5 month old - allergy to formula?

[littleduck]

DD has been exclusively BF until now and I have just managed to get her to take a bottle of EBM to prepare her to take bottles at nursery when I return to work in just under 5 weeks. Struggle at first but over last few days she has happily accepted the bottle of EBM as long as nice and warm.

I have today added a small amount of formula into her bottle (10/15 ml in a 180 ml feed) and I think she detected it, was reluctant to finish feed and cried, above all I noticed that about 2 hrs after her feed her little eyelids had become pink and puffy and she was rubbing her fists into them as if they were itching. nothing like this happened with the EBM.

I tried a proper formula feed (ie no mixing with EBM) a few weeks ago and she completely rejected it and would not take any at all, in addition I noticed a red rash round her mouth and in places where the milk had soaked through her clothes from spitting out/dribbling and some small raised white bumps in the rash. Mentioned this to HV who said nothing to worry about but this combined with the red and puffy eyelids makes me wonder if she is maybe allergic to the formula.

It will be very difficult for me to express at work ( will be taking short lunch hours to get home in time for DD bedtime plus nowhere to sterilise breast pump equipment and bottles) so was hoping to move her on to formula. Based on the above, if she is allergic what should I do, is there anything else I can give her? HV said she MUST have milk during the day and it is not enough to feed her morning and evening for the 3 days per week when I am at work. All help appreciated.

[tatt]

How old is she? Her need for day time milk will drop off as she has more solid food. Sterilising also becomes less important so you could take sterilised bottles in a cool bag into work but not fuss about the time lag to using them.

Or you could try a different formula or even ask the gp if they'd prescribe Pepti Junior, which is a low allergenic formula. It's not unusual to have to mix formula with breast milk to get them used to it.

[Bilbomum]

It does sound like she might be allergic, the rash on the skin where the formula had touched is a classic allergy sign. Just to make sure try a skin test with the formula on her back away from any dribbling areas. If it comes up in a rash then you have a problem.

You can get formula for allergic babies but it tastes vile and I never got DS to take it but it would be worth a try. It's on prescription only so speak to your GP, if you started mixing it with EBM it might work.

I went back to work when DS was 6 months (he has severe milk allergy) and managed to express by nipping into the loo a few times a day. I ran the pump equipment under boiling water from the kettle and made sure I had enough sterlised bottles from home with me. He had just enough EBM during the day when I worked and then fed madly on a night to catch up so it wasn't ideal but his growth didn't suffer at all. You could start expressing now and have a supply in the freezer to start you off.

I work 3 days a week and managed to feed ds until he was 21 months so it is possible. Work do have an obligation to provide somewhere for you to express but like you I had shortened my hours already so didn't want to rock the boat any further.

Good luck!

[AcademicMum]

This sounds very much like a milk allergy as it is the same initial symptoms that my ds2 got (which I ignored because of the HV telling that it was nothing to worry about and keep perserving with formula -in the end his allergy was so much worse than it might have been if we hadn't kept trying with the formula).

If you go to your GP you can get hypoallergenic formula on prescription. Cow and Gate Pepti tastes about the best so I'd recommend that as a good starting point. You might have a fight to get the GP to prescribe anything though as they are notoriously reluctant to do so due to expense.

Don't use soya formula as many cows milk allergic babies are also allergic to soya so this is not recommended unless everything else fails.

I would look into your rights regarding expressing at work though. My employer gave me extra breaks for expressing, my own fridge to store EBM and although I could express in my office, I think for those who are not in the lucky position of having their own office space, employers are obliged to provide a private room for you to express in (not the toilets/meeting rooms). Alternatively is the nursery close to your work? In this case you could possibly pop over there at lunchtime to feed? As I say, breastfeeding mothers have certain rights at work which employers are obliged to give you.

It's not easy by any means and I ended up cutting my hours right down to 1 day per week until we eventually got ds2 onto hypoallergenic formula at a year old - not ideal I know.

[littleduck]

Thanks so much for all your messages.

Tried a tiny bit of formula in EBM bottle again yesterday - no swelling of eyelids but DD did develop a rash all over her trunk and limbs as well as around mouth and neck where the formula had spilt. The reddened skin was hot to touch. This convinced me that there was definitely a problem so called GP this morning who phoned me to discuss the symptoms and then arranged to see us within the hour!

GP agrees that based on these symptoms it appears that DD has an allergy to cow's milk protein and has prescribed Nutramigen which he warned tastes horrid and will make DD's poo green. We have been referred to the local paediatric dietitian also, he spoke to the dietitian briefly in my presence and she agreed that Nutramigen would be appropriate given the symptoms.

I asked if I should try to introduce the Nutramigen by mixing with EBM like I was trying to do with formula and he said no - just give her a full bottle but I can't imagine she will take it so was wondering if it would be a good idea to mix little bits in as I intended. Any thoughts much appreciated.

Needless to say I am very worried about poor little DD but trying to keep a lid on it. My mother is very gloomy about it ('Oh, it was all going too well wasn't it, there had to be something, I'm so worried, I think she's going to be a very sensitive child' etc etc) which is really not helping - I am trying to normalise things I think and say it's not an uncommon allergy, at least we have a way forward, lots of children grow out of it and so on. I really hope that this is the case and that DD will grow out of it.

I am really confused that she has the allergy as I thought one of the things about breastfeeding was that it was meant to prevent allergies?

Work have dealt with mothers expressing before and are happy to provide a room for me to express in (this would be a meeting room which would be kept aside for me to express in at times of my choice), there is a communal fridge which would be the only place to store milk and there is nowhere to sterilise stuff. However even if I had everything on a plate there is still the problem that I manage to express very little so it would not be enough for DD to thrive on, she will need to take some formula so will have to get her on to something.

[AcademicMum]

We found that introducing the hypoallergenic milk a bit at a time worked best for us. We started off with a 90:10 mix of EBM:formula then 75:25 then 50:50 then 25:75 then 10:90 then completely formula. He was on the formula within 2 weeks.

Also don't forget that you should cut dairy out of your own diet to avoid problems with exposure to milk proteins via you.

Finally unfortunately the thing of breastfeeding preventing allergies is not entirely accurate. Current evidence shows that breastfeeding does not prevent allergies.

A reference for this is:

Kramer et al (2007), Effect of prolonged and exclusive breast feeding on risk of allergy and asthma: cluster randomised trial, British Medical Journal, 335: 815-B818)

Abstract: Objective To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years.
Design Cluster randomised trial.

Setting 31 Belarussian maternity hospitals and their affiliated polyclinics.

Participants A total of 17 046 mother-infant pairs were enrolled, of whom 13 889 (81.5%) were followed up at age 6.5 years.

Intervention Breastfeeding promotion intervention modelled on the WHO/UNICEF baby friendly hospital initiative.

Main outcome measures International study of asthma and allergies in childhood (ISAAC) questionnaire and skin prick tests of five inhalant antigens.

Results The experimental intervention led to a large increase in exclusive breast feeding at 3 months (44.3% v 6.4%; P

[littleduck]

Thanks Academicmum - I mixed a tiny amount of the Nutramigen in with her EBM bottle, even less than 90:10, and had the devil of a job to get her to take it. Tears, the works

It has taken me an hour to get her to take the complete 6oz bottle but at least she has taken it and no horrid rash on her or reaction so far so clearly the problem was the formula.

I hope it will get easier and she will start to accept it. She will have to start taking something other than EBM as I will have to increase my working days by the end of the year and travel and I just can't express enough milk to cover my absences, it is a struggle to get 3oz out in half an hour

[anothercoldcupoftea]

Littleduck - sorry, not stalking you, just replied to your message on the other board as well! Just wanted to so, do keep perservering with the 90/10 mixture - we found that that initial bit was the hardest, as it was the new taste that DD1 had to get used to. Once she was happy with that, then gradually increasing the concentration as mnetioned above was fine (we probably could have done it quicker than over 2/3 weeks, but wanted to make sure she didn't reject it). Good luck!

Another thing you could try, which was suggested by our paediatrician, was to try mixing it with some nesquick as well, to mask the flavour. We never tried this, as didn't really want her to be drinking pints of nesquick every day - but if you're desperate...

[whelk]

Hi Littleduck, i think it was me who directed you to the Allergies section which I knew about because dd1 had egg and other food allergies.

Somewhat ironically my dd2 had exactly the reaction you described above on trying formula for the first time today - she is 6months.

I will watch your advice with interest, as I now find myself in the same position.

I cannot express very much milk either but luckily am not back to work until Feb.

Its a massive bummer and altho I advised you that you do get used to it and managing to avoid the allergen becomes second nature, I have found myself in tears of despair to be faced with it all over again!