4 month baby not feeding properly

Your Baby at 4 Months | Patient Education

Patient Education A-Z

Development

Babies this age enjoy cooing and laughing as well as seeing and communicating with people. In fact, they are so interested in the world that they often would rather look around than eat. If your baby is not interested in eating, try feeding in a darkened room or use a receiving blanket to gently cover the baby's face. This may encourage the baby to focus on feeding.

Spend lots of time talking, laughing and playing "word games" with your baby. Try making a funny face or noise and see if your baby will copy you. When your baby makes a sound, copy it. In addition to "baby talk," speak to your baby in long sentences to help your baby learn language. This is a great time to begin reading stories and enjoying picture books together.

You may want to try using sign language to help your baby learn to communicate in a different way. Beginning at 6 to 8 months of age, try using a hand signal every time you use a word like "hungry" or "tired. " Babies may use sign language to let you know their needs before they can talk. The book Baby Signs covers how to use sign language with babies.

Sleeping

By 4 months of age, most babies are capable of sleeping at least six to eight hours a night.

Everyone wakes up during the night, but we learn to settle ourselves and go back to sleep. If you respond to every squirm and sound your baby makes, you're not allowing him or her to learn this important skill. If your baby is still waking at night, there are several ways to encourage longer nighttime sleep:

Develop a soothing bedtime routine. Sing or read to your baby or rock your baby at about the same time each evening.
Try to place your baby in bed drowsy but still slightly awake.
Try using a night light.
When your baby awakens, try to settle him or her without feeding. Or, if you are bottle-feeding, try giving your baby some water instead of formula. If you are breast-feeding, try feeding from only one breast. By decreasing the amount of food eaten at night, you will help your baby go longer between feedings.
Try to delay the middle-of-the-night feeding by holding your baby, offering a pacifier or letting your baby suck on your finger. Even if your baby still needs to eat after 10 or 15 minutes, prolonging the period before feeding will help your baby sleep a little longer the next night.

For more information, see the books Helping Your Child Sleep through the Night, by Cuthbertson and Schevill, or Healthy Sleep Habits, Happy Child by Marc Weissbluth.

Feeding

Breast milk or formula has all the nutrition your baby needs now, and you should continue feeding your baby with breast milk or formula for the next two months. Your baby does not need any additional food until 6 months of age. Four-month-olds still have an immature intestinal system and cannot control their muscles for chewing and swallowing, and therefore they are not ready for solid foods.

If your baby is mainly breast-fed, continue taking your prenatal vitamins and give your baby 400 units of vitamin D each day.

Teething

Teeth may appear anytime during your baby's first year of life. It is difficult to know when a tooth is erupting unless you can see or feel the tooth. Most 4-month-olds begin drooling and putting objects in their mouths, but this does not mean they are teething.

Teething makes some babies fussy or irritable. It does not cause a high fever. If your baby appears sick or has a fever, please call your baby's doctor.

If your baby seems uncomfortable due to teething, you can help by:

Letting your baby suck on a cold teething toy.
Giving acetaminophen as directed by your child's doctor. Do not use acetaminophen for more than 48 hours.
Avoiding topical medications like Orojel or Numzit, which may cause later allergies.

Safety

A few extremely important safety tips:

Falls — Your baby is becoming much more active and cannot be left unattended on a high surface like a bed or changing table. If you have to leave your baby alone, put him or her in a safe place on the floor.
Hot Liquids — Your baby can reach and grab objects now, so don't hold hot liquids or sharp objects while holding your baby.
Car Seats — Your baby should always be secured in a car seat when traveling by car or taxi. The car seat should still face backward. Babies who are accustomed to car seats behave better during car trips when they are older. Remember that you need to buckle up too.
Small Objects — As your baby learns how to hold objects and put them in his or her mouth, keep small objects out of reach to prevent choking.
Pacifiers — Don't tie or pin pacifiers to pajamas, as this may cause strangulation.
Cribs — Crib toys that stretch across the crib should be removed as your baby begins to learn how to sit. You may need to lower the mattress so your baby cannot roll out.

Immunizations

Your baby will receive a second set of immunizations at 4 months of age, followed by another checkup at 6 months. Please bring your baby's immunization card to each visit.

Used by permission of Jane E. Anderson, M.D.

UCSF Benioff Children's Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.

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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.

A child at 4 months eats very poorly - Pediatrics - 06/07/2013

Alexey Kuguchev

Hello! Your help is very much needed. The daughter was born weighing 3400.53 cm. The child is in the NE almost from birth, because there is very little milk. The last month he has been eating very badly. Before feeding the tantrum for about 15 minutes, I take it in my arms, I calm it down, it’s clear that he wants to eat. With grief in half, I manage to persuade him to start eating. She eats 90 grams herself, and for the last 2 days 60, then she spits out a pacifier, smiles, talks, tantrums and whims, we eat up to a maximum of 120 for an hour. If you don’t force it, she can eat no more than 400 grams per day. Weight at three months was good 6200, 63 cm, at 4 months they did not go yet. It's getting harder to feed her! I cry with her every feed. At first they ate Nutrilon Comfort, alternating with Nutrilon Sour Milk, recently Sour Milk with tantrums categorically refuses Comfort, although she used to eat normally. I was tested for lactose intolerance and everything was normal. On dysbacteriosis - found Staphylococcus aureus and hemolyzing Escherichia coli. We are treated with Bifidumbacterin and Rela Life. The doctor didn't prescribe anything else. Tell me, what are the reasons for such a poor appetite? I understand that we have a good weight, but it would not be so good if I did not wake her up to eat at night, if I did not sit next to her for an hour during the day. At night he can sleep for 7 hours, during the day he sleeps worse, three times an hour, sometimes 1 time for 2 hours. The child is active and does not seem to be bothered by anything. Only sometimes gaziki still torment. Can any other tests help us identify the cause of poor appetite? Or should I change the mix? And to what? How do you feel about Nanny's mix?

Ruzhenkova Irina Viktorovna answers

pediatrician

Hello! You asked a difficult question . .. Tell me, does she eat breast milk as badly as formulas? Or does the breast suck completely? It is usually advised to apply the baby to one breast, after it is completely empty - to the other, and only then supplement the mixture. If you follow all these rules and the girl empties both milk ducts, maybe she does not need as much supplementary food as you give her? Have you carried out a control weighing to determine how much milk the baby is getting from the breast? According to all our canons, it is strictly forbidden to force-feed a child. Wake up at night so that the baby eats - too. Enzymatic deficiency with such good weight gain, apparently, can be excluded from the list of alleged diagnoses. Dysbacteriosis is nothing more than a fashionable diagnosis ... Maybe it's worth looking at how the baby has added over the past month, and with good numbers, temporarily retreat from her? I'm afraid that excessive pressure and perseverance can bring up a neurotic out of her ... Not a bad option and you offer - to offer a different mixture. Which one can be decided only by the selection method. Science with a decrease in appetite and deviations in the composition of the intestinal flora recommends fermented milk mixtures with probiotics ("Agushu-2", for example). As heavy artillery, hydrolyzate mixtures can be prescribed ("Nutramigen", "Pregestimil", "Frisopep AS", "Damil Pepti", "Nutrilak GA", "Nutrilak peptidi SCT", "Nutrilon Pepti MSC", "Nutrilon GA 1" and " Nutrilon GA 2", "Alfare", "NAN GA 1" and "NAN GA 2", "Frisopep", "HiPP GA 1" and "HiPP GA 2", "Humana GA 1" and "Humana GA 2") - but they are very expensive, bitter and tasteless. I don’t have any personal preferences for mixtures, because. all my relatives were breastfed. In the end, by age, you can already try to introduce juices, and after 2 weeks - fruit purees. Maybe the baby will like juices and complementary foods more - however, their introduction so early threatens with the development of allergic reactions.

If a child does not eat well: what to do and what not to do

What to do if the child does not want to eat.

- Malyusik, well, one more spoon - and that's it! Last! I ate only two, let's have a little more, here's the most delicious piece for you! - says the average mother, offering a spoon with one hand, playing the accordion with the other, showing the trick with the disappearance of the handkerchief with the third, turning the cutlets over with the fourth, while doing somersaults on one leg.

Sound familiar?

Every dad has an instinct to bring food home, and mom has the instinct to feed the child. And if he refuses to eat, a signal is triggered - "I'm a bad mother" or "the child is sick."

In this case, the most important thing for a parent to understand is whether the child DOES NOT WANT or CANNOT eat?

If the baby is running around, having fun and looking good, without showing any signs of illness, then most likely he does not want to eat. There can be many reasons:

A breastfeeding child prefers milk and dairy products, intuitively understanding that he needs calcium, and now milk is healthier for him than soup.
The child wants a cookie, not vegetables.
He really wasn't hungry. For example, his metabolism is slow, breakfast has not yet been digested, and lunch is already being offered. Or the child was sitting in front of the TV after breakfast and his appetite had not yet had enough time to play out. Compared to the boy next door who was outside all day.
If a child is not genetically destined to become Uncle Styopa, then he can eat much less than his peers, who have tall parents.
Psychological problems. If earlier you accidentally gave your child a bitter cucumber, then he may refuse any green food. Or you yell at the child during the meal, and for him the food is perceived as a trauma.

If your child is lively, but at the same time he has a "bad appetite", then this is not his problem, but yours - the psychological problem of an unsatisfied instinct. If a child jumps, jumps, he has healthy nails, hair, etc., think less about what he lacks. Better think about something nice))

An active child = not a hungry child.

Wait for the natural desire and correctly distribute energy costs - walk more often, send the child to the sports section, or simply say: “If you don’t want to, take a walk, dinner is not earlier than seven and no snacks.” That is, if your child simply does not want to eat, normalize feeding - strictly at a certain time and without snacks. The body will get used to secrete gastric juice strictly according to the schedule.

And one more thing. There are no rules about how much a child should eat. He can eat a kilo (and make you very happy) and 9Send 00 grams to the toilet. Or eat 100 g and learn everything.

But it is much more difficult if the child CANNOT eat.

Causes: