9 month old won't take liquids at daycare

I have a nine month old that I am breastfeeding. He is in daycare for a good portion of the day. I returned back to work when he was four months, and he has refused the bottle all along. I waited until he was six months before starting solids. While he is at daycare he drinks only a MINIMUM amount of liquids. (Approximately 2-4 ounces of breastmilk and about 2 ounces on the average of juice/water mix ALL DAY!). He is very strong willed and will wait to nurse when I return home from work.

He will be one in December, and I am VERY concerned about how I will be able to wean him since he is not taking much liquids from sipper cups/regular cups. I just can NOT imagine that he will drink anywhere near the recommended 16-24 ounces daily! YES! I have tried all nipples, cups, etc. on the market! I have also brought him into the pediatricians office on several occasions and have and am regularly attending La Leche meetings for support! However, no advice has helped yet!!

Following is a typical day feeding schedule:

NOTE: Each cube is approximately equal to 2 Tbsp

4:00 am - nurse (I leave forwork at 5:00 am)8:30 am - cereal(about 3 Tbsp with 1 tsp bran)mixed with 1.5-2 ounces of milk2 cubes of prunesOFFER: additional 1 ounce ofbreastmilk in a sipper topbottle11:00 am - rice soup (made daily withpork or chicken or beef.  I donot feed him the meat... I usethe meat to flavor thesoup... like a broth.) 2-3 cubesof fruit (pear, peach,apple)OFFER: 2 ounces of breastmilk(rarely drinks this!)2:30 pm - 4 cubes of vegetables combination(sweet potato, yams, peas, carrot,squash)  2 ounces of breastmilk(usually mixed in to thinvegetables)Juice offered throughout the day(50/50  juice/water combination)6:00 pm - nurse8:30 pm - nurse9:30 pm - rice soup10:30 pm - nurse

CRAZY schedule I know... but this is the only way that I can ensure that he gets some liquid (mainly breastmilk)in him for the day. FYI: He generally nurses for 10 minutes on each side.

He has NEVER indicated hunger to me (He was a VERY SLEEEEPY baby from the beginning). Thus, I put him on a 3-4 hour feeding cycle since he was born.

NOW...I offer him finger foods, but he is definitely NOT interested in putting anything in his mouth. He can pick up a cheerio... and gets GREAT pleasure at this... but he will hold it in his fist for fun. He will also hold a cookie, but will not put it into his mouth. I have to take the cookie and offer it to him, and only then will he take a bite.

I am really concerned that he will not intake much liquid when I plan to wean him. Any suggestions?? I would rather not wean him "cold turkey", but substituting a feeding with a bottle, sipper cup or cup is really not an option. He REALLY refuses all! He has become expert at blocking anything coming towards him! (He will make a good hockey goalie some day) :-) ANY suggestions that you provide will be GREATLY appreciated. How to wean? How to get liquids in him???

I endured to get the nursing relationship going during the first two months of his life (rough)... and now I am in this predicament. (hmmmm...)

Also.... since I have been pumping at work... I have accumulated over 700 ounces of frozen breastmilk since he is not drinking much during the day. I have not offered formula since I am hoping to make it through his first year with breastmilk alone. Do you think he might take to the formula during the day instead of the breast milk???? Any suggestions as to what I should do with the back up supply? I plan to use it when I do wean... but by then... hopefully he will be able to transition into homogenized milk.

Well... this is my situation. A very complicated one at that. Do you think Alex is getting enough to eat during the day? He has gone from 75% to 50% and now down to 25% in weight in his last check up. BUT... his height is 90%. He weighed 19.2 lbs and was 29 3/4 inches a couple of weeks ago.

My main concern is that he gets enough food (liquid and solid) to ensure that his brain develops normally. Strange... but I worry about that!!!

Thank you for listening :-)
mhuie

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ABOUT THE EXPERT

Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Mhuie,

Thanks for that detailed description of your concern for your son's diet. First of all, although it is hard to quantify, it seems like he is getting plenty of liquids in his diet. Remember that the soup he eats is liquid, and fruits and vegetables are also mostly water, so from his solids he is getting a lot of fluids. It is not unusual for a nine month old to not be too adept at a sippy cup. You need to be patient and persistent with it. He will gradually take more and more from it. Usually fluid and food intake go down during the weaning process, but should pick back up again.

When a baby is weaned you need to be sure that whatever nutrition he is no longer getting from breast milk he is getting from his solid foods. Your son may be losing ground in the weight department because his solid foods diet is not substantial enough.

From reviewing the information you have shared, here are my insights. Most importantly, he is not getting enough iron in his diet. You need to address this issue first. Iron deficiency anemia can result in decreased hunger and sub optimal, physical growth and cognitive development. (Important for that brain development you are worried about, and it is a legitimate concern). Because he is not drinking an iron fortified formula, he should be eating two good servings a day of an iron fortified infant cereal.

Iron absorption is greatly impacted by inhibitors and enhancers. Inhibitors of iron absorption include bran. Therefore, you should stop adding the bran to the cereal. Serve the prunes at some other time during the day when he is not eating the iron fortified cereal. Iron availability is enhanced by the simultaneous consumption of foods high in ascorbic acid (vitamin C). Instead of serving the prunes, serve a baby puree applesauce or other fruit puree that has been fortified with vitamin C.

At night time, when he is home from day care, have him come to the dinner table with you to eat a bowl of iron fortified cereal. You can work your six pm nursing around this. Having him sit at the table with you will give him the opportunity to see you and his dad eating dinner (i.e. eating solids). Imitation is a great teacher. You can offer him some finger foods and a sippy cup at the same time. Let him be a part of a stress free social environment at the family dinner table. The fact that he is at day care will eventually help him learn to eat solids. As he sees other children eating, he will catch on to the idea.

The second thing to address is the caloric content of his solid foods. Broth with rice, fruits and vegetables are all very low in fat and calories. They are also very low in protein. Try substituting some foods that contain more fat and protein. Those two nutrients are high in formula and breast milk, and during the weaning process are the nutrients that will need to be replaced.

I suggest you substitute a pureed meat (or alternate protein) dinner for the rice soup. It will give him many more calories and protein, and will help him gain back some of that weight. You can either make your own, or buy already prepared baby food. He is ready for egg yolk-- which is high in protein and fat. Whole milk yogurt is another great food for a nine month old. Unless you have a family history of milk allergies there is no reason why he cannot have some dairy products in his diet.

You can make a pudding using some of your stored breast milk and some egg yolk. Here is a recipe: 1 egg yolk, 1/4 cup milk, 1/4 tsp vanilla extract, a little sweetener if you must. Blend ingredients together. Pour into a four ounce custard cup. Set cup in oven proof pan, pour hot water into pan until halfway up the side of the cup. Bake in a preheated 350 oven for 30 minutes or until set. You can also make a rice pudding using milk and egg yolk. To make a more nutrient dense meat meal, cook together ground beef, rice, and broth until rice is tender. Blend in a food processor or blender until smooth. Serve, and freeze the extra in cubes for later use. In short, look for ways you can add more nutrient dense foods to his diet. Continue to include fruits and vegetables.

I am sure I cannot give you better advise on weaning than La Leche can. However, I am wondering if you need to be overly concerned with total weaning by age one. Of course if you are anxious to, you should, but if you are okay with continuing for a while longer, there is not need to force the issue. You would probably, for convenience sake want to cut back to a bedtime and morning time nursing and eliminate the ones in between. One way to nurse without going cold turkey is to gradually reduce the amount of time you allow your son to nurse, at each nursing, until your milk supply at that time diminishes to nothing. Just be aware as you cut back on breast milk, that somewhere else you have added in some food or milk to make up for that loss.

Alex will not starve himself, but he may eat a reduced amount if he gets involved in a power struggle over food. It is up to you to make the feeding relationship as stress free as possible. Rather than forcing a sippy cup, just make it available. Have it on his high chair tray night after night. Mild praise is appropriate if he drinks from it. If he throws it off, put it on the table, just out of reach, but in sight. Do not offer to nurse at the end of the meal as he will be smart enough to learn to hold out for it. Keep nursing times away from meal times. Nursing can and should still be an important part of his diet, but he will also learn that solids are an important part too, and a separate part.

Finally, realize that Alex is his own person, on his own individual schedule. While some nine month olds have long since self weaned, others are still enjoying the closeness of nursing. Eating development is just like learning to walk or crawl, each baby, given the right encouraging and supportive environment, will eventually learn to do it. All kids end up walking, all kids end up eating solid food from the table. They all go about it differently. Alex may still be nursing at 18 months or two years, but he will also be eating solids foods, because you are encouraging him and giving him the opportunities that he needs to learn.

I hope all goes well for you and Alex. I also hope I have managed to address all of your concerns, let me know if anything is unclear.

Thank you for writing.

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