Poor feeding in infants is used to describe an infant with little interest in feeding. It can also refer to an infant who is not feeding enough to receive the necessary nutrition required for adequate growth. Poor growth associated with lack of feeding can lead to a separate condition called failure to thrive.
Poor feeding is caused by a variety of incidents. It is different from picky eating, in which a baby may reject one form of milk for another, or a toddler may refuse certain foods. No matter what the precise cause of poor feeding, undernutrition is a top concern. In fact, the World Health Organization (WHO) estimates that 45 percent of child deaths are related to undernutrition.
It is important not to dismiss poor feeding as something that will improve over time. This is a critical point in your child’s life, and missing key nutrients can lead to physical and cognitive problems.
One of the most common causes of poor feeding is premature birth. Premature babies are typically poor feeders because they often have not yet developed the skills needed to suck and swallow milk. Still, feeding usually increases as the baby grows. If your baby was born prematurely but still has feeding issues after leaving the hospital, it’s important to call your pediatrician right away.
Other causes include congenital conditions such as herpes and jaundice, and infections such as viral gastroenteritis. Once these conditions are treated, poor feeding usually subsides.
Poor feeding can also be caused by serious conditions, such as Beckwith-Wiedemann syndrome. This is an overgrowth syndrome that causes infants to be particularly large and grow at a considerably fast pace. It affects an estimated 1 in 13,700 newborns worldwide. Other serious conditions include:
- congenital hypothyroidism: occurs when the thyroid fails to develop or function properly
- hypoplastic left heart: rare condition that occurs when the left side of the heart fails to develop properly, and is unable to pump blood to the body
- infant botulism: can occur when an infant ingests the Clostridium botulinum bacteria, which produce a dangerous toxin in the body that can affect breathing and eating
- Down syndrome
Less Serious Conditions
Other cases of poor feeding aren’t related to a congenital condition at all. Temporary illnesses can make feeding uncomfortable (and even painful) for infants. Common ailments that get in the way of feeding include:
- ear infections
- coughs and colds
When in doubt, it’s always best to double check with a pediatrician. You don’t want to assume a minor illness when in fact there could be a serious underlying condition.
Feeding difficulty is a serious matter. When accompanied with other symptoms, emergency care may be required. Seek immediate medical attention if your baby is showing any of the following signs:
- has not fed in over four hours
- has a fever of over 100 degrees F
- is vomiting after feeding
- is vomiting blood
- has a persistent and worsening cough
- is crying constantly
- has bloody stool
- is wheezing
- is becoming unresponsive to touch
Poor feeding that is caused by an infection will normally stop when the infection is treated.
Treatment is the same for other causes of poor feeding. This can involve changing the feeding schedule to consist of smaller, more frequent meals. It can also involve switching feeding methods from breast to bottle. If a milk-based intolerance is suspected, your doctor will work closely with you to find a formula that suits your baby. If you have been formula feeding your baby, your doctor may ask you to try breast-feeding to see if your baby feeds better.
While serious cases of poor feeding require prompt medical care, other cases can be resolved at home with the advice of a pediatrician.
If your baby is breast-feeding, try to avoid:
- exercise right before feedings (this can lead to a buildup of lactic acid in your milk)
- eating a lot of different foods you don’t normally eat — these can show up in your milk and turn your baby off
- medications that can enter breast milk
- applying lotions and other skin products to your breasts
- high levels of stress — this may also make your milk taste differently
Other considerations may concern formula feeding as well as infants who have started solid foods.
While breast-feeding is the preferable method of nutrition for infants recommended by health agencies such as WHO, it is a fact that not all babies are successful with this method. If your infant doesn’t seem to latch on despite repeated attempts, you may consider talking to your doctor about formula feeding.
Despite feeding with formula, you may still be able to try breast-feeding. The key is that your baby gets adequate nutrition.
After 6 months of age, your pediatrician may encourage you to introduce solids to your baby. While solids shouldn’t replace breast milk at this phase of your child’s life, most infants require additional nutrients around the 6-month mark. Examples include rice cereal, pureed fruits and vegetables, and infant yogurt bites.
Introducing solid foods can be exciting for both parent and child. However, some infants don’t take to solids as readily as other babies. This can be alarming, but the issue may be solved by:
- mixing cereal with solid foods
- offering solids in small increments
- only giving solids two to three times a day
- starting with one food at a time, and then introducing others as your baby gets used to solids
When an infant doesn’t like solids, it’s easy to jump to the conclusion that they are a “picky eater.” However, this phase doesn’t usually start until your baby becomes a toddler.
When your baby is eating poorly, it’s easy to get stressed out. This is especially true for new mothers who may not yet know the differences between serious conditions and minor feeding problems. Remember that stress can worsen feeding problems; not only does stress cause breast milk to taste bad, but your infant is also unlikely to respond to your attempts at feeding if they sense something is wrong.
Managing your stress won’t treat all causes of poor feeding, but it can help in many cases. It’s difficult to find time for yourself during this busy stage of your life — even a few minutes a day can help. When you feel stress coming on during feedings, take a moment for some deep breathing beforehand.
Poor feeding in infants can lead to serious issues such as malnutrition and stunted growth. It is essential that babies feed and digest the necessary nutrients to thrive and develop. Any infant who is feeding poorly should be taken to a pediatrician for evaluation. After a proper diagnosis, treatment may be necessary. In other cases, poor feeding can be resolved through refined techniques and perseverance at home. If you suspect feeding difficulties may be causing other issues, call a doctor right away.