4 week old showing symptoms of cmpi and reflux

[sheeplikessleep]

Ds3 has, in the last week or so started to show a lot of the symptoms ...

Runny, snotty nose
Crying after feeds
Windy, humongous burps
Sick after feeds ... Mucousy rather than milky (DH thinks its the mucous that is making ds3 gag)
Rash on his face ... Small pinprick rash with white 'centres'
Gagging, as though he is choking ... Not when feeding, but in between feeds. This really upsets me, it's as though he holds his breath and about to be sick, it nothing comes up.

Ds1 was on gaviscon when he was a baby, but I've forgotten what I did and in what order. Feel a bit lost and bewildered, with where to start and what to do. I just remember cutting out all of the foods I love and it not really being obvious what the problem really was. I want to try to be a bit more definitive this time.

Any advice or thoughts really appreciated. How do I work out if its reflux or cmpi? Tempted to book dr apptmt, though we Have our six week check in 2 weeks.

Feel v grumpy I can't eat bar of choc with my name on it!!

[noblegiraffe]

Go to the doc. No point in waiting two weeks if baby needs medication now.

However, are you sure the rash isn't baby acne? The snotty nose and coughing up mucous just a cold? Just to rule some other things out.

[JiltedJohnsJulie]

Yeh sounds like it could be baby acne and the mucous could be normal too. Having said that I'd get him checked for tongue tie and if you suspect CMPI have a read of this before you go to thy GP

[sheeplikessleep]

Thanks for posting. Another upset night, hate seeing him in pain after a feed. He screams and kicks around. I'm sure it's not hunger, as his hunger cry seems much more 'consistent' and monotonous if that makes sense.g His snotty nose is worse after a feed, I don't think it's a cold. He did have tongue tie, but that's been snipped.

Thanks for the link, the rash is all over his face, so likely to be just acne.

I've also seen that when he poos, as well as yellow runny poo, he has clear liquid out of his bottom. No green poo or mucous poo though, which is a good sign!!

[JiltedJohnsJulie]

If he's had his tt snipped, are you getting some RL support now? Are you in touch with a BFC or lactation consultant?

[sheeplikessleep]

I have been to a local breastfeeding drop in, before he was snipped. He is putting on weight though and his latch is better since snip. Do you think I should go back again?

[duende]

I think the only way to tell if he has cmpi is to eliminate all diary from your diet (I'm sorry!) and ideally soya too, and give it two weeks. My DD improved a lot about 16 days after I did that, I believe it takes 2-3 weeks for the dairy to leave your system and then some time for the baby's gut to heal.
The gagging does sound like reflux, I'd look at a list of infant reflux symptoms, print it, highlight the relevant and go to see your gp.

They will usually start with infant gaviscon (not that many babies respond to it and can cause constipation)
Then ranitidine (from low to high dose)
Then omeprazole

My DD is on omeprazole and it made a massive difference.
It could also be that your baby will not need medication once you've eliminated dairy.

Good luck, I wouldn't wait for the 6 week check.

[JiltedJohnsJulie]

Personally I wouldn't start eliminating things from my diet until Lo had been properly allergy tested. I suspected CMPI intolerance and reflux with my DS but it was tt and upper lip tie. Eliminating dairy and soy from your diet is such a faff and its best that you know for sure anyway

[sheeplikessleep]

Thanks duende. I've started dairy free now, I'm going to the supermarket later to stock up on dairy free foods.

I am going to book a dr appointment too. Thanks

[sheeplikessleep]

Oops, cross posted jilted!
It is such a faff (particularly as I am craving biscuits and cakes constantly since starting bf'ing!), but I just want him to be a bit more content. I'm not sure i will get him referred, without trying dairy free first?

[noblegiraffe]

Thing is, babies change a lot when they are little so he might improve and you think it's because you eliminated dairy, when actually he was going to improve anyway. Then you're stuck on a dairy free diet for no reason because you think it was that that sorted the problem.

Also, a baby being so intolerant to dairy that they are affected by the tiny amounts in breastmilk is really rare. So best investigate the more common causes first (reflux, tongue tie, baby just being a baby)

[JiltedJohnsJulie]

Totally agree with noble. Allergy uk recommend getting the tests done before you start eliminating. Keelymom has some useful info too

I'd book the doctors appointment first, push for allergy testing and see a BFC or lactation consultant, they should be able to check if the tt is still there and to observe a complete feed.

[sheeplikessleep]

It could be reflux, that's what I am trying to work out or cmpi or something else. I just don't know how seriously a dr will take it, without having tried dairy free first. I would love to get him allergy tested definitively.

Ds1 was on gaviscon and ranitidine for 6 months as a baby. They seemed to help a bit, but I also cut back on dairy too. I think a dr will just dish out gaviscon. I don't want to go down medication route for reflux if it is cmpi.

[JiltedJohnsJulie]

Does the allergy uk info have a bit on how to talk to the GP? When I went for testing I just told him what I'd read on allergy uk, he googled it, talked to me about why I thought it was an issue and referred me. Really can't see why you need to eliminate things first, especially when you are a bfing mum and need all the nutrition you can get.

[sheeplikessleep]

Oops cross-posted again.
I will book dr appointment and see how we get on.

The gagging is the most distressing, it's like he can't breathe and looks like he is choking and he always follows through, in the end, with mucousy sick.

Agh, wish babies could talk :)

[sheeplikessleep]

Yes, that allergy information is useful, thankyou

[Bakingtins]

Totally disagree - most babies for whom CMP is an issue have a non-IgE reaction and will be negative on allergy tests. CMPI affects 2-3% of all babies and 0.5% of breastfed babies (i.e. the others are ok on breastmilk and only become symptomatic when given formula or dairy based solids) so whilst it's not a huge proportion it's not rare either. If you do an elimination diet and think you see improvement then you should challenge (be eating the suspect food again) to see if you get any relapse, before considering continuing the diet longer term. That is the gold standard way of diagnosing food intolerances.
allergy UK advice on delayed food reactions and link to the NICE guidelines
I have found Little Refluxers website and this book massively helpful.
See the doctor sooner rather than later and be prepared to be very assertive, get a clear plan in place for what happens if treatment plan A doesn't work in a specified timescale.

[sheeplikessleep]

Thanks all for posting

[duende]

jilted the problem is there is no reliable test that would confirm or rule out cow milk protein intolerance, so for both ff and bf babies the recommendation is elimination trial.

[duende]

Xpost with bakingtins who is far more knowledgable :)

[sheeplikessleep]

It's so confusing!

[noblegiraffe]

Don't cut out dairy until you have seen the doctor. If the doc wants you to cut out dairy he can ask you to do it then you can make another appointment later.

Do you think you might have forceful letdown or oversupply? That can cause problems with babies, including being gassy and being sick.

[SpecialJK]

I totally agree on the forceful letdown. I had that and it caused DS to gag and cry and have wind. I think DS had mild reflux when he was young, we ended up on low dose ranitidine, but before that I tried colief which did help. Colief helps break down the lactase and can be taken from birth. Might be worth trying before doing a dairy free diet? The mucous might be a cold, there's loads of them going about at the moment.

DS's signs of reflux were hiccuping, not liking lying flat, we had to tilt him or put him on his side. He also didn't like being held towards someone, as it pressed his tummy, he liked being held outwards.

[sheeplikessleep]

The gagging isn't whilst he is feeding, it's more when he is relaxed, sometimes when he is asleep. He wakes up, starts chewing and gagging, whilst holding his breath. It looks like he is choking or something stuck in his throat and then he brings up mucousy thick sick.

I will book a dr appointment. Thanks for info everyone.

[JiltedJohnsJulie]

Have you propped up his Moses basket at the head end?

[sheeplikessleep]

He is sleeping on me, as he isn't a good sleeper