Reflux or milk allergy? Or both? What's the difference?!

[sorcha80]

Hi,

So I've written loads of detail about my LO below so as not to drip feed but to cut to the chase, my question is: has anyone found that there is a way to hint at whether a baby just has reflux or if it's a milk/other allergy? Are there any symptoms that one usually has that the other doesn't? I'm wondering what to try next, whether to ask for ranitidine or something or to get milk free formula and eliminate milk from my diet right away. If it's impossible to tell we'll have to just continue on our journey of trial and error, this is just been going on for a while so wondering if anyone had any advice!

My son is 3.5 months old, and is mostly BF with one evening formula bottle. When he was a small baby he had signs of reflux such as a lot of spitting up, even hours after feeding but was pretty happy and fed well. After introducing the evening formula bottle he started sleeping a good 6 hours before his next feed.
He's gotten progressively worse in the past month or so, firstly he started wheezing and gurgling. The GP said it's not in his chest but his throat looked a bit red so it's probably from acid reflux so we tried gaviscon for a while - not even the full dose, maybe 3 doses per day. He stopped pooing every day and went every 3 days instead, not constipated but obviously having more trouble getting it out and started getting horrendous wind instead.
Tried gripe water for the wind which seemed to work for a day but then things got worse not better!
After about 9/10 days we stopped the gaviscon, he had 4 poos in one day and seemed much happier! I decided on the recommendation of a friend to try comfort milk, which seemed to have pretty much the same effect as gaviscon, only helped the reflux slightly and made tummy issues worse.
So we're now on no medications at all and back to normal formula milk.
Currently his symptoms are excessive spitting up (not vomiting, but spitting a little even hours after a feed), gurgling and wheezing, very fussy feeding, squirming, I can hear his tummy gurgling when feeding. At night he seems really uncomfortable, he's waking up 3 times a night (he used to only have 2 night feeds), and pulls off and cries constantly while feeding day and night. Sometimes he's up fussing for almost an hour, particularly in the early morning hours.

I've also got some dentinox drops but I'm almost afraid to use them! Also they'd only help the tummy issues and not the reflux anyway.

Any ideas much appreciated! My GP is great but kind of gives me all the options and asks what I would like to try so I feel I should have an idea before I go in again and then we can discuss it.

Thanks!

[sorcha80]

Oh and he also has eczema which I thought may indicate allergy...

[EveryoneTalkAboutPopMusic]

Sounds very much like Cow's Milk Protein Allergy (CMPA). Please have a read of this on Kellymom.

I'm not an expert, although I do have CMPA, so I might have got this wrong but I thought reflux was a symptom rather than a diagnosis. So essentially something that needs treating but not the actual issue. A bit like pneumonia will make you cough, so the cough is just a symptom rather than the real issue.

If he were mine, I'd take him to the GP and refuse to leave until I got a referral to a Paed. Is there anyway that you clan cut out the dairy from your diet and stop the formula to see if he improves?

Allergy UK have a Helpline if you want to talk it through with them before seeing your GP.

Other things that might help are filming him when he's uncomfortable and taking someone with you when you see the Dr. It's a sad fact that many Mums seem to have their concerns dismissed but if Dad shows up too, the Dr often takes more notice.

Have you got a Walk-in Centre near to you?

[EveryoneTalkAboutPopMusic]

*can not clan

[sorcha80]

Thanks so much for your reply!
We don't have a walk in Centre particularly close but I'm pretty happy with my GP, I can usually get an on the day appointment if I call first thing and I think she would refer me if I insisted and also would prescribe milk free formula etc before referring me. I was just hoping to have a better idea of the differences between reflux caused by allergies and reflux just on its own (due to immature digestive system or something else).

I've done a few little tests in the past few days. Firstly I tried just winding/settling him at his first wakeup but he was definitely starving! Then last night I tried the dentinox and he slept really well with only 2 night feeds. Unfortunately it does seem to have made the reflux worse, lots of spitting up!
I could go back to the GP and try ranitidine but as you said, I do wonder if I would just be treating the symptoms - creams for the eczema, meds for the reflux, drops for the gas...I think I'll go to the GP on Monday anyway and tell her the whole story and see what she suggests.

The one thing I have been curious about is that he's quite squirmy while feeding sometimes, but it's usually worse on one side (the "slow" side as I call it) and he's not squirmy AT ALL when he has his evening formula bottle, he just sits there and drinks it quietly! That makes me wonder if it's not an allergy/intolerance.

Anyway thanks for replying and for that link to the info. Will see what the GP says!

[EveryoneTalkAboutPopMusic]

Being squirmy at this age when Bfing can be perfectly normal. Did the kellymom link help at all?

[sorcha80]

Yes that link was useful - as you can imagine I've done a LOT of googling the past few weeks to try and make sense of things but that page is pretty comprehensive.
I've just read back my last post and can see that the way I wrote about the squirminess may not have been clear - you're right it can be totally normal for a breastfed baby to be squirmy (I actually think he gets super frustrated at the breast when it's slow, he has no patience!). What I was trying to say was that when we had a bottle he's not squirmy at all, so I was wondering whether that might point to NOT having a milk allergy (if he had an allergy/intolerance I would have thought a formula feed would be just as uncomfortable).

Going through the kellymom list, he doesn't have a huge amount of the symptoms of an allergy - he doesn't cry inconsolably for hours (maybe half an hour a day, and it's when he's obviously tired so could even just be tiredness and not anything to do with discomfort!), he doesn't have constipation or diarrhoea or anything, he just has the reflux symptoms (spitting up - not vomiting, and wheeziness), mild eczema (don't even use steroid any more) and what I think is wind/tummy trouble (sometimes this isn't always obvious).

I'm keeping track of how he feeds and what his behaviour is like each day and to be honest I'm just getting more and more confused. I go back and forth from thinking "he must have a milk allergy" to "he's not that bad, maybe it's just a bit of reflux".

Hopefully when I review he diary before going to the gp tomorrow/Tuesday I'll see a bit more of a pattern!

[EveryoneTalkAboutPopMusic]

The eczema and wheezing can be symptoms though. The wheezing would concern me.