All newborn babies will have occasional mild feeding difficulties.  Ultimately, what is most important is that your baby is gaining weight and developing normally. Some of the most common feeding speed bumps will be discussed below.

Is my baby eating too much?

A typical newborn infant should eat between one and 4 ounces per feed.  She should eat approximately every 3 hours but some babies eat more frequently. Some indications that your baby may be eating too much include: taking more than 4 ounces per feed, vomiting after feeds, fussiness after feedings, or excessively loose stools.

Solution: Try feeding her no more than 4 ounces per feed.  If she is still fussy after feeding try playing with her or cuddle with her.  If she is not gaining excessive weight you may want to try feeding her a little bit more frequently.

Is my baby eating too little?

A typical newborn infant will have some feeds where she takes in more and some feeds where she takes in less.  Ultimately, your baby should be eating enough to have good weight gain and to avoid dehydration.  The best way to know she is getting adequate calories is to monitor her weight gain.  You can do this at your pediatrician's office.  The best way to know she is getting adequate fluid is to monitor her urine output.  She should be having wet diapers at least every 4 hours. Most babies have diapers and much more frequently (sometimes as often as every hour). Some clues to look out for are listed below:

• If she is breastfed and she feeds for less than 10 minutes
• But if she is taking less than 1 to 2 ounces every 3 hours
• If she has hard or infrequent stools
• If she seems unsatisfied or fussy after feeding
• It she has excessive jaundice (yellow skin color) in the first few weeks of life
• If she does not have wet diapers at least every 4 hours
• If she is not alert and active at some point in between feedings

Does my baby have lactose intolerance?

Probably not.  However, you probably have heard that many babies do not tolerate cow milk based formulas.  This is most likely due to intolerance of the protein in the milk and not the sugar (lactose). Lactose intolerance is very common in older kids and adults but it usually does not present until about four years of age or older.

Does my baby have milk protein allergy?

Many babies should not tolerate the proteins found in cow milk based formulas. The signs of milk protein allergy include: excessive spitting up, excessive fussiness after feedings, a skin rash, loose or watery stools, or blood or mucus in the stools.Milk protein allergy generally is not harmful however you should discuss this with your pediatrician if you suspect it.  Less commonly, a serious infection can have the same symptoms.Some of the symptoms of cow milk protein allergy are listed below:

• Frequent loose stools (especially if they completely soak into the diaper like urine)
• Blood in the stools
• Mucus in the stools (mucus looks like snot or vaseline)
• Skin rash
• Excessive spitting up after feeding
• Excessive fussiness or colic

Solution: This definitely needs to be discussed with your doctor, however most doctors would recommend a formula change - probably to a hypoallergenic formula type. If your baby is breastfed, the first strategy often is to remove certain food categories from the mothers diet (i.e., cow milk, eggs, shellfish, soy, peanuts, etc.).  This also should be discussed with your doctor because the mother needs to be on a well balanced diet for the baby's breast milk to remain nutritious.

My baby sucks forever but doesn't empty any milk from the bottle?

Are you using a slow flow nipple?  If so, you may want to try a medium flow nipple.  If your baby is gaining weight and taking in adequate milk, she may be suckling simply to soothe herself.  You may want to try giving her a pacifier.

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