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sooo we have struggle with this on and off LO's whole life (just had a post about it a few days ago at 7mo). It really started at 2.5 mo though and she got progressively worse until she refused food entirely and we had to feed her only when she was asleep. For us we figured out the cause was silent reflux (I.e. she didn't spit up a TON but she did spit up sometimes and also arched a lot when eating) + MSPI. We think eating was hurting her and that was the root cause. But I also believe strongly that my response to her refusal did not make things better (and this was pretty much confirmed by the docs). I was so scared of her not eating we force fed her. We'd trick her into eating by switching the paci in/out with the bottle, try to distract her looking at the fan and sneak a bottle in, and downright force her through crying just to get her to EAT. What I've learned (about my kid anyways) is that she is stubborn. I think the more I pushed the more she refused. And I feel like if we hadn't forced it with her (i.e. let her go a bit longer and actually get really hungry vs. forcing it every 3 hrs) maybe it would've been better.

So I guess my totally non-expert advice would be first to stop forcing it. Especially in the short term. Low ounces for a day or two are not going to seriously harm your kid. (The matrix the nurses told me is that as long as she had a wet diaper every 5-6 hours she was okay in the short term). That could help if she's just going through a fussy phase. I'd also try a faster flow nipple. When we've gone through less serious periods of refusal that has been a solution for us.

And I'd also look for signs of reflux or allergy to talk to your doc about. If you see arching while eating, crying after starting to eat/right after eating, a lot of spitting up or vomiting, any blood or mucous in her diapers... definitely mention those to your doc.

Good luck! Sorry, eating issues are the worst

@Pumpkin Pie: Our first doc? Not much, unfortunately. Which is why we switched. It was a lot of drama honestly. I suspected reflux based on her symptoms and made an appt and they stuck me with a PA who wrote an rx for zantac and had no advice. I was freaking out because it was like noon when I was in for the appt and I'd only gotten LO to eat 4 oz since bedtime the night before and she was all "oh really? well hopefully this helps." sigh.

Then it did not help and things just kept getting worse. I called the doc and a nurse called me back and I asked if I should maybe try a hypoallergenic formula and elimination diet (I was combo feeding bc I had low supply) and the nurse said no it wasn't an allergy. And she said they weren't concerned bc LO's weight was okay. But this had only started a week prior so her weight had not had time to drop, plus we worked our ASSES of fighting with her 8 times/day to get her to eat. I knew it wasn't normal and they just didn't take us seriously. So I switched docs to one that I had heard was good with eating issues and she did take me seriously and her first suggestion was to try nutramigen + elimination diet. I did that and within 4 days my baby started eating awake again. Within 2 weeks she was eating willingly for every meal (although we still had to work a bit for it, she had a lot of requirements-- but if we did all the things right she ate). The doc had said that her later issues were behavioral based on her learning that food = pain and we would have to see if we could work her back to eating normally. And if we couldn't she'd send us to therapist to work with her on eating.

Nipple flow? Have you sped them up?

@Pumpkin Pie: might be worth trying a faster nipple just to see. I can't remember when we switched the flow the first time, I think it was maybe close to 4 months but at that point we went from level 1 to level 3 because level 2 seemed the same as 1 and I figured what the hell, try level 3. We just switched to level 4 today with our 7mo lo even though the package says 9+ mo. Feeding babies is definitely more art than science!

@Pumpkin Pie: My story was similar to Mae's.....My LO had trouble from the start latching correctly and fussing/screaming at the breast, so I ended up switching to EPing by 3 months, but at 3 months she started refusing the bottle as well. She wouldn't scream at the bottle, she just wouldn't take it into her mouth.

We had many, many days of trying to get her to eat all day, and we would only get 12-17 oz total into her, and her % started dropped. 50% at 1 month, 36% at 2 months, 28% at 3 months, 26% at 4 months...sometime around 3 months her bottle refusal was at its' peak and like Mae, I asked my doctor if it could be an allergy and the Ped said no--that my LO wasn't displaying signs (like crying all the time. She was a very calm baby, except when I tried to get her to eat).

However, about a week after she turned 3 months, I noticed teensy tiny streaks of blood in her stool and I called the Ped back and insisted on bringing her diapers in for a blood test (it's a super simple test they do by smearing some poop onto a little testing kit)--and sure enough, LO had blood in her stools.

So at that point, my doctor did suggest eliminating dairy. However, I'd read enough at that point to know that often, infants are intolerannt to both dairy and soy and I figured I would rather just eliminate both for 2 weeks and see if there were any improvements.

And there were! Within 3 days of me eliminating, LO drank a 4 oz bottle STRAIGHT. She hadn't done that in almost 6 weeks at that point. I remember crying and calling my husband at work, I was so relieved and excited.

After I eliminated, it because *so clear* that LO had a major intolerance. After a month or so of eliminating, my doctor still seemed skeptical and suggested I try alimentum for a trial 3 day period (I think she didn't quite believe that LOs issues were MSPI and not "just a stage") so I pumped while giving LO Alimentum, and her diapers were like, full blood. SO MUCH blood.

I was kind of angry at the doctor for suggesting alimentum (since it's not 100% dairy free) but I also felt vindicated, so that was nice. =) LO started drinking 30 oz a day--sometimes more!--and jumped back up to 40% by the time she was a year old.

I ended up staying dairy and soy free (not even soy oil or lecithin) until LO was 11 months, then I started slowly adding soy oil back into my diet--then last, soy lecithin right before I stopped pumping when LO was 13 months).

She is now 17 months and *still* can't tolerate dairy or forms of soy other than soy oil. She can have very small amounts of soy lecithin but gets an upset tummy if she eats a lot of it.

In some ways, after I got used to eating MSPI style, I realized it was kind of a good thing--I'm very lazy when it comes to cooking, but LOs intolerances have forced me to give her almost totally unprocessed foods and she's a very healthy eater now. She happily eats salmon, broccoli, peas, green beans, roasted chicken, roast beef, all fruits, eggs, oatmeal---she's still not a fan of carbs (probably associates them with stomach pain since they usually have soy or dairy).

hope that helps! Don't be afraid to try an elimination diet in spite of your doctor. I think 2 weeks of eliminating can't hurt--you'll either see a difference or you won't and you can go from there.

@Pumpkin Pie: sometimes the blood is totally invisible.

@Pumpkin Pie: I wouldn't say it was sudden, but it happened gradually. When I was trying to BF, LO definitely seemed to prefer to bottle and would just gulp down a bottle after I finished trying BF her.

But some time after 2 months, she started eating less and by 3 months it was a full-blown major issue. I literally would spend all day (and night) trying to get her to have a few ounces. My pediatrician was really unhelpful and would be like, well, as long as she gets 12 oz a day, she won't dehydrate herself. If she goes below 12 oz, you can take her to the emergency room for rehydration--but no help on what was causing the issue.