Are these symptoms likely to be CMPI or 'just' silent reflux?

[apricot72]

I posted this in the feeding forum but was advised I might get more advice here.

DS2 is 14 weeks, ebf and since about 2 weeks old has had symptoms of what I've thought have been silent reflux (very fussy feeder, restless thrashing at night, sudden bouts of crying, lots of hiccups etc). He's now on a fairly good dose of ranitidine and seems a bit happier in himself though whether that's the ranitidine or not, who knows.

However he's still a fussy feeder, windy, quite unsettled and miserable at times and has very watery poos, usually yellow, sometimes green. He is also very restless at night after about 4am which I read somewhere was often linked to CMPI. After a lot of dithering and many weeks of hideous sleep deprivation we put him to sleep on his tummy (with a breathing monitor) which has helped quite a bit up until 4ish.

I have tried going dairy (and soya) free for about 2+1/2 weeks but I wasn't conviced that it made a huge difference, though now I'm wondering whether he's been more unsettled since restarting dairy about 2 weeks ago.

He seems to be putting weight on fine and looks pretty healty so I'm not sure whether that makes CMPI less likely. Also he is rarely sick.
So with these symptoms would anyone advise a longer period of a dairy free diet or should I have noticed something within the 2+1/2 weeks? Obviously I'd like to avoid another dairy free period unless necessary! And does his weight gain / lack of vomiting fit more with 'normal' silent reflux than CMPI?

Any suggestions gratefully received! Feeding him is an on-going unenjoyable chore at the moment and it is very hard watching him being so uncomfortable and miserable. Thanks.

Hello apricot72 sounds like you're having a tough time - I remember it well! Does your little one have any other symptoms such as eczema or skin rashes? You mention that he's gaining weight but has he followed the centiles well or dropped down at all? If so, then I would suggest that something other than 'just' silent reflux could well be going on. It could be dairy intolerance or it could even be an allergy to cow's milk (particularly if he has eczema/skin rashes). The watery green/yellow poos sounds more like an intolerance than an allergy to me though (intolerances tend to have more gastric symptoms). Unfortunately, 2 & 1/2 weeks is not normally enough to see a significant difference and you would generally need to be dairy free for at least 6 weeks to see any real changes in symptoms. Btw, have you tried raising up the top of his mattress? This can really help with reflux and is safer than putting them on their tummies. You just put a pillow underneath the top of the mattress and this allows the baby's head to be slightly elevated which stops the acid rising up the throat and causing discomfort.

Thank you, that's very helpful. Yes it does feel like tough going - not the idyllic 2nd period maternity leave I had hoped for! When he was weighed a couple of weeks ago he had pretty much stuck to the 75th centile from birth. Which amazes me as sometimes it feels like he hardly eats anything in 24 hours. He doesn't really have any eczema or rashes apart from slightly dry flaky skin around his eyebrows and last week he had a bit of a spotty face (but also had a cold).
I suppose I had hoped that I'd go dairy free and within 48 hours I'd have a different baby like some accounts I've read.

We have tried raising the end of the mattress to varying degrees but it didn't make much of a difference, apart from the extent to which he'd end up in a crumpled heap at the bottom of the moses basket.... Now he's in a cot and it's flat again so I will try raising the end again but the tummy sleeping really has been a transformation, and it's hard to imagine going back to the 3 or 4 hours of broken sleep per night we were getting though we've not taken the decision lightly.

Looks like I'll be back on the rice milk then for the next few weeks. I should go back and see the GP really but I'm not sure that they'll have anything different to suggest other than perhaps a paeds referral.