Stopping bf a milk-allergic bottle-refuser

[vvviola]

I have been advised to stop bf 13 month old DD. We're having trouble narrowing down the source of some of her allergic reactions (already avoiding egg & dairy). I'm a bit upset, but to be honest I was getting near ready to think about it anyway.

But we have a few complications:

• she's a bottle refuser. Will take a few swigs (we're using soy formula for crèche days) from a bottle or cup, but not a big cozy feed. Which leads on to...
• she still feeds to sleep about 3 nights out of 7. And most naps when she isn't at crèche. And the days she self settles in her cot she has had a long cozy feed beforehand
• she wakes between once & three times a night and bf back to sleep.

I'm happy for it to be a gradual process (even 1 to 2 months is fine), but I just don't know where to start. Naps? Bedtime? Post-creche feed?

Any help would be great. Thanks!

[Napdamnyou]

Why have you been advised to stop? It sounds like BF is working well...

[vvviola]

Mainly because she's very sensitive to even small amounts of egg & dairy that I eat, and she's having reactions to something unknown. Doctor thinks that it might simplify the search.

I was close enough to wanting to stop soon-ish anyway.

It is/was working well, but I'm not totally against stopping.

[Napdamnyou]

Aha. How's your bedtime routine? D you have other elements in there besides BF? For example, could you replace long cuddling BF with long cuddling lullabies and talking about the day? Or play particular music with lights down,lying on a bed? Or massage? What does she do when she doesn't feed to sleep? Can you try shush pat when she wakes in the night, or gentle rocking and crooning or mumbling inte dark, very boringly but comfortingly, so she gets the physicality of your touch but nothing too exciting? Maybe try gradual and very gentle stages?

[MigGril]

did you know that some children who are allergic to dairy are also allergic to soya. The protein is similar and I'm apprised you've not been prescribed a soya free formula.

You could also cut out soya from your diet, even of it's just while you are stopping. I wouldn't introduce a bottle at this age as they are supposed to stop them at 12 months anyway. There are other alternative milks you could try if you wanted to substitute them for milk feeds, but you'd probably need to discusses that with her doctor.

Is start with night weaning, try kellymom website, there is a good section on night weaning. Then probably go with the daytime feeds leaving the bedtime one till last.

[greenbananas]

Who has recommended that you stop breastfeeding? Was it a GP or a paediatrician who has specialised in allergies? The latest guidance from NICE says that mums who are breastfeeding children with food allergies should be given information about exclusion diets.

MigGril is right about soya. If your DD has confirmed milk allergy then you should have been prescribed a hypoallergenic formula. Soya is one of the 'big eight' most common food allergens in the UK, and a large percentage of children with milk allergy go on to develop problems with soya.

If the person who recommended that you stop breastfeeding is the same person who suggested that you try soya formula, then I would definitely seek a second opinion!

If you want to continue breastfeeding, then you could try keeping a detailed food diary of what you (and your DD) eat. That might help you spot any links. My DS reacted to all sorts of seemingly random foods in my diet, as well as just eggs, milk, nuts and the other 'obvious' ones (he is also allergic to peas, lentils, sesame, bananas...)

Restricting your own diet can be hard, and although I personally feel it can be good practice for cooking suitable family meals, I do recognise that this is not for everyone.

What do YOU feel would be the best thing for you and your DD? The medical professionals should be supporting whatever feeding decision you make - they should not be recommending that you stop breastfeeding without giving you much more information.

[vvviola]

Thanks everyone. A few responses to the questions (sorry can't put the name to the answer as I'm on phone & can't scroll back)

• we have been prescribed a hypo-allergenic formula, just today. Pepti Junior. The GP suggested the soy formula as the skin prick tests came back negative to soy
• today was a member of the acute paediatrics team (according to the system here, DDs allergies aren't complex enough for referral to the specialised immunology team, but they advise the doctor I saw today & she does a lot of work with allergies
• I have been on an exclusion diet & we have a referral to a dietician too after today, but there's still something slipping through the cracks & making DD miserable. I've kept a food diary & nothing stands out (except perhaps chickpea, which they did a RAST test for today). She has dropped from 80th to 25th percentile partly as a result of not eating due to stomach issues from the reactions so I'm getting concerned.

[vvviola]

Bedtime routine at the moment is cuddles with Daddy (when he's not working), nursery rhymes & songs (not as calm as I'd like due to DD1 getting involved), then into bedroom, feed & bed.
The nights she self-settles, she goes into the cot drowsy & I rub her back til she settles. Can take the best part of half an hour. It has only worked once overnight (sleeping arrangements have made it more difficult, but we move to a new house at the weekend where she'll be in her own room - at the moment she's in with her sister)

At the crèche they put her in a modified swaddle for naps, give her her teddy & she settles after about 5 minutes of grumbling. If I try it she gets totally hysterical.

[vvviola]

greenbananas in an ideal world I'd keep breastfeeding for another 5 or 6 months, but it's getting progressively harder for me to manage for various reasons. I think if she'd take an occasional bottle I would have been more willing to try to continue, if that makes sense.

I love feeding her, but I've fed her for 8 months longer than I fed DD1, and while I'll be upset to stop, I won't feel guilty about it. I just want to make the transition as easy & gradual as possible for us both.

Is it possible to have a snuggly feed using a cup? Or if we try to avoid bottles would that mean no bedtime feed?

[KnockedUpMell]

My DS refused bottles for a long time, and then started accepting them at around 1y. Worth perverting with the bottles and trying different brands provided you don't have any issues with it (some people feel strongly that after 1 it should be cups and not bottles that they use).

We also used almond milk as I didn't like the idea of soy (due to phytoestrogens), and DS loved it. Some of them are sweetened though, so be sure to get the unsweetened version.

At that age my DS wasn't big on milk anyway, and made up for it by eating solids. As long as they're getting a nutritionally balanced diet and plenty of calcium and protein from other sources, I don't think it's a huge issue

[vvviola]

Thanks KnockedupMel. We've seen the almond milk around but have been advised to avoid it for the moment as DD hasn't been checked for all ground/tree nut allergies, but does have a peanut allergy.

(I did taste some myself at an allergy show and thought it was vile , but then I quite liked oat milk which some of my friends can't stand.)

But I've been told that all of those are for over 2s (or 5s in some cases) only. Or is that just being over cautious?

I never knew how easy we had it with DD1

[greenbananas]

in an ideal world I'd keep breastfeeding for another 5 or 6 months... I think if she'd take an occasional bottle I would have been more willing to try to continue, if that makes sense.

That totally makes sense. Breastfeeding can be overwhelming at times (whether or not your child has allergies!) If you want to keep on breastfeeding, then it has to be in a way that suits you and your family.

Really glad you have been prescribed the Pepti formula - but worth bearing in mind that Pepti is still based on cow's milk and some very sensitive children do react to it. If your DD doesn't get on with the Pepti, she might be prescribed Neocate, which is a completely artificial formula built up from amino acids and is all that some very allergic children can tolerate.

I'm still breastfeeding my four year old, so probably not the best person to advise on cutting down on breastfeeding. However, might be best to start with dropping one feed at a time. The bedtime/going to sleep feeds might be the last to go (breastmilk contains natural sedatives so is great for getting children to sleep). Snuggly feeds with a cup sounds feasible to me, but your DD's daddy might have more success with that than you - many mums find their children settle without breastmilk far better with somebody who does not have breastmilk to give them.

Good luck with whatever you decide.

[vvviola]

You know, I swear she knows I was thinking about cutting down feeds

Since I posted this she has been feeding really frequently, and also refusing to stay asleep without a nipple in her mouth, she's not helping her case, it's very frustrating and I'm exhausted, but I don't see how I'm going to even start cutting back.

The Pepti junior arrived yesterday, so I'll be giving her a first taste on Saturday.