Feeding Problems in Infants

Newborn babies need few things: food, sleep and protection. But feeding your newborn can be more complicated than you anticipate. Both breast-feeding and bottle-feeding babies sometimes have problems maintaining proper nutrition and healthy growth.

The Facts

Newborn infants need to eat regularly and frequently. Their fast growth rate--an average of four to seven ounces a week during the first month--means they need to take in a lot of nutrition, but their small stomachs mean they can only eat a little at a time. Problems in infant feeding need to be diagnosed quickly before they escalate and lead to dehydration, low weight gain or failure to thrive.

Types

Most breast-feeding problems are related to the baby's latch, or the way the baby attaches its mouth to the breast. Latch problems can lead to the baby not getting enough milk or to the mother experiencing discomfort. An infant can also have physical abnormalities, such as a cleft palate or tongue-tie, that create breast-feeding difficulties. Bottle-feeding problems include problems with air and nipple flow in the bottle due to incorrect usage and allergies or intolerances to formula. Both breast-fed and bottle-fed babies can also experience problems with thrush, reflux, teething and poor weight gain.

Identification

The most obvious way to identify feeding problems is by watching a baby's weight gain and diapers. Newborns should gain weight steadily and should have at least six to eight wet diapers per day. Most newborns will also have at least one dirty diaper per day, but breast-fed infants may go as long as 10 days without a dirty diaper without having problems.

Discomfort can also indicate a feeding problem. If a baby seems very uncomfortable or has allergy symptoms such as bloody stool, diarrhea or dry skin, this can indicate an allergy to formula or to something in the mother's diet. White spots in the mouth can indicate thrush, which can make sucking painful. For a breast-feeding mother, any nipple pain during nursing indicates a problem. A clicking sound while the baby is nursing or a lack of swallowing while breast-feeding can both be indications of a poor latch, or the attachment of the baby's mouth to the breast.

Effects

Feeding problems in infants can lead to poor weight gain and failure to thrive. They can also cause discomfort and fussiness in babies, resulting in frequent crying and sleeping problems. For mothers who are breast-feeding, problems often result in early weaning from the breast. Most feeding problems can be overcome with the right treatment, but if a problem is misdiagnosed or not properly treated, it will often result in the mother stopping breast-feeding earlier than she had planned.

Prevention/Solution

You should have any suspected feeding problem evaluated by your pediatrician as soon as possible. For a breast-feeding baby, have the baby's latch evaluated by a lactation consultant. Poor latch can be treated with practice and with tools such as nipple shields. Sometimes poor latch is caused by physical problems such as a tongue tie, or short frenulum. The frenulum is the membrane that attaches the bottom of the tongue to the mouth. If it is too short, it can make it difficult for the baby to thrust its tongue forward enough to get a good latch. Sometimes, this condition needs to be treated by a simple surgery in which the frenulum is clipped to allow the tongue to be more mobile. Thrush is treatable with several over-the-counter and prescription medicines; if your pediatrician diagnoses your baby with thrush, he can advise you about the best treatment. If your formula-fed baby seems to have a milk allergy, you can switch to a soy- or rice-based formula. For problems with reflux, burp the baby frequently, keep the baby upright while feeding and don't overfeed.