Baby won t feed while awake

Sleep Feeding - Why Your Baby Only Feeds While Drowsy Or Asleep – Baby Care Advice

You might choose to breastfeed or bottle-feed your baby while sleeping in a bid to influence his night time feeding pattern, or perhaps because it’s now the only way he will feed without dispute. If sleep feeding your baby is something you plan to try, or would like to change, this article may help you decide the next step to take.

What is sleep feeding?

Sleep feeding, sometimes called dream feeding, occurs when a baby feeds while drowsy or asleep. Baby might be awake at the start, then fall asleep while feeding and continue eating during light sleep. Or a feed might be provided when baby is already in a drowsy state, while sleeping, or as he begins to arouse from sleep.

Sleep feeding can be baby led – something baby does in response to an underlying feeding or sleeping problem. Or Parent led – something a parent initiates in an attempt to resolve an infant feeding or sleeping problem.

Reasons some babies prefer sleep feeds

Feeding your baby in a drowsy or sleepy state might not be something you choose to do, rather it could be something you feel compelled to do if he rejects feeds when awake, does not eat enough when feeding while awake, or because he appears to favor feeding in a sleepy state.

Your baby could partially sleep feed. Perhaps he takes some milk awake, then falls asleep while feeding and finishes the rest, or you might wait until he’s asleep before offering the remainder of his feed. Alternatively, your baby might exclusively feed during sleep.

Some reasons babies appear to prefer sleep feeding include:

1. Sleepy newborns

The time and effort to feed consumes a great deal of energy for a newborn. Newborn babies characteristically begin feeding in an alert state, become drowsy once their initial hunger is satisfied but continue sucking during light sleep, stopping only once deeply asleep or when the bottle is drained.

Most newborns have a strong desire to suck at times in addition to feeding. They particularly enjoy sucking when tired. Newborns have an active sucking reflex, which means they are likely to feed, awake or during light sleep, whenever a feed is offered.

2. Feeding-sleep association

When a baby repeatedly falls asleep while feeding, feeding can become a sleep association (something he psychologically links with the act of falling asleep). A feeding-sleep association means a baby will seek to feed (by rooting, sucking his fist, fussing or crying) whenever he is tired and ready to sleep, irrespective of whether he’s hungry at the time or not, because past experiences have taught him that this is how he goes to sleep. Reliance on feeding as a sleep association increases the risk of broken sleep (see Sleep Associations for explanation). So baby’s naps may be cut short causing him to awaken still tired. As a result, he tolerates only short periods awake before tiring and then starts crying to be fed to sleep once again. If a feed is denied, he becomes progressively more distressed. If a feed is provided, he quickly falls asleep. When fed on demand, a baby who has developed a feeding-sleep association that causes broken sleep will appear to want to feed frequently, perhaps more often than expected, and feed mostly in a sleepy state. If his nutritional needs are met during sleep feeds, this eliminates the need to feed while awake, and it becomes increasingly more likely he will feed solely in a sleepy state out of habit.

3. Behavioral feeding aversion

Pressure applied in an attempt to compel a baby to feed or continue feeding when he doesn’t want to, makes feeding an annoying, unpleasant or stressful experience for baby (and parents). When repeated time and time again, pressure to feed can cause a baby to develop a behavioral feeding aversion. Sleep feeding is a situation that commonly evolves when a baby has developed a behavioral feeding aversion due to pressure.

When averse to feeding, baby becomes distressed and refuses to feed either as soon as he realizes he’s going to be fed or after consuming a small amount (typically, a similar amount each time). However, when drowsy or asleep, and therefore less aware, he lets down his guard, sucking instincts kick in and he feeds well with minimal resistance. After discovering that baby feeds without objection in a sleepy state, many parents choose to wait until their baby is drowsy or lightly asleep before attempting to feed him. That way they can avoid feeding battles. Over time the balance between awake and sleep feeds can shift towards baby being solely fed drowsy or while sleeping.

Due to advancements in brain development, babies become progressively more aware of their surroundings during light sleep as they mature. Around 5 months of age, it generally becomes increasing more difficult to sleep feed a baby who has become averse to feeding while awake. If baby senses he’s being fed while sleeping, he will either resist or stop feeding, and if the parent persists he will wake and vigorously reject the feed. When sleep feeding fails, parents may find they have no means to ensure their baby receives sufficient quantities of milk and as a consequence baby’s weight falters. (See Feeding Aversion for more).

Co-existing problems

The 3 problems described above can occur in isolation, or they can be connected. A sleepy newborn is susceptible to developing a feeding-sleep association if parents don’t take active steps to prevent this from occurring. As a result of a feeding-sleep association, over time baby may develop a habit of feeding in a drowsy or sleepy state. Frustration over the fact that baby rejects feeds while awake can cause a parent to try to gently pressure their baby to feed. If pressured to feed, this can cause a baby to develop an aversion to feeding, adding another layer of complexity to this problem. This situation can occur if baby is breastfed or bottle-fed.

Health professionals in general are unaware of the behavioral reasons why this common feeding problem develops. They are therefore unable to advise parents on how to encourage their baby to return to willingly feeding while awake. But we can! Baby Care Advice professionals have extensive experience in supporting parents to resolve these and other types of feeding problems.

Fact or fiction?

Babies who suffer from acid reflux prefer to sleep feed.

FALSE: When a baby displays distressed behavior during feeds, this is commonly attributed to pain associated with acid reflux. (As is most other problematic behavior displayed by healthy babies when the reason is unclear). Sleep does not prevent a baby from feeling pain. If pain is the reason for a baby’s distress at feed times when awake, pain would cause baby to awaken and display distressed behavior when sleep feeds are attempted. Pain associated with the burning effects of acid reflux is not exclusive to awake feeds, and it does not suddenly disappear simply because the feed has stopped. A baby experiencing pain during feeds will scream long after feeding has ceased. (See Reflux for more).

A behavioral feeding aversion is far more likely to be the reason for a baby to display aversive or distressed feeding behavior while awake and yet feed well during sleep. In the case of a behavioral feeding aversion, baby’s distress ends soon after parents stop trying to feed their baby, and he feeds well during sleep because he’s unaware that he’s being fed and therefore does not resist.

Problems associated with sleep feeding

Most newborn babies will occasionally or often sleep-feed without any obvious complication. However, regardless of whether it is something that is initiated by a parent or baby, there are potential problems linked with sleep feeding.

Sleep deprivation

A feeding-sleep association can result in broken sleep, which could then cause infant distress due to sleep deprivation.

Underfeeding

A chronically sleep-deprived baby might fall asleep before completing the feed. A rigid feeding schedule in this case could result in underfeeding.

Overfeeding

Newborns babies are susceptible to overfeeding because they have an active sucking reflex. Offering feeds that are not demanded could create or add to an overfeeding problem. (The GI symptoms associated with overfeeding are commonly mistakenly blamed on reflux, milk allergy or intolerance. See Lactose Overload for more).

Tooth decay

The frequency of swallowing decreases during sleep compared to awake. Milk can pool in baby’s mouth providing food for bacteria that cause tooth decay to flourish.

Aspiration

Feeding in a sleepy state increases the risk that a baby might choke or inhale milk into his lungs.

Respiratory infections

Studies show that babies who sleep feed are at increased risk of developing respiratory infections.

Financial strain

The search for a solution that will encourage baby to return to feeding while awake can be an expensive one. The first thing that parents usually try is switching formula, often multiple times. Then different nipples and bottles. When this fails, as it generally does for this type of problem, most parents will then seek medical advice. Typically babies who display aversive behavior when awake are diagnosed with acid reflux. (A diagnosis of acid reflux mostly occurs because medicos in general are unfamiliar with the management of problems such as a feeding-sleep association, feeding aversion, overfeeding and other behavioral problems commonly affecting physically well babies. See Why Others Fail). So baby is prescribed medications, in some cases multiple medications, which may be switched many times. If medications fail to improve the situation, which they will if the source of the problem is behavioral, next baby may be diagnosed with suspected milk allergy or intolerance and switched to a hypoallergenic formula. If that doesn’t help, baby may be referred to one or more medical specialists, a dietician, speech or occupational therapist, and possibly undergo a series of diagnostic tests. (No amount of medication or dietary change will make a difference if the source of baby’s troubles is behavioral and not physical).

Parental stress

When a baby will only feed in a sleepy state, ensuring he gets enough to eat dominates family life. Feeds need to be timed precisely to when baby has just fallen asleep or when he’s stirring awake. Because babies can be in light sleep for a short period of time, the amount of milk taken at each feed may be small, which means baby requires feeding more often than average for age. Most parents feel they’re housebound because they don’t want to miss a feeding opportunity by going out with baby. Parents might choose to sleep feed baby multiple times during the night in a bid to increase his total daily milk intake.The stress associated with hours trying to ensure baby gets enough to eat, exhaustion from providing multiple night feeds, numerous health visits and the associated financial strain, can take a significant toll on parents’ physical and emotional health.

Reasons parents offer dream feeds

You might choose to sleep feed your baby in the late evening for one of the following reasons.

1. Change baby’s nighttime feeding pattern

Some babies will have their longest block of continued sleep in the first half of the night and wake in the early hours of the morning to feed. Dream feeding your baby before you go to bed could potentially encourage him to have his longest block sleep from that point onwards, thereby increasing your hours of uninterrupted sleep.

2. Reduce the chance of baby waking at night

In general, babies under the age of 6 months require one or more feeds during the night. Providing your baby with a feed while asleep, before he wakes to demand one, may enable him to continue sleeping. The benefit is you don’t need to settle him back to sleep.

3. Increase baby’s milk intake

Providing a sleep feed or two at night might increase your baby’s total daily milk intake.

How to dream feed your baby

A dream feed is the feed that you give baby before you go to bed. Aim for the feed to be between 10pm and 11pm, but allow 2.5 to 4 hours to go by since your baby's last feed.

Keep lights low. Avoid talking or loud noise.

If breastfeeding, gently take your sleeping baby into your arms.

Dream feed a bottle-fed baby in his crib. Prop him on a pillow so that he feeds in a semi-reclined position. Remove the pillow and lay him flat once he has finished feeding. (Never leave your baby to feed unsupervised or leave a pillow in the crib with a baby).

Without waking him gently rub your nipple or the nipple of the bottle across his lips. If he doesn’t react, try to gently open his mouth and insert the nipple.

Burping is usually not necessary because babies generally swallow very little air while sleep feeding. If you feel your baby needs burping, try sitting him in an upright position. Rub his back rather than pat. If he has not burped within 2 minutes, give up.

If you have picked your baby up, return him to bed while he’s still sleeping. If he begins to awaken at any time, try making a shushing sound to soothe him back to sleep.

Only change his diaper if its heavily wet or soiled.

Automatic, rhythmical sucking and swallowing is strong during light sleep but decreases as sleep deepens. With a dream feed, your baby may have already been sleeping for a number of hours, and its possible that he could be deeply asleep. If he’s not sucking, you may need to arouse him slightly by stroking his cheek, chest, a hand or foot. If you’re not able to arouse him enough so that he feeds, try a different time tomorrow night.

If you’re already sleep feeding your baby during the day, perhaps because it’s the way he feeds best, you have probably already figured out that feeding him during light sleep (i.e. when drowsy, or shortly after he has fallen asleep, or when he is arousing from a nap) works best.

Disadvantages of dream feeding

Many parents swear that a late evening sleep feed (dream feed) promotes better sleep for their baby and therefore better sleep for themselves. However, others find feeding their baby during sleep does not provide the benefits they hoped for. And in some cases, it has unintended and unwanted consequences; for example:

Baby doesn’t suck

Babies tend to spend longer periods of time in deep sleep during the first half of the night. If your baby is deeply asleep when you attempt to sleep feed him, there’s a good chance he’s not going to suck. Also the ability to feed while sleeping decreases as a baby gets older

Baby still wakes at the same time

There’s no guarantee that a dream feed will help your baby to remain asleep for the period you hope he will. For many babies dream feeding makes no difference to their nighttime sleeping pattern. They continue to wake at the same time regardless of whether they receive a dream feed or not. Hunger is not the only reason that babies wake during the night. The presence or absence of familiar sleep associations has a strong influence over a baby’s ability to fall asleep and remain asleep, more so the older, and thus more aware, baby becomes.

Destabilize baby’s internal body clock

If your baby is not waking to demand a feed around the time you dream feed him, then how do you know he actually needs feeding at that time? The older your baby becomes the more likely it is that sleep feeding will hinder the natural progression of his circadian rhythms (24-hour internal body clock). Sleep feeding can disrupt a baby’s natural sleep-wake patterns causing him to wake more often during the night. It also has the potential to provide more milk than a baby needs to consume during the night, and by doing so decrease his appetite and desire to eat the next morning.

You might lose sleep

Without achieving the benefits you hoped for, sleep feeding could mean you are needlessly sacrificing some of your sleep by staying up late or getting up at a set time to provide your baby with a feed that he may not need.

Disadvantages also include the potential problems associated with sleep feeding listed above.

Written by Rowena Bennett

‘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.

Rowena's Online Bottle-Feeding Aversion Program - AVAILABLE NOW

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

Baby won’t eat! – Could it be a feeding aversion?

Baby won’t eat! – Could it be a feeding aversion?

It is estimated that 25 to 45 percent of normal developing babies experience feeding problems. The percentage of babies who display avoidant feeding behavior as a result of an aversion to breastfeeding, bottle-feeding or solids is unknown. Possibly because aversive feeding behavior displayed by babies is in general poorly recognized, often misdiagnosed and mismanaged. Consequently, countless families needlessly suffer emotional and financial stress associated with their child’s unresolved feeding aversion, for weeks, months or years.

Having specialized in the area of infant feeding aversions for over 10 years, the biggest mistake made by parents and health professionals that I see, is that they often make an assumption (without consideration of all possible causes of aversive feeding behavior) that the reason for baby’s distress at feeding times is because he’s experiencing pain. An assumption of pain can blind them to other possible causes, and limit their search for a solution to medical treatments. While a feeding-averse baby’s distress at feed times or meal times can appear like pain, in the vast majority of cases the cause is not related to pain. If pain is not responsible, medical solutions will be ineffective in improving a baby’s willingness to feed.

What is an aversion?

An aversion is the avoidance of a thing or situation because it’s associated with something that is unpleasant, stressful or painful.

A feeding aversion refers to a situation where a baby – who is fully capable of feeding or eating – exhibits partial or full feeding refusal. Baby tries to avoid feeding because he fears similar unpleasant, stressful or painful experiences as has occurred in the past.

Behavior associated with feeding aversion

A feeding-averse baby may display a number of the following behaviors.

Becomes tense, cries or screams when a bib is placed around his neck, when placed into a feeding position, when shown the bottle, or after stopping to burp.
Reluctantly eats only when ravenous and then takes only a small amount.
Takes a few sips or a small volume of milk and pulls away or arches back and starts to cry.
Avoids eye contact while feeding.
Rejects feeding while held in arms for feeds, and fusses when held in a position he associates with feeding even when not being offered a feed.
Clamps his mouth shut and turns or arches away from the bottle.
Moves the nipple around his mouth with his tongue and refuses to drink.
Fights being fed with every ounce of his strength until he’s too tired to fight any longer.
Feeds only while in a drowsy state or asleep.
Consumes less milk than expected.
Accepts milk from a dropper, syringe, spoon or sippy cup or enthusiastically eats solid foods after refusing to drink from the bottle or breast.
Displays poor growth or has been diagnosed as ‘failure to thrive’.

The type and intensity of avoidant behavior displayed by babies who have become averse to feeding varies depending on their age and how parents or caregivers respond to their behavioral cues, in particular those that indicate rejection.

In general, babies don’t display clearly identifiable aversive feeding behavior before the age of six to eight weeks. (But could experience feeding difficulties for other reasons.) As a baby matures his memory, awareness and physical ability to feed or refuse to feed is enhanced. And so, it becomes increasingly more obvious that he’s choosing when he will and won’t eat.

If the parent or caregiver responds quickly to baby’s subtle signs of rejection (eg pushing nipple out with his tongue, turning his head) by stopping the feed, he learns that subtle behavioral cues get the desired response. Whereas, if the parent where to overlook or ignore his subtle signs of rejection, and persist in trying to feed him, he will understandably become upset. And the intensity of his behavior will escalate, possibly to the point of forcefully pushing the bottle or breast away, arching back to distance himself, kicking his legs, crying or screaming as he fights against his parent’s efforts to make him continue eating. When repeated, he learns that only an intense, aggressive or vigorous display of rejection will eventually get his parent (or caregiver) to provide the desired response and end the feed. In time, he automatically kicks his legs, screams, thrashes and arches away – behaving in a distressed manner – a his sole way of expressing rejection.

Another behavior commonly displayed by around 80 percent of feeding-averse babies is what I call ‘conflicted’ feeding behavior. Conflicted behavior occurs when a baby has learned that feeding will soothe pangs of hunger, and so he wants to eat. But past feeding experiences have also taught him to expect something bad will happen while feeding, and so he wants to get away before it happens again. And so he swings between wanting to eat and not wanting to eat.

It’s obvious he’s hungry and has the desire to eat, but at the same time he acts as if something is preventing him from eating. He willingly latches, takes a few sucks and suddenly turns away or arches back in tense or upset manner, perhaps crying, but then almost immediately returns and willingly latches, sucks a few more times before pulling away again. Repeating this disjointed feeding behavior over and over.

A baby’s feeding aversion can be resolved but an effective solution relies on accurate identification and removal of the trigger that is causing some or all feeding experiences to be unpleasant, stressful or painful, and thereby continue to reinforce baby’s determination to avoid feeding. The first step is to figure out what’s causing baby to feel so anxious or fearful of feeding that he would rather go hungry or eat only a minimum for survival.

Why babies may become anxious or fearful at feeding times

The following are the most common reasons for babies to develop feeding aversions.

Stress caused by being repeatedly pressured or forced to feed against their will.
Stress associated with frequent gagging or choking episodes while feeding.
Stress and/or pain associated medical procedures involving baby’s face,mouth or nose.
Pain upon swallowing due to an inflamed esophagus caused by acid reflux or milk allergy.
Pain while sucking due to mouth ulcers.
A sensory processing disorder.

If like most parents of feeding-averse babies, you feel convinced that your baby’s distressed behavior is due to pain, you might find that consideration of other possible causes to be beneficial. Choking episodes are obvious. As are mouth ulcers. It’s rare for babies to have a sensory processing disorder. So this narrows the field to the two most likely causes – stress associated with being pressured or forced to feed, and pain occurring when baby swallows.

Stress or pain?

When a hungry, feeding-averse baby displays distressed or conflicted feeding behavior parents understandably suspect pain. However, pain is seldom the cause.Being repeatedly pressured to feed against their will is THE most common of all reasons for babies to display aversive feeding behavior. And yet, parents and health professionals seldom consider ‘pressure’ as a potential cause.

Some health professionals believe babies are too young to display avoidant feeding behavior in response to being repeatedly pressured or forced to feed. And many encourage parents to ‘do whatever you have to do’ to make sure their baby drinks a ‘should have’ volume per feed or per day.

Parents might overlook ‘pressure’ as the cause because they may have always pressured their baby to feed but he may have only started to display resistance to feeding around two months of age. (Before this age babies are limited in their ability to control the feed and demonstrate when they wish to stop.) Also, once averse to feeding babies often display avoidant/distressed behavior in anticipation of being pressured. This causes confusion because at the time baby demonstrates distressed behavior the parent may not have pressured baby. But baby remembers being pressured in the past and is expecting to be pressure again, and so he’s feeling anxious in expectation of what will come.

It is possible for a baby to experience pain while feeding due to an untreated physical problem AND become stressed as a result of being pressured to feed. Thereby, doubling the reasons for him to want to avoid feeding. Alternatively, a baby may have experienced pain in the past, which has since been effectively treated with medications or dietary change, but while he continues to be pressured to eat his feeding aversion is reinforced.

Behavior that is reinforced will continue. Repeatedly pressuring a baby to feed can create a ‘fear-avoidance cycle’.

How to tell if the cause is ‘pressure’ or ‘pain’

Your answers to the following questions may help you to hone in on the cause of your baby’s aversive feeding behavior.

1. Do you pressure baby to feed?

YES: Many parents pressure their baby to feed out of loving concern. I know I did! If a battle of wills occurs over when or how much baby eats – with baby wanting less and parents wanting more – it’s likely that ‘pressure’ is partially or completely responsible for his aversive feeding behavior, and hence why he may now be eating less than he needs for healthy growth.

A ‘yes’ answer does not rule out a pain or other feeding problems. A baby could refuse to feed because it’s painful to suck or swallow and be pressured to feed. Or he may have difficulty feeding due to inappropriate or faulty equipment, or because he was previously an exclusively breastfed baby and has not yet learned how to bottle-feed, and be pressured to feed.

NO: Be aware that ‘pressure’ occurs in varying degrees from subtle to obvious. Subtle forms of pressure could include feeding practices like repeated offers, restraining baby’s head or arms, following his head with the bottle, jiggling the bottle, and touching his face, if these things are done as a means to try to make him continue eating when he wants to stop.

You might be unaware that some of your infant feeding practices involve pressure. You might be feeding your baby in a way that you were taught, and have always done (which might not have appeared to object to prior to two months of age). Or you might think you’re encouraging him to eat. It’s what your baby thinks that counts. If he becomes tense or upset during feeds, it could be because he’s feeling pressured, (but of course there are also other reasons for a baby to be upset during feeds). Whatever the reason, when your baby becomes upset while feeding, you need to stop and figure out what’s bothering him rather than try to make him continue eating. To do so makes for an unpleasant or stressful feeding experience.

2. Does baby feed better while drowsy or asleep?

YES: When a baby predictably fusses or refuses to eat while awake, but then feeds better or well while in a drowsy state or asleep, this is a strong indication that stress rather than pain is responsible for his avoidant feeding behavior while awake. When awake a feeding-averse baby’s guard is up in anticipation of being pressured, and so he fusses and rejects, or reluctantly accepts and eats very little, or displays conflicted feeding behavior. However, when drowsy or asleep, he’s not fully aware he is feeding. His guard is down and so he’s less inclined to resist (depending on his level of hunger and sleep state). And so a feeding-averse baby is more relaxed and may be more inclined to feed while in a drowsy state or when already asleep.

Sleep does not numb a baby to the sensation of pain. If pain is due acid reflux, milk allergy or any other physical problem prevents him from feeding while awake, it will also prevent him from feeding during sleep. Pain upon swallowing will cause him to wake. Similarly, if baby had a physical problem that prevented him from sucking effectively while awake, like tongue-tie, he would experience the same sucking difficulties feeding while drowsy or asleep.

NO: Not all babies will feed during sleep, especially as they get older. So refusing feeds in a sleepy state is not evidence of a physical cause. Alternatively, if a feeding-averse baby arouses and becomes aware he’s being fed, he may wake and fuss or cry due to rejection rather than pain.

3. Does baby calm quickly once the feed has ended?

YES: The stress displayed by a baby in anticipation of being pressured, or while being pressured, will quickly dissipate once he realizes the feed is over. It might take a couple of minutes for him to realize that the feed has ended, but he calms quickly once he does.

Pain fades. It does not suddenly disappear simply because baby stops sucking. If pain upon swallowing, due to acid reflux or milk allergy, is responsible for baby’s feeding refusal, he would continue to be upset for quite a while after the feed has ended.

NO: This might indicate pain. But is not evidence of pain. A feeding-averse baby could continue to fuss due to unsatisfied hunger (and yet reject offers to feed out of fear of being pressured) or fuss due to tiredness or other reasons unrelated to pain.

4. Is baby generally content between feeds?

YES: Many parents of feeding-averse babies claim their baby is happy between feeds, and that the only time baby fusses or cries is at feeding times.

Pain caused by physical problems, such as acid reflux and milk allergy, is not restricted to feeding. When effectively treated these problems will cause a baby no further distress. When untreated or ineffectively treated these conditions will cause baby to become distressed at random times both day and night, in addition to feeding. Baby will have a hard time sleeping, will wake during the night screaming in pain, and will not be readily soothed or quickly helped back to sleep in some way.

NO: Pain is not the only reason a baby might be irritable between feeds. Hunger and sleep deprivation are two major causes of infant irritability, and as such need to be considered before assuming that any fussy or distressed behavior outside of feeding is due to pain.

If you have answered ‘yes’ to most of these questions, it’s likely that your baby’s feeding refusal is at least in part due to being pressured to eat. This does not imply that he does not have a physical problem or condition that causes pain (when untreated). However, it does mean that pinning all your hopes on finding a medical solution to his feeding issues may prove futile if his distress at feeding times is no longer due, or was never due, to pain. No amount of medications or dietary change will break the ‘fear-avoidance’ cycle or resolve a feeding aversion that was caused by and/or continues to be reinforced as a result of being pressured to eat.

I appreciate that it would be very upsetting for loving parents to come to the realization that their infant feeding practices may have contributed to a situation where their baby acts as if he would rather go hungry than eat. It’s not my intention to upset any parent. But it’s essential to identify and remove the cause so that you can remedy the situation. The power to resolve a pressure-related feeding aversion, and make feeding something your baby enjoys, is in your hands.

By enhancing your knowledge about the causes and solutions to infant feeding aversion, you may finally find the solution to your baby’s feeding issues that you so desperately seek. You can read more about feeding aversions and how to resolve them in my book ‘Your Baby’s Bottle-feeding Aversion’. (Note: The same principles apply to resolving a breastfeeding aversion.) Printed and eBook copies are available through leading online booksellers.

Written by Rowena Bennett, RN, RM, MHN, CHN, IBCLC, and author of ‘Your Baby’s Bottle-feeding Aversion’ and ‘Your Sleepless Baby’.

Websites: www.babycareadvice.com and www.yourbabyseries.com

This article has been written for Pediatric Feeding News. Copyright laws apply. Permission to copy must be obtained from the author.

Refusal to eat | Nestlé Health Science

Nestlé Health Science
health care
Refusal to eat

Food refusal is a feeding problem that usually occurs when the baby is six to nine months old. If the child does not eat due to excessive refusal to eat or lack of appetite, this can lead to growth problems.

Why is my child not eating?

As your baby develops, he will begin to establish a feeding routine with you. If you or your baby is not easily recognizing feeding signals, it can lead to confusion and refusal to eat.
An underlying medical condition may also be present, which can upset the child and lead to refusal to eat. A traumatic experience from eating a food that causes choking or vomiting can also lead a child to refuse to eat.

Symptom analysis

Could it be CMPA?

A child who does not eat or refuses to eat presents a typical symptom for infants with Cow's Milk Protein Allergy (CMP) .
Children with CMPA usually have more than one symptom, and these symptoms can be very different from each other.

If your child refuses to eat it could be CMPA.
You may have noticed other symptoms (besides food refusal) that may affect other parts of the child's body.

For a simple and easy way to check for typical symptoms associated with CMPA, you can use our Symptom Checker.
This will allow you to select all cow's milk symptoms your baby may have. You can then discuss this with your doctor.

In any case, if you have any doubts or concerns about your child's health, you should consult with a healthcare professional as soon as possible.

Other symptoms of cow's milk protein allergy

ANAPHILACTIC SHOCK

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CRYING AND COLIC

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CONSTIPATION

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COUGH

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DIARRHEA

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ECZEMA

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GROWTH DISTURBANCE

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urticaria

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RASH

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REFLUX AND BUCK

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Runny nose and sneezing

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EDITEC

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VOMITING

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HRIP

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IMPORTANT NOTE: : It is possible to continue breastfeeding if the infant is allergic to cow's milk protein. To do this, the mother needs a special diet with the exclusion of all sources of cow's milk protein. Only if these measures do not bring the desired effect, the doctor recommends the use of a special therapeutic mixture intended for children from 0 to 1 year old. It is important to follow the correct methods of preparing the mixture: using boiled water, sterilized bottles and following the rules for diluting the mixture. Medicinal mixtures intended for diet therapy of CMPA should be used under the supervision of a physician.

90,000 how much the child should be awake - the article “Babysleep” about how much the baby should be awake

06/24/2011

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Article

Elena Muradova

9001 BabySleep, the first sleep consultant in Russia, author of the BabySleep methodology

Mother of three children

A newborn child in the first days of life sleeps almost constantly: after all, he was directly involved in the process of his birth, he is tired, and he needs to regain strength. Gradually, the time that the baby spends actively increases: a monthly baby can stay awake without overwork for a maximum of 1 hour, and by the year this interval increases to about 4 hours.

Where did these numbers come from? Should the child fit into the norms of being awake? Is it good for a child to stay awake longer than tabular norms? What can parents do to keep their baby busy during daily activities? Let's talk about everything in order.

Child crisis calendar

How long can a baby be awake at a given age?

Waking time (WT) is all the time the child is awake between waking up and falling asleep the next nap. These are not only games, but also preparation for sleep: feeding, changing clothes, the ritual of laying down and the process of falling asleep. Of course, young children have much shorter wake times than adults.

Sleep intervals increase as the child grows and develops. We always remember that children are different (temperament, characteristics of the nervous system, sensitivity). Some may stay awake longer than their peers, others tire more quickly, and some need more sleep to fully recuperate.

Wake-age norms are based on statistical data and numerous studies of healthy children, which confirm the effect of bedtime on sleep quality. But remember that the table is only a guideline, and the main criterion is the child's behavior!

If you have a cheerful baby who falls asleep easily and wakes up without tears, sleeps well at night, is actively awake with a good mood, the duration of his daytime sleep is an hour or more - he gets enough sleep, even if the total number of hours of sleep per day does not fit into sleep age chart.

It is very important for parents to listen to the child's signals and adjust the time of wakefulness. How to understand in which direction to change it - to increase or reduce? To get started, familiarize yourself with the age norms of wakefulness in children, i.e. the time that babies can usually stay awake during the day without overworking and crying.

Closely observe the child's behavior shortly before the end of the waking hours. Your task is to notice the first signs of fatigue and immediately proceed to the ritual of laying down. Laying down for signs of fatigue is more important than meeting the time indicated in the table. The kid should not fit into the average framework. It is important that he falls asleep calmly and without protests.

This chart will be your guide.

Important!

Wake times in the chart are for children who are getting good sleep. If the child had too little sleep or there is a lack of sleep accumulated over several days, the time of wakefulness will be less. When the child sleeps off, compensates for lack of sleep, his wakefulness time will approach the table.

If the baby had a lot of emotions, bright events, pleasant or unpleasant (noisy guests, a trip to the clinic, a lesson in the pool, etc.), rest will also be required earlier.

Focus on the values from the table if:

the child wakes up in tears
sleeps for 20-40 minutes and wakes up crying
begins to act up and cry a lot before going to bed
arranges festivities at night.

In such cases, the child needs the help of parents: prolonging or reducing the time of wakefulness.

If your baby is awake longer (or less) than indicated in the table, but you can see that he has enough sleep, there is no reason to worry. This is not so rare, especially with the next leap in development, changes in family life, moving, illness, teething, etc.

Child's day regimen

Some parents of newborn children begin to ask themselves the question "when will the child live according to the regimen?" But before 10 months, it's too early to talk about a clear regimen. Intervals of sleep and wakefulness rhythmically replace each other several times during the day, but the picture of dreams often changes.

In the first 3-4 months of a baby's life, very important processes take place: the formation of a sleep structure, like in an adult, the beginning of the body's production of melatonin, the "hormone of the night", the consolidation of sleep around the night. It’s good if parents manage to put the baby to bed on time: at the moment when he is already tired and ready to fall asleep, but has not yet overtired and has not begun to cry in a state of fatigue. In the first months, the initial form of the regime is gradually formed - a more or less stable rhythm of sleep and wakefulness.

If you do not monitor the duration of wakefulness and be late with bedtime, the child cries and becomes more and more naughty from overwork, it is more difficult for him to calm down and fall asleep. Even 5-10 extra minutes of wakefulness can be critical, so up to 10 months it is important to focus more not on the clock, but on signs of fatigue.

After 10 months of life, the rhythm of sleep and wakefulness of the baby becomes more and more stable. Walking within 15-30 minutes no longer affects the quality of sleep so much.

Try to show your baby the difference between day and night as clearly as possible. This helps the process of consolidating sleep around the night. The night is just a time for sleep. Do not turn on the light, speak quietly, do not start the game and communication.

What to do with a child while awake?

It depends on age, but there is a general rule. It is important to divide the child's wakefulness into two parts - active and calm. The active part includes fun games, practicing new skills, and physical activity. Read recommendations on games for each age in our service "Games with a child month by month". Closer to sleep, you need to organize calm activities without emotional and physical stress: cleaning toys, reading, drawing, bathing (if it relaxes the baby), light relaxing massage, feeding, etc.

Note to mom!

Waking time includes not only games, feeding and preparation for sleep, but also the ritual of bedtime and the process of falling asleep. If the duration of wakefulness by the age of the child is 1.5 hours, calculate how long it takes to change clothes, prepare the room, ritual, fall asleep.