Were you advised to trial dairy in your CMPI/MSPI child?

[GrumbelinaPicklebottom]

Hi,

I have two children, DS aged 26 months and DD aged 8 months. Both have severe reflux, and milk, soy and egg intolerances.

I have been advised by three paediatricians (2 private, 1 NHS) to periodically trial dairy "to see if they have grown out of it". I was not given any more guidance than this, nor referred elsewhere (eg dietitian/allergist) with either child. My son's care under the NHS has been less than satisfactory, but that is another matter.

I have duly, every 4-6 months, trialled my son on dairy, and had to stop it again. During this time, his reaction seems to have evolved from painful gas/wind when he was very young and breastfed, to constipation, to a nappy rash, which on the most recent trial (July 2014) was painful (he complained of a burning sensation and asked me to blow on his bottom each time I changed his nappy). After previously tolerating eggs, he had a similar reaction to them (painful nappy rash), so I have now also excluded eggs from his diet.

I haven't had the greatest support from my GP surgery throughout this, but have now found a GP in the practice who is understanding and slightly more helpful. She has said that as far as she is aware, children should not be periodically trialled with food allergens, or indeed trialled at all, until much older. I hasten to add, she said this in a completely professional manner and without undermining the paeds who had given me this advice.

Just wondering if anyone can weigh in on this? Of course, one wouldn't try at home with severe IgE medicated reactions like anaphylaxis, but otherwise, what were you advised to do for your dairy intolerant children? I wonder if my repeatedly challenging him has caused the intolerance to worsen. For what it's worth - we are now awaiting appointments to see a dietitian and allergist.

[pashmina696]

Hi, my DS who is 2 has a non IgE milk protein allergy and this is exactly what i have been advised to do by his allergist and dietician. The hospital provided a ladder to follow, starting with a biscuit containing dried milk. He hasn't tolerated it, so i have been advised to try again in a couple of months.

[GrumbelinaPicklebottom]

Hi Pashmina,

Thanks for your reply. It's reassuring to know they weren't completely off the mark. I do worry, though, since his reaction is changing with time that perhaps challenging him isn't helping.

What symptoms of milk protein allergy does your son have, if you don't mind me asking? Has his reaction changed (either improved or worsened) over time?

[OohOod]

Ds has CMPI and we were advised by dietician re introducing it v gradually. Every few months. We were given a schedule of order of foods.

Similar to this

[GrumbelinaPicklebottom]

Thanks ooh, especially for the link. I have seen a similar one (can't figure out how to link it from my phone) by Dr Adam Fox, which is a little more gradual - I think there were 12 stages in their "ladder". That's the approach we used last time and sadly, DS got the nasty nappy rash from having 2 malted milk biscuits (step 1) a day for a few days.

Interestingly, some of the items in stage 1 don't actually contain milk (eg mcvities rich tea biscuits).

When you say gradually - did you succeed at one stage, and then continue with those foods for a few months before moving on to the next?

[3boys3dogshelp]

Hi my ds has cmpi and soy intolerance. I have seen a Dietician who advised trialling dairy 2-4 times a year, following a similar protocol (although stage 1 is half a malted milk biscuit daily for 3 days). I saw him when ds was 7/8 months and was advised not to bother trialling him until at least one year old.
Recent research shows the majority of children don't grow out of their intolerances until 6-8yo, not 1-2yo as previously thought, so there is no rush.
Ds recently tolerated stage 1 then reeacted to stage 2.so I will be sticking to stage 1 only for the next few months.

[OohOod]

We succeeded at shop biscuits through me but not him. Stopped for a bit to clear him up then I've carried on but never more than a couple a day.
He gets a couple if nights of string wind and 2 weeks of diarrhoea.

[OohOod]

Strong not string!

[GrumbelinaPicklebottom]

3 boys - thanks for your message. I think perhaps the protocol you were given is the same one I have seen. Is your son still tolerating stage one foods? My son tolerated a few things for an extended period, before suffering from symptoms - I am not sure if that's a typical experience, but I had never heard of ladders at that point, so I just tried yoghurt.

I am really glad to know that the general advice for my son's type of reaction is not complete avoidance. I was so fearful that my repeated trials had done him harm.

[GrumbelinaPicklebottom]

Ooh - thanks for that.

How old is your little one now? Hoping things improve for him soon.

[pashmina696]

Sorry not been online, my DS gets eczema, disturbed sleep and constipation, though a glass of milk would go through him very fast and give him diarrhoea and nappy rash. After 3 days of a malted milk biscuit his sleep got disturbed, his eczema returned and he got constipated. He is 29 months.

[OohOod]

He's 20 months now. I'm keen to eat more dairy as I'm really missing cheese but we aren't rushing it.

[littlealien01]

@Pashmina66 how was your sons allergy picked up? Dd has those exact same symptoms (altho not the diarrhoea so far) and weve just started our own elimination diet to try and find the culprit. Id be really interested to know more of your experiences

[pashmina696]

Hi, it was dismissed by the drs for ages - he was exclusively breastfed for 9 months without issue, he had very little dairy in early stages of weaning, and at 9 months i introduced one feed of follow on milk as he was not taking on enough breastmilk during the day, that seemed to give him some mild constipation, though i didnt connect the two at the time. at 12 months i gave him cows milk and it was through him in a couple of hours, the nappy rash was immediate and took a couple of weeks to heal. He didn't have this after having cheese, yogurt or butter only pure milk.

I then tried lactofree milk and he appeared to tolerate it (and loved it), i went to the dr a couple of times with him, and mentioned it to my other sons allergist and was told to try normal cows milk every 3 months to see if he had grown out of it and keep on the lactofree as he appeared to tolerate it. at age 2 he was still unable to tolerate milk, and had been having distrupted nights and also was getting more and more eczema. In the early summer the eczema and getting him to sleep at night got even worse and he had started eating a little ice cream.

I then really cut most of the dairy out his diet, switched to dairy free spread and swedish glace etc but i wasn't strict on it. I asked to be referred to an allergist, as he wasn't having immediate reactions to dairy i wanted to be sure it wasn't lactose intolerance. We saw Dr Adam Fox at st thomas' at the beginning of september and he advised it appeared to be a delayed reaction to Cows Milk Protein and to try a 6 week total exclusion - the results were pretty quick though it took about 5 weeks for his gut to heal and that side of things to return to normal. I do wish I had pushed for a referral a bit sooner or worked it out myself (though i had convinced myself it was lactose intolerance), though it really only started to get worse in past 6 months. Cutting dairy totally took a couple of weeks to get used to but i dont find it too difficult now! Hope that helps - feel free to message me directly.

[MrsHenryCrawford]

Ds is a year old and the paed told me to reintroduce dairy. From what I've read, normally 50 percent outgrow the allergy after 12 months and 80 percent at three years. Paed said he is more likely to develop a tolerance to dairy if I keep challenging him. We are almost at the top of the milk ladder, so far only have experienced some disturbed naps and a lot of belching.

[TheGrinchWearsStripes]

Just to say, NICE guidelines state that any child who is dairy free for more the eight weeks should be seen by a dietitian, and any child under two should be seen within one month. We had to fight hard for a referral, but quoting the guidelines got us a referral (complete with eye rolling from gp and 'whatever makes you happy') our dietitian is fantastic and offers quite different advice to the paediatrician. Which seems to work for us - DS has now been almost symptom free for 4 months, barring twice when he accidentally ingested dairy (resulting in hours and hours of screaming at night. NOt ready for the milk ladder, I think!). It's worth pushing for the referral.

[flanjabelle]

Dd has cmpi and I was told to trial dairy. I was told to dip the back of a spoon in yoghurt once a day and slowly increase the amount. After a week she had the rash back on her face and diarrhoea so I stopped it. I'm going to try again in January.