Newborn Drinking Less: 5-Week Worries?

It is common for new parents to worry about whether their baby is drinking enough milk. While each baby's feeding needs may vary depending on their weight, age, and other factors, there are some general guidelines to keep in mind. During the first month, babies need to eat 8-12 times a day, or about once every 2-3 hours. Breastfed babies may feed every 30 to 90 minutes and up to 15 times a day. After the first few weeks, newborns will start to feed about every 3-4 hours. By the time they are 5 weeks old, babies may drink about 4-5 ounces every 3-4 hours. It is important to pay attention to your baby's signals of hunger or fullness and to consult a doctor if you have any concerns about their feeding.

Solid foods decreasing appetite for milk

It is normal for newborns to drink less at 5 weeks as their appetite increases and they become more vocal about telling you when they are hungry.

Introducing solid foods to your baby's diet can decrease their appetite for milk. It is recommended that babies are given solid foods when they are around 6 months old. This is because, by this age, they need more energy and nutrients than milk alone can provide.

When first introducing solid foods, it is advised to offer your baby about 1 to 2 tablespoons of food twice a day. It is important to remember that breast milk or formula should still be your baby's primary food source for their entire first year. Babies should still drink about 4 to 6 ounces per feeding when they are 4 months old. According to the American Academy of Pediatrics (AAP), once they turn 6 months old, they may take up to 8 ounces every four to five hours.

If you notice your baby is not breastfeeding as often after introducing solids, it is recommended to offer breast milk before feeding them a meal. This is because most of their calories should still come from breast milk or formula at this age.

Insufficient bottle teat size

Slow flow teats are generally recommended for newborns, while they are still learning how to feed. Once the baby is older and more used to bottle feeding, a faster flow rate can be introduced. However, some babies prefer to stay on slow flow teats for many months.

Signs that your baby's teat flow is too fast include:

• Gulping, coughing, or gagging during feeding
• Excess milk dripping out of their mouth

If your baby is experiencing any of these issues, you may need to switch to a slower flow rate teat. It is important to follow your baby's feeding cues and ensure they are comfortable and getting enough milk.

In addition to flow rate, the size and shape of the teat can also impact a baby's feeding experience. Teats come in a range of shapes and sizes, and it is important to choose one that is suitable for your baby's age and feeding needs. For example, wider teats may be recommended for babies who are combining breast and bottle feeding, as they can help reduce nipple confusion.

It is recommended to replace bottle teats regularly, typically every two months or at the first sign of damage or weakness.

Baby chooses to avoid feeding

It's normal for newborns to drink less at 5 weeks, as their appetite and feeding schedule will change as they grow. In the first month, babies need to eat 8-12 times per day, which is about once every 2-3 hours. Breastfed babies may feed every 30-90 minutes and up to 15 times a day. After the first few weeks, newborns will settle into a more predictable feeding routine and go longer between feeds.

If your baby is choosing to avoid feeding, there could be several reasons. Firstly, it's important to recognise the signs that your baby is hungry. These include:

• Moving their head from side to side
• Opening their mouth
• Sticking out their tongue
• Placing their hands, fingers, and fists in their mouth
• Puckering their lips as if to suck
• Nuzzling against the mother's breast
• Showing the rooting reflex (moving their mouth towards something that's stroking or touching their cheek)

If your baby is displaying these signs but is refusing to feed, there could be a few explanations. One reason could be that they are not hungry. Crying is a late sign of hunger, and babies may cry for other reasons such as being sick, tired, too hot or cold, in pain, or having colic. Additionally, your baby might be going through a growth spurt, which can cause them to be hungrier than usual.

If your baby is refusing to feed, here are some things to consider:

• Talk to your doctor: If you are concerned about your baby's feeding, especially if they are very small, not gaining weight, or were born prematurely, consult your doctor. They can advise you on the appropriate steps to take and address any underlying issues.
• Recognise fullness cues: Babies will give signals when they are full, such as turning away from the bottle or breast, sucking with less enthusiasm, or falling asleep during a feeding. Respect your baby's fullness cues and don't force them to finish the feed.
• Respond to hunger cues: Feed your baby before they get upset and start crying. Offer feeds when they display hunger signs and follow their hunger cues.
• Adjust the feeding schedule: If your baby is still hungry after a feed, they may be going through a growth spurt. Continue to feed on demand and increase the amount of formula or breast milk as needed.
• Introduce solids: If your baby is around 4-6 months old and meets other developmental milestones, you can introduce solid foods in addition to breast milk or formula. Consult your paediatrician for guidance on when and how to start solids.
• Check for other issues: If your baby is fussy after feedings, wets fewer diapers, or would rather sleep than eat, there could be an underlying issue. Consult your doctor to rule out any medical concerns.

Baby is too tired to feed effectively

It is common for newborns to not feed much in the first 24-48 hours of their birth. However, if your baby is too tired to feed effectively, there are several things you can do to help them.

Reasons for Baby's Tiredness

Firstly, it is important to consider the reasons why your baby is too tired to feed. In the first few days, some babies are sleepy or uninterested in feeding, especially if they are small, the labour or birth was difficult, or if pain relief medication was administered during labour. Jaundice or an infection may also be factors. Additionally, your baby may be sleeping to conserve energy if they are not getting enough food or if they are apart from you for long periods.

What to Do

• Ensure your baby feeds at least 8-12 times in 24 hours, including at least once at night.
• Encourage active nursing on the first breast, watching and listening for signs of swallowing.
• Use breast compression to keep your baby nursing actively.
• Offer the other breast in the same way, switching back and forth several times if it helps your baby stay awake and feed.
• Encourage cluster nursing whenever your baby is more alert.
• Give expressed milk if they are not feeding well.
• Keep your baby close by, day and night, so they don't sleep too long and you don't miss their feeding cues.
• Dim the lights and keep your surroundings quiet and peaceful.
• Maintain a room temperature of around 18°C, or undress your baby slightly if the room is warm. Being too hot can make a baby sleepy.
• Unwrap any blankets.
• Try biological 'laid-back' breastfeeding positions, where your baby lies on your body with their chest and tummy against you as you recline at about 45 degrees.
• Hand express your colostrum and give it to your baby by syringe, spoon, dropper, or cup.
• Aim for lots of skin-to-skin contact to soothe your baby and give them the opportunity to feed.
• Find a comfortable feeding position with the help of your midwife.
• Get your baby ready for a feed by massaging their skin, changing their nappy, and expressing a little milk for them to taste.
• Ensure you are getting enough rest, eating a balanced diet, and staying hydrated.

When to Seek Help

If your baby is consistently gaining less weight than expected, or they haven't regained their birth weight by 14 days, seek skilled help to assess whether they are getting enough milk. Additionally, if your baby is too sleepy to feed effectively, speak to your midwife or health visitor for advice and guidance.

Baby has poor appetite

It can be concerning if your baby is not eating enough, but it's important to remember that a baby's appetite can change from day to day and week to week. There are many reasons why your baby may have a poor appetite, and in most cases, their appetite will return to normal without any intervention.

Possible Causes

• Teething: The pain and discomfort of teeth coming through can cause a loss of appetite.
• High fluid intake: Drinking too much water or juice can fill up your baby and decrease their appetite.
• Infections: Viral and bacterial infections can cause pain and rapid breathing, making it hard for your baby to eat and sleep.
• Heat: Excessive heat can cause crankiness, rashes, and a decreased appetite.
• Allergies or intolerances: Allergies or intolerances to certain foods can cause bloating, itching, vomiting, diarrhoea, and loss of appetite.
• Sore throat: A sore throat can make swallowing difficult and reduce appetite.
• Growth: Babies grow at their fastest rate from 0 to 6 months, then start to slow down. So, an older baby may eat less simply because they don't need as many calories.
• Full tummy: Some foods take longer to digest, so your baby's tummy may be full, causing them to refuse food.
• New foods: When introducing solid foods, your baby's body needs time to adjust, and they may eat less as a result.
• Worm infestation: Worm infestations can cause appetite loss, weight loss, and restlessness in infants.
• Illness: A fever, cold, cough, or digestive problems can cause a loss of appetite, which should return to normal after recovery.
• Vaccinations: Some vaccinations can reduce appetite due to increased temperature and pain.
• Excess fluid: Too much water or juice can fill up your baby and leave less room for milk or food.
• Food intolerance: Intolerance to foods like eggs, milk, soy, or peanuts can cause itching, bloating, diarrhoea, and low appetite.
• Constipation: Constipation can reduce appetite.
• Anaemia: Low iron levels can cause loss of appetite.
• Over-tiredness: Too much playtime can tire your baby out, reducing their appetite.

When to See a Doctor

• If there is no improvement in your baby's appetite after a week.
• If their loss of appetite is accompanied by a rash, fever, or changes in their stool (diarrhoea or constipation).
• If they are losing weight.
• If they are excessively irritable or inconsolable.
• If they have not gained weight in six months.
• If they are gagging on or vomiting their food.
• If you suspect dehydration or a feeding disorder.

How to Treat Poor Appetite

• Be patient and provide a variety of age-appropriate food choices.
• Cut out juice and other liquid calories.
• Offer foods that may increase appetite, such as cinnamon, ginger, or mint.
• Ensure adequate gaps between meals (3-4 hours).
• Create a calm and welcoming mealtime atmosphere with minimal distractions.
• If your baby is over 6 months old, ensure they are getting about 16 ounces of whole milk per day.

Frequently asked questions