Feeding Changes at Around 4 Months of Age

I often get consult requests when a baby is around 4 months old and parents have concerns regarding sudden breast refusal, supply issues &/or poor weight gain.

In most cases these perceived issues are due to developmental changes, with baby actively choosing to interact with the world now, rather than feeding.

In the early months, when a baby wakes s/he will go to the breast and will instinctively suckle without interest in anything else going on in the room.  At around 4 months babies become more interested in engaging with the outside world and practicing new skills. They will frequently choose to interact and play when they wake, rather than feeding at the breast.

When they refuse the breast, or jump on and off it, mothers can naturally interpret this as a supply issue – believing baby is frustrated with low supply, rather than simply being uninterested or distracted.  A decrease in intake/weight can however occur if breastfeeds aren’t offered at other times when baby is less distracted and would be more interested in feeding.

So how do you manage these changes?

• When baby wakes you can offer breast, however as soon as they begin fussing/pulling away cease feed and put them on tummy for play time (or go about other activities if out and about). If they are happy to be put down and don’t grizzle they are not hungry.
• Allow baby to play until they show tired signs (become disinterested in toys, grizzly, wiping eyes etc).
• Where possible, once baby shows tired signs take them to a quiet place with minimal distractions to breastfeed. Usually at this time baby will settle in for a longer relaxed feed.

Other things to be aware of:

• Depending on a baby’s temperament, they may be more highly distracted during the day at different phases. Some babies will barely feed at all during the day when they are going through developmental leaps, and mums need to breastfeed them more at night when they are sleepy and less distracted.
• Expected weight gains decrease at around 3 months and again at around 6 months.  Where babies put on an average of 200g per week in the 1st few months, an average gain after 3 months is about 100g per week. Often parents are unaware of this change and are unnecessarily concerned with the decrease in gains.
• Sometimes concerns are legitimate with supply issues or other health concerns present. It is always worth having an IBCLC check baby and feeding. They can manage most concerns and refer to other health professionals where necessary.