Loss of appetite in a four-month-old baby

A brief variation between feeds can occur, but a clear change from your baby's normal pattern should be discussed with a clinician the same day. Young babies rely on breast milk or infant formula for hydration as well as nutrition.

A blocked nose can make sucking and breathing together difficult. Fever, mouth discomfort, vomiting, diarrhoea or another infection can also reduce intake. Feeding may change after a stressful or tiring day, yet persistent refusal or weakness needs assessment rather than watchful waiting alone.

Judge the change against the baby's usual number and length of feeds, not another baby's pattern. Record what was offered and taken, wet nappies, vomiting, stools, temperature and behaviour. This gives the clinician a clearer picture of hydration and illness.

Offer breast milk or correctly prepared infant formula more often without forcing the baby. If the nose is blocked, saline drops and gentle suction before a feed may help. Keep the baby upright while awake for feeding, with pauses for burping if needed.

Do not dilute formula or change its preparation, and do not replace milk feeds with plain water, juice or herbal remedies. Avoid starting solids as a solution to poor milk intake. If feeding is painful, the baby coughs or chokes repeatedly, or milk intake continues to fall, seek medical guidance.

Seek emergency care if the baby is hard to wake, floppy, struggling to breathe, blue or grey around the lips, having a seizure, or unable to keep any feed down. Green vomit, blood in vomit or stool, or a markedly swollen abdomen also warrants urgent assessment.

Obtain same-day advice for noticeably fewer wet nappies, a dry mouth, no tears when crying, a sunken soft spot, fever, repeated diarrhoea or vomiting, persistent feed refusal, or behaviour that is clearly unlike normal. Do not wait for every dehydration sign to appear.

Share when the feeding change started, the last successful feed, recent wet nappies and any fever, congestion, rash, vomiting or diarrhoea. Ask how to continue feeds, whether the baby needs an examination now and which changes mean you should go directly to emergency care.