Brand New 3 Month Old to My Family Daycare---unusual Feeding Schedule

I think you should tell the doctor about this one. It seems to me that he is not digesting his food properly.

It sounds like he may be overfed or that he's spitting up so much that he's not getting the milk to his belly.

Also, the recommendation if anywhere from 4-6 months to start cereals now, though some (mostly breastfed from my experience) have held out longer.

Poor little guy, I hope it resolves soon!

My advice to you is to tell the Mom to call her Baby's doctor and tell the doctor everything you have stated in this email to be on the safe side. Better to be safe then sorry.
Kathy

Reflux babies are a class of their own. And just like all other babies, each one is different! My own daughter was very much like "Andy". Most of the time (at 3 months), she nursed every 2 hours (all night too). The screaming is typical, as is the constant need to suck. His mom is right - he WILL keep eating if you offer it. Keep that paci handy! My daughter refused a pacifier, so she sucked on my (clean) pinky much of the day.

With reflux, the sphincter muscle at the bottom of the esophagus does not shut properly. So when milk gets into the stomach, it mixes with stomach acids, then sloshes right back up into the esophagus. It burns, so to cool the burn, the baby demands more milk. When the stomach gets over full, projectile vomiting is normal and can be frequent. It's a self-perpetuating cycle. Many babies find relief if they are held upright (gravity helps to keep everything down), and many also "get better" once they can sit up on their own (that is, they're better during the day!). It can take a few years for the sphincter muscle to develop correctly, though. Most kids seem to "outgrow" reflux between 18-24 months.

Things that may help Andy - hold him upright, or carry him in a sling in a "sitting" position. Or use a Snugli or Baby Bjorn, which hold the child upright naturally. When he naps, prop up his torso. They make wedges for this, but be sure to use one that is specifically made for reflux babies - more than a 30 degree incline. We had luck having our daughter nap in her swing, buckled in, with me right in the room to keep an eye on her. Some babies sleep great in their car seats because the incline helps; others HATE their car seats because the incline is not enough. Babies who are super uncomfortable will simply demand to be held - and when there is nothing else that seems to help, holding him will at least help him feel secure and loved.

Mom was right about the food at 4 months. And you're right about pediatricians saying "not before 6 months". The major exception to the 6-month rule is for reflux babies. The idea is that the cereal is heavier than plain milk, and more likely to stay down. Personally, I did not find this made any difference for MY daughter, but as we know, all children are different! It sounds to me like Andy's mom has done her research and is working with her pediatrician.

There are medications for reflux, but many parents don't want to medicate their babies unnecessarily. Also, 4 years ago, there were about 80 medicines approved to treat babies and only ONE of them was for reflux. And that one (Zantac) diminished in effectiveness pretty quickly, and was not very effective for severe cases. Keep an eye on Andy's symptoms. If they get really severe, you'll be an important reference for Andy's mom and pediatrician, if they are trying to decide which medication to start with. For example, some medicines neutralize stomach acid, while others thicken the slurry in the stomach, and others can actually heal esophageal erosions.

If you want more info on reflux, there's a lot on the internet - type in "infant reflux" or "GERD" in your search engine. One of my favorite sites is "AskDrSears.com". Also, ask Andy's mom what sites she has visited - then both of you can be on the same page regarding Andy's care.

It sounds like Andy is a naturally happy baby - that makes it a lot easier. Keep in mind that unless he's screaming and arching in pain, the spit up and projectile vomiting are not bothering him.

Good luck helping Andy through this - it sounds like he has a caring and concerned caregiver. Best of luck!

-K.

Well, my son went through reflux and a lot else his first three months but it all resolved before he first birthday. He had meuconium in his lungs from his delivery and so he was on a resporator and an IV for a little while and had to be switched to eating normally afterwards (all in all 10 weeks in the hospital). When he was first starting with the bottle he spit up at nearly every feeding. The hospital put him on Prevacid for the reflux, and added a teaspoon of oatmeal cereal to each 4 oz bottle (rice can cause constipation). We used Dr. Brown's bottles with Y cut cereal nipples. We burped at half a bottle and then sat him upright in a bouncy seat (with as little jiggling as possible) for 20-30 minutes after eating. The hosptial only fed him every 3 hours and tried to stretch it until 4 hours but he was hungry sooner-- 2.5 hours at first but he got used to 3, 4 hours was too long for him and he was a bigger baby (over 12 lbs at 3 months). That is what we did--all well supervised by the hosptial staff. I have heard that 6 months is the ideal age for starting solids but also many times babies with reflux get the cereal mixed in sooner. Basically these are all pretty common interventions but it is always a good idea to check with the pediatrician first. We didn't do a lot of switching formulas (some people try that) and regular Similac Advance and some breastmilk worked for us (there are no real food allergies in our family). Because of all the rest going on with my son he was also seen a few times by the pediatric GI specialist and was taken of the prevacid at 10 months (he was walking by then and rarely just lying down except when sleeping) I hope this helps. It sounds like your little guy is in the normal range--reflux is pretty common--and probably the parents, you and the pediatrician can find some ways to help him be more comfortable.

Dear R.,

I know you've gotten a lot of responses already, but I wanted to add one more thing. This sounds a LOT like a cow's milk allergy. My son had similar symptoms -- even though I breastfed, the cow's milk protein was processed through my milk. He literally nursed every waking minute (when he wasn't spitting up, that is) for his first seven weeks, until I eliminated all cow's milk from my diet. You might gently suggest to his parents that they try a nondairy formula.

I also wanted to say that you sound like a WONDERFUL carer. Andy and his parents are lucky to have found you.

My thoughts are that he could be hungry and ready for food, he could have an umdiagnosed hernia or he just might have a small stomach.

i had a highly refluxy baby- didn't go away till about 9-10 months old. We eventually put him on pepsid(probably around 3 months) and after about two weeks he was tremendously better. If it's severe reflux then medication might be needed to at least calm the situation a bit- but this is something they shoudl talk to their doctor about of course. If your baby has a reflux situation all the doctors i have spoken to suggest starting cereal at about 4 months- otherwise wait until 5-6 months for food(if baby is showing they are interested. If he starts food, feedings will be more spread out. i always kept baby sitting up whenever possible- especially after feedings for 15-20 min. Bouncy chair is the best. Tummy time helps too.

Hope this is helpful!! If you have other questions let me know.

Hi R.,

All I can say is that my son ate every 2 hours for his first five months, then stretched out to every 3 hours for a couple more months, before finally stretching out to a less rigorous schedule (rigorous for me as I nursed him throughout all of this!). He also was miserable with gas every evening. Don't know if that helps, but he is perfectly normal today at age 9 when it comes to health and eating.

D.
mother of 5

Wow, you have truly found your calling! Sounds to me like he may have piloric stenosis, which is the stomach tube not being properly attached to the esophogeus, if I remember correctly. If not piloric stenosis, he may just have severe reflux. I imagine that the parents have consulted with their pediatrician? What has he/she said? BTW, my husband had piloric stenosis when he was a little guys, which required surgery to correct. My firstborn son had feeding problems like "Andy's", but did not have piloric stenosis and eventually (@ 18 mos.) outgrew it. Please let us know the outcome!

I used to watch my nephew, and he did the SAME things. Ate 6 oz bottles every 1 hour 45 minutes and spit up massive amounts. Your little guy is fine eating that much and the spit up is probably fine as well, but it sounds like he does get gas, I would suggest switching bottles to see if the projectile vomits stops.

Reading your decription of this little boy gives me goosebumps remembering the same in my DD when she was little. I know how hard it is- you sound so wonderfull to be so caring! What ended up being the issue for my dd was asperation. Where the fluids would go into the lungs as she was swallowing. With the reflux it was hard! It takes about a year to really clear up (usualy does, as they get stronger)

If this could be the issue I'd say she should talk to the pedi about it- they don't think of it right away (not super common). I understand the hesitation to start cereal- in this case it probably will help- not to feed it to him straight, but use it to thicken his bottles. This is the treatment for asperating. When the liquids are thicker they make it past the flap in the throat and don't go into the lungs. They can try out Enfamil AR and see if it helps- it is thicker then regular fomula. Or just add enough rice (millet would be best) cereal till it's honey consistancy or just a bit thinner. If that seems to help after a few days it may or may not be something the parents want to have diagnosed. The tests are pretty involved. (Tell them a modified barium swallow study FIRST- then the other options!) But if he is getting sick or is raspy when he breaths then it's a must! Aside from all that keep him upright as much as possible and let him have the paci as much as possible.

With my dd we had to switch to Nutramigen thickened with liquid thickener (modified food starch avail at the pharmacy) and it made a huge diffrence!!! It got better pretty quickly.

I hope that helps some- now that I know the signs of it I see it in babies pretty easily- hopefully they can get it figured out. A speech therpasit will be a great reource for them.

Thanks for caring so much about him!

~J.

My 3 month old eats (breastfed) every 2 or 3 hours throughout the day, though I don't think she's getting 5 ounces each time. The pediatrician said she would probably eat frequently during the day when she goes for long stretches (6-8 hours)at night. She usually whines for a bit after nursing until I get up and walk her around. She tends to burp once or twice on her own; my burping her usually results in cries and/or throwing up (because I've leaned her forward on a full stomach). I'm a new mom, so I don't know if this 'normal', but it's working for us.

I have a three month old that is the same way -- always smiling and happy, and also spits up a lot. Yes, 2 hours is normal, and spit up is normal. My baby is breastfed and she is always spitting up ...sometimes curdled milk, sometimes not. And we used to burp during the feedings, but she'd scream and arch her back too, so we wait to the end. We've talked to the pediatrician about reflux, and she said its not reflux. She's getting enough to eat if she's growing, even after what seems like a ton of spit-up.

If there is a concern, the parents should talk to the pediatrician. It is very possible that he is just very, very hungry, and in that instance some pediatricians will tell them to start cereal early. This usually happens when they eat what we think they should eat, but are always hungry (and making it known by screaming). My niece started on cereal close to three months because she was hungry, and now she's over a year and doing great.

But he sounds very normal, and very much like my little girl :)

Dear R.,

I am an owner of a daycare/preschool and have cared for many babies so I can understand your concern. I think eating every two hours is a feeding schedule for a newborn. The problem is modern doctors insisting that babies are not introduced solids until six months. I say let them go onto a liquid diet for six months and see how they feel. My problem with this is that no two individuals are alike just like no two babies are alike. Some people have a larger appetite than others. So insisting that all babies not eat solids until six months old is ridiculious. In the past i have seen solids introduced especially for children with reflux because the solids will stay down easier than formula. Not much cereal but just a few teaspoons offered will not only fill the baby but help the formula to stay down. I think this baby is hungry. I think if you sit down with mom and dad and ask them to speak with the doctor again and ask if they can try some cereal. I am old school and the mother of a twenty three year old and a nineteen year old who both had cereal by three months old and they are healthy, adults now. Sometimes as moms we have to use our own common sense in raising our children. A doctor can only give you a general guidline to follow. I think we can draw from that but sometimes we have to handle each child in an individual manner. I think you are right for being concerned, just be careful how you present your ideas to the parents. I know sometimes they can take offense. Good luck

i don't know about anyone else, but i always was told 4 hours. it allows them to digest what they ate and then let their stomach rest. otherwise thier little stomach never gets a rest. T.

My son had reflux when he was born. My doctor recommended giving formula every 3.5-4 hrs. DO NOT OVERFEED!! Also, try burping often and keep the baby up in a vertical position for about 20 minutses after each feeding. That should reduce the spitting.
My son was also prescribed medication. He took Prevacid for a couple of months and then stopped. The reflux went away and then came back when my baby was about 6 months old. He was on meds for another couple of months and hasn't had it since. (he's 19 mos now)
Good Luck!

Hi R., Sounds like you have a real good service and it is obvious you love children. I agree that it seems this little one may be eating too much. One of my sons had the projectile vomiting(this was before we heard about reflux) and I was told he was eating too much. He needs the sucking so the pacifier idea is a good one. You may want to try some water here and there. This could also help with pooping(once a day seems too little) I would like to see what the other moms say. I have learned a lot reading the responses. I have been a mom for 42 years and there is still more to learn. Grandma Mary

I swear you are talking about my little boy! He is almost 3 months too and he eats 4 ounces. While at home he wants to eat every 2.5 hours and at my parent's house every 3 hours and at the daycare, every 4 hours. Needless to say, I get very little done. I actually recently posted on this site regarding my son's frequent spitting up. He has reflux as well. We have been giving him Zantax and that has seemed to help. When we used to try to burp him, we would get the same reaction (arching back, screaming). Since we have had him on the med and changed to organic formula (does not have corn syrup in it) he has been a bit better. Less frequent spitting up and does not scream too much. Sometimes not at all. He also will down a 4-ounce bottle and want more.
He takes "cat naps" as well, sleeping only a small amount during the day but does sleep almost through the night. (about 5-6 hours).
Sometimes my son does not have a BM all day, sometimes 3.
Bottom line is that from what I have read in response to my posting, that these are normal behaviors and will disappear eventually. Mind you they also said that it would disappear at about 6-9 months! Hang in there. I have learned to take it day-by-day and somedays are good and some days are not.
Good Luck!

Hi R.,

I have a three and a half month old son who is a super happy boy as well and takes to pretty much anyone. Sounds a lot like the little guy you are working with. My son also eats A LOT like this little guy and sometimes fusses/cries when we are burping him. My son eats 4-5 times a day usually every 3-4 hours. I nurse him in the morning before I go to work, then he eats 3-4 bottles (some formula and some breastmilk depending on how much I am able to pump). His bottle feedings are usually 7 1/2 oz., and we burp him 3-4 times. We find that if we get up and walk with him while burping him it tends to calm him down. He is super curious and wants to check everything out. The more we burp him the less he spits up, as you have found out with the little guy in your care. At the end of his bottle if he is still fussy we too give him his pacifier, and it calms him right down. I am also planning to speak with our perdiatrician about cereal at his 4 month visit the end of this month. Our son sleeps through the night after his 4th or 5th feeding depending.
Hope this information helps!

It sounds like maybe he is being overfed. My second son is similar in that he cries 2 - 2 1/2 hours after eating on the button. We were thinking that he was hungry again, but it is usually something else bothering him - usually gas. And if he is spitting up what looks like curdled milk, that is what is left in his belly from the previous feeding that he hasn't had a chance to digest - nurses in the NICU told us that while he was in there. Try gripe water for gas and keep him upright - he may just be screaming because of an air bubble. Good luck!!

R.,
My son ate every 2 hours, and I had to introduce rice cereal at four months to stay sane. I also found that burping often decreased spit up, but if Andy has been diagnosed with reflux, you might want to ask the parents about using Little Tummys gas relief drops. My friend has a little girl with reflux that would spit up (significantly)several times an hour, and putting a dropper of Little Tummys in her bottle dropped the number of spit ups to just a few a day. Good Luck with Andy. It sounds like he is a great baby with a big appetite. He also might eat a lot because his stomach is upset by the reflux, and he doesn't know the difference between hungry and upset stomach. The Little Tummys could help with this as well.

I hope this helps,
C. Thomson

Hello R.,
If the baby has reflux, he will vomit often - and be hungry often because he is vomiting up his food. If he is not under a doctor's care for the reflux, he should be. There are certain feeding and positioning recommendations, meds, etc - but only the parents can take this step.
It's normal for formula fed babies to poop only once a day (and you may not be seeing the poop since you only see him a certain percentage of the day).
As for solids, the American Academy of Pediatrics recommends not starting solids til 6 months so a doctor who recommends something different is not practicing in accordance with what the best medical research indicates.
Good luck with this new baby in your care. I hope that his parents get this medical issue under the care of a medical professional

Dear R.,
I'm M. I read your story I'm a believer in God and the power of prayer I truly believe in miracles I prayed for this baby Andy he is healed in the name of Jesus amen.
To those of you who don't believe in God I will pray for you. Have a bless day.
M. in Brooklyn, NY

Is he on medication for his reflux? If not he needs to be, and if he is it truly does not seem to be working. I am the mom of 3 kids who all have had reflux - I myself have had it for as long as I can remember. Not every baby responds to the first medication they try. The feeding schedule given is supposed to help with reflux, but it neds to be under control to begin with.

As for solids, they do recommend starting them early (mainly rice cereal used to thicken formula) because thicker liquids and solids stay down far better than thinner liquids in a reflux-y baby.

Hi,

Babies' digestive systems, especially boys', are not fully developed when they are born, they still need to mature, so spitting up is often a result when they eat too much for their small stomachs that can't handle it. If they are spitting up without crying or arching, then they are a "happy spitty baby", probably no big deal. However, arching and crying may indicate reflux, and the baby will need to be put on medication for that. My son had reflux, I hated the idea of the medication, but it helped tremendously, and as he grew his system matured, the spitting up stopped, and I was able to stop the medication -- he was only on it for a few months. I would advise you speak to the parents about this possiblity, and that they should take him to the pediatrician. I'm sure everything will turn out fine.

Good luck, and let me know how it turns out!

D.

My Eric had reflux until he started in on cereal. He was four months adjusted (six months in age - he was 7 weeks early) when I started him on cereal, and that stopped the reflux (and the spitting up) almost immediately. My MD didn't put him on any meds because a) he was gaining weight and b) he was a "happy" spitter - he'd spit up (as much as an hour later), but then go back to being his normal, happy-go-lucky self. He was also a cluster feeder - he would nurse from 7pm-11pm almost every night - until we put him on cereal. The other thing that helped was burping him sitting up on my lap instead of over my shoulder.

HTH

Reflux can last up until ages 12-18 months unless it runs in the family, then it can be lifelong. I agree that you feed kids when they seem ready, my ped wanted me to wait, but once he saw my son was taking 48 oz a day at 4.5 mo and there were no famiy history of allergies, he agreed it was time for food. A word about meds, reflux meds can be really helpful if the MD feels it is necessary. My son was put on the at 12 mo to help with this asthma and his spitting up (which had been after every meal) stopped. I would be more concerned with the projectile vomitting, that could cause this baby to rupture something in his esophagus and be a sign of allergies or something mre serious. I hope the parents would be willing to get it checked out!

R.,
The schedule sounds right - I agree about waiting until 6 months, but pediatricians are different. Mine still says 4 months.

Reflux may or may not disappear soon.

As far as being hungry - that is worse because he's spitting up, and having an extra bottle or two, an ounce apiece, might help with that. Certainly helps to have extra food! :)

Good luck,
M.

I think this may be abnormal and possibly an allergy. He is spitting up and throwing up too often. Without alarming the Mom and Dad, suggest they take him to their Pediatrician and explain the situation. He may be having stomach aches and indigestion as well.

He should be eating at least on intervals of 3 to 31/2 hours and not so often. Have the parents give you a detailed report from their physician. Good luck. Lee

Is the baby on any medication for the reflux? My daughter had the same symptoms...vomiting, spitting up, always wanting to eat. Once we got her on medication she was like a new baby. You can tell she was more comfortable and felt better. The doctor said babies with reflux want to eat often because it pushes the acid back down and doesn't hurt as much. Interesting. My daughter also started sleeping MUCH better once on meds. She even slept through the night( 8-10 hours!!) by 10 weeks. If not on meds the parents should definately look into that. My daughter was on Prevacid tabs and that worked for her. Good luck! It sounds like you are a wonderful caregiver and "Andy" is very lucky to have someone like you watching him!!

It sounds like this little guy is confusing a tummy ache for being hungry. I had a nephew who was like that. Starting cereal did help because it was settling to his little tummy and he stopped spitting up so much. My dr suggests starting cereal at 4 months so there are dr's out there still giving this recommendation.

Yes, it gets better/easier. My daughter had reflux and it does make feeding hard. But, burping will NOT help in the way it seems like you're doing it. You don't pat burp, that just forces the liquid back up. You need to do gentle but firm upward strokes on their back, and then keep him upright for at least 15 minutes after feeding. NEVER feed a reflux baby to sleep. For his age, it is very normal to still want to feed every 2 hours. My daughter was like that too. The books said 3-4, but she was more frequent. I always thought it was because she spit up so much of it, she was hungry faster. For her, after 3 months it got much better. By 6 months it was gone. Hopefully you can hang in there with this little guy! If he'll tolerate an activity seat after feeding, that is an idea too. I also put a crib wedge in my daughter's crib to elevate the head of her crib a bit. That helps with reflux babies too. Laying flat is a problem because the acid comes up the back of their throat and burns it. Is he on any reflux medication? My daughter started it and it took 3 weeks for it to really help because the esophagus takes 2 weeks to heal. It didn't stop the spitting up, it just didn't hurt her as much.

My son had horrible reflux for the first six months of his life. He spit up or vomitted at least 10 times a day. He had no trouble gaining weight so at first the dr. was not concerned. He said to put one teaspoon of rice cereal per one ounce of formula in his bottle and switch to Dr. Brown's bottles because the reduce air. We used the # 3 nipple I think (to accomodate for the thickness).
These things worked a bit but he was still having "episodes" where his reflux would happen and literally take his breath away. It was pretty scarey. We saw a pediatric gastroenteroligist who switched his formula to Alimentim (which was 100% covered by insurance) and put him on medicine. His reflux was much better after that and his vomiting was much reduced. We still had to keep him upright for at least 20 minutes after each feeding and feed him mostly upright though. If I tried to put him down early, he always vomitted.
So, as far as what YOU can do, I'd be sure to kee him upright as much as possible and stick to the schedule the parents gave you. But also, suggest that perhaps they should see a specialist to "rule out" any other medical condition. Left untreated, reflux could do some real damage to his esophagus. And if he has any more serious problems (which is possible) then they would find that out too. And I definitely think it is unusual that he isn't having more frequent bowl movements.
good luck!

Hi,
My now 8 yr. old, had colic and reflux. She only drank 2-3 oz. every 1 1/2 hr until 6 mo. The dr. recommended putting 1 tsp. rice cereal/ oz. I did 1 tsp/2 oz. He explained that she was still hungry but her stomach couldn't hold all that liquid causing the overflow (spit up). Making it thicker held her longer. Try not to put him flat for at least 1/2 hr. I put her to sleep in her bouncy seat or swing. At night, I propped the mattress up with pillows until I purchased a wedge. Good Luck! I hope his family knows how lucky they are to have such a caring mom taking care of their little one.

ihave a 2 week old and he eats 3 1/2 -5 oz every 2 hours as well we did start giving rice due to the fact he gained 2 pds in 4 days (per the doc)the mother might want to talk to the doc about changing his form.there are diff. forms. out there that help protect against spit-up and throw-up.talk to her and find out.good luck

Hmm...my son Matthew went through that. He would chug the bottle in seconds flat and project all over the place afterwards. He even got to the point where he would bite the top of the nipple off because he wasn't getting enough formula fast enough..strange child he was.

Now he's 19, 6 foot, and 195lbs of steel and muscle. His appetite has not changed...lol.

I guess cereal would not be a bad thing to try..just make the hole bigger in the nipple. Maybe he doesn't like the formula. It sounds like he's not getting enough to eat according to his standards...lol.

Good luck,
Nanc