I agree that the 4 month old who refuses the breast sounds like he's on a
nursing strike.  I also wonder how much he's getting when he nurses at night.
 Remember that other kids his age are "sleeping through the night" for as
much as 10-12 hours and doing all their "eating' during the 12-14 hours that
are left in their day.  So if this kid is "nursing through the night" he
could probably go most of the day on very little Visible Intake.

Mom could try renting/borrowing an accurate-to-the-gram scale and weighing
the kid in his pajamas before he goes to bed and before the first diaper
change in the morning.  The difference should be the overnight intake.
...That is, if she wants to figure out how much he's eating at night.  I know
it might just make her more worried.

Peace.  Chris.

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