Common Formula Feeding Problems

Fussiness

If you’re feeding your baby on demand (which many experts recommend), you should take your cue from early signs of hunger (smacking and sucking lips, opening mouth, nuzzling into breast, rooting) and not wait for your baby to cry, which is a late sign of hunger, in order to feed him. If your baby is too hungry, he may grow agitated during feedings.

To get him to calm down, gently rock or pat him during feedings; place the bottle on his lips, tickle him with a drop or two of formula, and allow him to open his mouth to take in the bottle; hold him close, with his head slightly elevated, and gently press his cheek with your hand while he’s feeding; and minimize distractions-or, if distracting him works better, feed him in front of a mobile or nightlight that changes colors or creates patterns. If the fussiness continues for longer than, say, 20 minutes, take a break, play for a few minutes, and then try again. If he’s not showing an interest in taking his bottle, don’t force it. Just try again when he’s ready.

If your baby misses two or three feedings in a row, however, consult your pediatrician.

If your baby is fussy after feedings, that could be a sign that he’s swallowed air and is feeling discomfort from gas. Try burping your baby. That may help.

Spitting up or vomiting after feeding

If your baby spits up or vomits regularly after feedings, it may not be anything to be concerned about. Babies are prone to reflux (when the contents of the stomach re-enter the esophagus) because their stomachs are so small and can be distended when they are full and because the immature valve in the lower esophagus may not yet tighten up properly to prevent food from re-entering the esophagus during or following feedings.

If your baby spits up or vomits occasionally or even regularly but is otherwise content, shows no signs of discomfort, doesn’t seem to have any trouble breathing as a result of the spit-up or vomit, and is growing steadily, you probably don’t have anything to worry about. The reflux will generally abate sometime in the first year – often when a child is about 4 or 5 months old – on its own, without treatment, as the lower esophagus valve matures.

However, if your baby’s vomiting appears to be causing him discomfort and pain, such as heartburn; breathing problems, such as choking, gagging, coughing, wheezing, or even pneumonia caused by aspirating the stomach contents into the lungs; or is not growing properly, due to vomiting-related nutrition loss, your baby may have Gastroesophageal Reflux Disease (GERD), and you should speak to your pediatrician about diagnosis and possible treatment.

You might find that your baby spits up and vomits less if you keep him in an upright position for about 30 minutes after each feeding, allowing gravity to aid digestion. Also refrain from putting any pressure on the stomach: no waistbands, no tight seatbelts, etc. And make sure that you’re not overfeeding your child during feedings. If your child gives you an indication that he is full, don’t force him to finish the rest of the bottle.

Constipation

If you suspect that your baby is constipated and you’re using a powdered or concentrated liquid formula that needs to be mixed with water, make sure that you’re using the amount of water and formula specified on the formula label. Adding too much formula or too little water, could make your baby constipated – or even dehydrated. If your baby is less than 8 weeks old and hasn’t pooped (or peed much) in two or three days, if his poops look hard and dry and are difficult for him to pass (or if he has liquidy stools), or if his weight gain has slowed, you should talk to your pediatrician. He or she may recommend switching formula – and will be able to let you know if something else might be going on with your baby.

When your baby is constipated, exercise and massage are two ways to help resolve the issue.

If your baby has not yet begun to crawl, try lying him on his back and gently moving his legs in a circular, forward motion, as if he’s riding a bike. If your baby has started crawling, encourage him to get moving.

You can also place your fingertips about three finger-widths below your baby’s bellybutton and press gently for about three minutes.

Formula allergies

Some babies are allergic or sensitive to the cow’s milk protein that is found in most formula – and about half of those babies are allergic or sensitive to soy-based formulas as well.

Signs that your baby might be allergic or sensitive to formula include:

• Rash
• Hives
• Eczema (patches of skin that are dry and flaky)
• Vomiting

More subtle signs include:

• Continued crying or fussiness after feedings
• Excessive gassiness/swollen, tight abdomen
• A persistent rash around baby’s rectum
• Hard and dry or extremely loose, watery stools (also smelly)
• Excessive spit-ups

If these symptoms occur, speak with your child’s pediatrician to discuss switching to a different formula.