amount might involve some form of pressure. Repeatedly pressuring a baby to feed against her will is likely to cause her to develop a feeding aversion, which in turn will cause her to underfeed. So, what eventuates are repeated feeding battles that stress baby and parents.

If a baby is not eating enough, there is a reason. Pressuring or forcing a baby to feed or eat is NOT an effective solution. It’s likely to create greater problems. 

Misdiagnosis

The two most common reasons that a baby might be assumed to be underfeeding are because:

  1. Baby is not drinking as much as expected.
  2. Baby is not gaining as much weight as expected.

In many cases where parents worry that their baby is not eating enough, there’s nothing wrong with baby’s milk intake or growth. 

Baby is not drinking as much as expected

If your baby displays visible signs that indicate she’s getting enough (described in the table above) then the problem might lie with your expectations or baby’s healthcare professional’s expectations about how much milk she needs.

There are numerous reasons why a baby might drink more or less than parents and health professionals expect. See How much milk does a baby need? for these.

Baby is not gaining as much weight as expected

If your baby displays signs that indicate she’s well fed then it’s likely that what is perceived as poor growth is due to a false alarm, a variation of normal growth, or that the problem that caused her growth to falter has already been resolved.

Unrealistic expectations can occur as a result of mistakes made by health professionals when assessing a baby’s growth. (See Top 10 baby growth mistakes.) 

How we can help
  • Your Baby's Bottle-feeding Aversion book
  • Baby Care Advice consultation
  • Rowena Bennett's Online Bottle-Feeding Aversion Program

Your Baby's Bottle-feeding Aversion book

In my book, ‘Your baby’s Bottle-feeding Aversion’, I have described physical and behavioral reasons for babies to develop an aversion to bottle-feeding. How to identify the cause and the solutions to match. Included are step-by-step instructions on how to regain your baby’s trust and resolve a feeding aversion caused or reinforced by repeated pressure to feed.

While the book was written for bottle-fed babies, many nursing mothers have found that applying the same strategies has also helped them to successfully resolve a breastfeeding aversion.

You might find that reading this book is all you need to do to understand the steps you need to take to resolve your baby’s feeding aversion and get him back to the point of enjoying eating until satisfied. 

Baby Care Advice Consultation

If you would like an individualized assessment of all reasons for infant feeding problems, not just feeding aversion, we also provide a consultation service. Baby Care Advice consultants have extensive experience in pinpointing the cause of feeding aversion and other behavioral feeding problems such as those related to equipment and the parent’s feeding practices. (For more on what’s included in a consultation).

Rowena's Online Bottle-Feeding Aversion Program 

Six time-saving modules to help your family enjoy feeding again with Rowena's step-by-step plan. Enjoy additional tools to manage anxiety, troubleshoot any issues, introduce new carers, how to manage illness/teething and much more.

  • Module 1: Understanding feeding aversions
  • Module 2: Identify the cause
  • Module 3: Prepare for success
  • Module 4: How to resolve your baby's bottle-feeding aversion
  • Module 5: What to expect
  • Module 6: Troubleshooting
  • BONUS: Guided meditations

 

By Rowena Bennett, RN, RM, CHN, MHN, IBCLC.

© Copyright www.babycareadvice.com 2021.  All rights reserved.
 Permission from author must be obtained to reproduce all or any part of this article90,000 3-month child poorly eats

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Guest

I also had this at 3 months. at 3 months, lactation usually settles down, milk no longer flows, milk becomes smaller. Therefore, many people stop feeding at this age - "the milk is over." My milk began to go worse, and the child got used to it pouring by itself, taking a boob, sucking and spitting a couple of times - milk does not go. I myself expressed a little so that the milk would flow, then I would give it to him. He realized that there was food there, and then for up to a year they fed without problems. Or maybe you ate something, so the taste of milk has changed - it won’t get into it

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Nastya77

Thank you yet! We will be suffered by breasts for longer!

It also happened to me: the child sucks out the first "light" milk, and spits out the boobs - then the milk flows already difficult and he is too lazy to suck, but there is milk in the chest. then I also strained a little so that the milk would flow and give him a boob, he sucked further. if he does not eat up to the end, then each time there will be less milk and it will burn out.

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#12

. I need milk, but curiosity outweighs. Curiosity makes babies move forward, crawl, walk, grab, scatter, paint... Until he gets used to the new visual sensations, feed "around sleep" before and after, and during sleep.

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#22 9Experts Woman05

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    Nastya

    I have the same problem, we have been eating the mixture since 2. 5 months, now 4 months, I began to eat badly ... I also feed immediately after waking up, or when almost I’m rocking to sleep ... it’s hard, now the doctor told us to give porridge, so she doesn’t want to eat them at all even in a sleeping state, and with a spoon, and through a bottle ... not into any ... I don’t even know what to do, in weight Gaining little, lost weight ....((( CAN ANYONE TELL YOU HOW TO BE???? PLEASE ...

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    katya

    And I have the same thing, 3 months to us. For 2 weeks now she eats only 60 ml and then pushes out the bottle with her tongue, turns away! We are on iv. But he behaves well, agukae, gurgles, smiles ... What can it be, can the mixture be changed?

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    Katya

    We are 3.5 months old, formula-fed baby, eats only 90 ml. Very worried. Has anyone had a similar experience?

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    Christina

    2.5 months old baby we eat formula, we ate well everything by the hour, day and night, already like 4 days at night she wakes up to eat, hysteria wants because you bring the bottle right away and rushes at it as soon as you start to feed it turns away and does not allow to feed ... today, for example, at 2 am I barely fed 125 ml, although it was supposed to be 180 ml and now it was 8. 00 the second time I fed 15.00, only the third time we ate and again 125 ml and then within an hour I ate it in several visits .. tell me why it can be like that, otherwise I'm worried ... 911 May 2018 Very worried. Has anyone had a similar experience?

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    valentina

    my son is also 3 months old, we are artificial people, I don’t know why, but he began to refuse to eat, he can eat in the morning and then only starts asking again at 15:00 playing gurgling smiling that it could be no idea who knows tell me please

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