I have a 5 month old baby who, literally 24 hours after receiving her 4 month shots, just refused to eat. It has been almost a month and a half, and

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I have a 5 month old baby who, literally 24 hours after receiving her 4 month shots, just refused to eat. It has been almost a month and a half, and it is still so. She will be hungry (we know that she is because it has been over 5 hours since her last feeding and she will be crying), but when you try to put the bottle of formula in her mouth, she will either scream and refuse it, or will take a few sips, then cry, then take a few more sips, then cry again, and eventually refuse it. The only way we have been getting by is that she will eat in her sleep. So most of the time, she ends up crying so much that she falls asleep, then I feed her.We are almost certain that this is related to her immunizations. After her 2 month shots, she refused to eat for 2 days and we had to take her to the ER because of deydration. There, they also found an infection in her urine, but could not figure out what the infection was. They did treat her with antibiotics though. But that time, this feeding issue was only for those first few days after the shots.What should we do? I have talked to the doctors, even switched doctors, and everyone just thinks she is being fussy. But I know that is not the case. Why would she be hungry but just refuse to eat, except in her sleep? I have tried different formulas, thinking it is the taste that has changed, but it doesn't help. The strange thing is that she will gladly drink water out of the bottle. She also has reflux and takes Prevacid for it. Her weight gain has been fine, at least up until her 4 month check up. She has of course decreased her formula intake to about 15 ounces per day, and that is with a struggle. It is very upsetting to see her go through this, but I don't know what to do. I hate that each feeding time she will cry and cry, but just won't eat. I have tried rice cereal, but of course she is small and her main source of nutrition will be formula. Plus, I am terrified of her receiving her 6 month shots. Do you think it's possible that immunizations could cause these kinds of reactions, or could they cause her to have an infection again?? Please help!!!!!!Thank you!!!http://drpeds.blogspot.com

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Answer:
I have a 5 month old baby who, literally 24 hours after receiving her 4 month shots, just refused to eat.
====== pain., insecurity and inflammation associated with the prick makes many children scared and they get scared of feed or drink, which can be reestablished by forcing few drops/sips

It has been almost a month and a half, and it is still so.
========= i will consider you wish to sya refused to feed. common causes of refusal to feed can be associated common cold, constipation, ear ache, throat infection, or inconsistency of feed or non palatable feed. A child who can not take good volume of feed , can never pass good amount of urine. Its the quality of feed that matters for growth.


She will be hungry (we know that she is because it has been over 5 hours since her last feeding and she will be crying),
======== she is surely hungry,

but when you try to put the bottle of formula in her mouth, she will either scream and refuse it,
======but she is not able to feed due to some discomfort. i see many such babies having a nose block, constipation or diverting attention as the reason. If the feeder and baby are not comfortable , such situation is more common.

or will take a few sips, then cry, then take a few more sips, then cry again, and eventually refuse it.
========= such clear "suck cry suck" or "suck rest suck" can be seen in different children. The first one is seen in nose blocks or noisy or nasal breathing and the second one is seen in some illnessses. The purpose of intermittent sucking for baby is, baby is trying to breath in that phase or trying to build reserves to suck again. she gives up when she notices its not helping. her cry is a cry for help- to clean nose, take care of constipation or do burping.


The only way we have been getting by is that she will eat in her sleep.
========== in sleep most muscles are relaxed. and child doesnt realise the discomfort stronger. this is classically seen in throat infections when taking a sip causes discomfort in throat that insists child to refuse the feed, which is less perceived in sleep.


So most of the time, she ends up crying so much that she falls asleep, then I feed her.
========== should not be recommended. if you are feeding witha bottle i suggest to feed with a small spoon in semisitting posture. And if its possible to approacha doc, give soothing throat nebulisation so that feed will be smoother when awake.

We are almost certain that this is related to her immunizations.
========== you are certain. i m sure.. its not related to it.

After her 2 month shots, she refused to eat for 2 days and we had to take her to the ER because of deydration.
======== this short episode can be blamed to immunisation related anxiety and pain..

There, they also found an infection in her urine, but could not figure out what the infection was.
======== that give sanother clue. unrelated to immunisation.

They did treat her with antibiotics though. But that time, this feeding issue was only for those first few days after the shots.
======== ok.

What should we do? I have talked to the doctors, even switched doctors, and everyone just thinks she is being fussy. But I know that is not the case.
========= true! nothing is without areason. i would like to know detailed history fo what feeds and how long it was given. was her refusal related to change in feed or feeder. also is she constipated? does her stomach look little nloated most often? doe she make wierd faces some times? are her milestones ok? well, all may give me some clues for further action.

Why would she be hungry but just refuse to eat, except in her sleep? I have tried different formulas, thinking it is the taste that has changed, but it doesn't help.
========i said above.. its the chroic infection .. may be related to botle... sometimes we find inflammation of tonsils pharynx and adenoids... presnting in this way.

The strange thing is that she will gladly drink water out of the bottle.
=========== well, you should have told me this very first. This also confirms chronic throat inflammation and also unpalatable or bland feeds.

She also has reflux and takes Prevacid for it.
======== all infants have refulx, unless it causes huge vomitting, medicines will cause more harm. like bloating, loose stools, abdominal discomfort... and also refusla to feeds. I suggets you try stopping prevacid for 15 daya if her reflux was minimal.

Her weight gain has been fine, at least up until her 4 month check up.
======= that suggests she is having adequate intake despite her problems, and surely her problem is more like indigestion-constipation-etc

She has of course decreased her formula intake to about 15 ounces per day, and that is with a struggle.
====== may be you add extra water sips 3 rimes a day.

It is very upsetting to see her go through this, but I don't know what to do. I hate that each feeding time she will cry and cry, but just won't eat.
======== i can surely help u out.

I have tried rice cereal, but of course she is small and her main source of nutrition will be formula.
========= true, with water and calcum and vitamin supplements.

Plus, I am terrified of her receiving her 6 month shots.
========= believe me they are safe.

Do you think it's possible that immunizations could cause these kinds of reactions,
= no

or could they cause her to have an infection again??
======== well its a non serious infection if at all it were it would have affected her health.

Please help!!!!!!Thank you!!!http://drpeds.blogspot.com





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Dr kondekar santosh is a pediatrician, lecturer at G S Medical college from KEM hospital Mumbai, India. He is clinical expert in various childhood illnesses including asthma , cold, allergy and respiratory diseases. he is also a pediatric intensivist at KEM hospital Mumbai. The KEM hospital caters to a vast number of patients from various category and speciality. Dr is exposed to various children suffering from infectious diseases including tuberculosis, pneumonias, malaria , leptospirosis, dengue fever etc and congenital hearts and metabolic diseases.
The PICU at KEM hospital also caters to difficult respiratory cases including ARDS and also to serious infections like tetanus. ACademicians are always welcome to discuss various cases with dr kondekar at paediatric yahoogroup.


Dr Kondekar Santosh venketraman is a MD pediatrician at seth GS medical college and
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