Lactose intolerance/Cow's milk protein intolerance

[raininginbaltimore]

HV thinks this might be what is wrong with dd, went to GP he agrees so has prescribed Nutrimigen. I thought silent reflux but they both think this is more likely.

How long should it take to see a difference?

It is something she'll.grow out of? I'm assuming there is no harm in trying, if it stops the screaming.

Reflux symptoms can be caused by the allergy, according to our GP, so basically you are probably right as well.

It takes about 2 weeks to completely empty the system of all the proteins, so it could take that long to see a significant difference, but it should get progressively better.

some kids grow out of it, some don't, and unfortunately it is hard to know which is which.

Glad you've got an answer and hopefully it all improves soon!

Silent reflux/reflux is a secondary problem to cows milk protein intolerance. if the nutramigen is going to help you should see an improvement within two wks. babies tend to grow out of cows milk protein intolerances by the time they are 9-12 months.
I would also ask for Zantac to cover all bases as screaming sounds refluxy to me. All 3 of my dd's had silent reflux, my dd3 is 18 wks now and on Zantac and enfamil AR.
Dd2 was thought to have an intolerance and was on nutramigen and then neocate plus Zantac, this was from the paediatrician.
What symptoms does your dd have? I assume you have already tried the thickened formulas. Nutramigen really is horrible stuff.
In my experience some gps are great at handling this and some aren't skilled in this area at all. It just seems odd to go with nutramigen straight away before trying reflux treatment.

SorrY should also say Reflux of course may just be a Physiological problem too and not necessarily to do with any intolerances.

Ds had reflux, badly enough that he lost weight.

Symptoms are unsettled, screaming and crying a lot, which seems to be pain. Often about 15mins after feed. Waking up crying out in pain. Lots of farting (!), arching and flailing, gagging, coughing.

I think the logic is that gaviscon didn't work. But it didn't work with ds, he ended up on ranitidine and domperidone. But he had a flow chart and as we have now ruled out colic (dentinox, infacol and massage and winding well), reflux this was next stage.

The reason they don't think reflux is also as she doesn't seem to mind lying flat, and propping up etc doesn't help.

Argh I don't know, I am so tired and I just want the screaming to stop.

Gaviscon only worked for about 3 wks with dd3, then she needed Zantac. The dose has had to be upped twice but we seem to be controlling it with 1.5 ml x 3 daily. Losec was the plan for her if the last increase didn't help. She too has no problem lying down and propped up didn't stop the crying. Even with the enfamil AR she is still bringing it up but it is controlled and she is much happier. I would push for Zantac again, as you know gaviscon really only does so much. Good luck, it really is awful when you see your baby going through this and it is so stressful for you as you feel powerless to help them.

Thanks. Yes the gaviscon made a slight difference, but only for a week.

I will have to go back on Monday as only have 400g tin.

The coughing definately could be the stomach contents coming back up, plus the arching and gagging. Did you try enfamil or stay down?

We tried thicker formula and it didn't seem to help. I actually think it made her cry more. Could have just been a bad day though.

Well the best of luck. Every time my dd has a bad day I am so worried that this is the reflux becoming a problem again. With dd2 I almost went around the twist as the gp wouldn't deal with it and referred onto paeds and then paeds referred to a gastroenterologist which took months. Eventually I think she grew out of it herself as the medication/formula seemed to do very little.

Conversely when she has a good day I worry that I am making it all up!

FrOm what I understand of reflux some days it can be worse than others. I know what you mean. Whenever I see my gp my dd's tend to appear absolutely fine for the duration of the visit only to relapse the minute we leave!

Now I realise I need to give it longer but I think she is more unsettled on nutramigen. She won't take more than 2oz at a time and has been very sleepy, but in-between she is very unsettled, arching, griping and being much more sick.

Normal? Keep persisting with it?

Nutramigen tastes really horrible. My dd2 wouldn't drink it or neocate unless she was asleep, it was terrible. We used to put 2 drops of vanilla essence into it to try to mask the taste. Lots of babies hate the taste of it, you could try adding an oz at a time to her old formula and introducing it that way. The trouble is when a baby is used to normal tasting milk they find it harder to accept this foul stuff. I guess you do need to persist for now but I would speak to the dr next wk when you are in regarding reflux treatment in conjunction with this.

Thanks.

She is constipated as well, and j have just realised (because Dh noticed) that the black bits in her poo are blood. How crap am I.

Not crap at all! You and your LO are having a really tough time at the moment and you are doing all you can to help her. My dd has been constipated since starting enfamil, same on gaviscon too. We tried brown sugar and prune juice in water to no avail. We have her on 5 ml lactulose twice daily now since starting this formula and she is still constipated. I feel really bad having a young baby on lactulose but nothing else helps and even this doesn't make much of a difference. My dd just started solids this wk so I will add prune juice to her purees, plenty of pears, etc.

My DS was also allergic to Nutramigen, it still contains cow's milk protein although altered to make it less allergenic.

If your DC has not improved I would ask to try something like Neocate that has no cow's milk protein at all.

Yes I had forgotten about that. Although is extensively hydrolysed it still contains casein which is a milk protein. Most babies immune systems dont recognise it because it is so broken down but a small percentage still do.

She isn't better. We haven't had the screaming, but she will only take Sal amount (prob cos it is grim) and has started being sick. She was never really that sick. And she is more unsettled, not.screamy but wriggly and grumpy. And only happy sleeping. She is barely awake.

you have a dd who has blood in her stool, is vomiting and very sleepy. Is there another GP who would perhaps take this more seriously? Seems to me that you are not getting the help you need right now, and I'd say that you're probably stressed enough without having to deal with getting a doctor to actually listen to you and help. So sorry you are in this position.

We ended up ay out of hours doctor. She has thrush. Again. They told me to feed her whatever she would take. By syringe if necessary. So we went back to normal formula. After a few drops, she downed 5oz.

This morning she has thrush nappy rash as well. So I'm back to doctors. I have made are it is GP I know will listen to me.

Oh your poor dd! No wonder she was miserable. It sounds as though she really disliked the nutramigen. Good luck today I really hope you get the help that she needs.

Just came across this thread and i feel your pain. My little one is 2 years old now but she had a milk allergy for MONTHS and no doctor woudl listen to me. I went to a private doctor and wtihin minutes she diagnosed a milk allergy and she prescribed Neocate milk, this was amazing like a new child! They don't like giving out Neocate becasue it's so expensive but it's just great and you can get it on prescription but have to fight to get it. My private doctor said that the sickness and the fact that my little one was really stuffy in the nose was a sign that she had a milk allergy. We could't lay her flat at all in fact we had to hold her upright for at least an hour after every feed before we went onto the Neocate. It was awful we didn't sleep for months. Good luck x

P.S took about 10 days for my litlte one to adjust to Neocate, i know it's hard as you want it to work as soon as possible but can take a good week or so for their system to clear of old milk!

So by the morning she had thrush in her nappy as well, horrible blisters. This doctor (who I trust, she is good) thinks that milk allergy is unlikely (no diarrhoea, excema) and much more likely reflux. She has referred us to paed, as they won't prescribe ranitidine (which ds was on). She said they could prescribe Enfamil or staydown milk (we tried thicker milk, but not these ones). I'm not that happy about these ones as you have to make with cold water, and I'm not sure how you are ever supposed to leave the house.

At the moment though we both agreed that we need to sort out the thrush. Although she possets she never screams then, and the screaming is never linked to being laid flat, or after feeds. It is possible that the thrush is causing it, and that yeast from thrush is in gut and causing gas.

So we have been referred, and we have antibiotics for thrush and cream for nappy thrush. Once that is sorted then we can see what symptoms are left.

Poor dd! My gp this time around did prescribe Zantac, with dd2 I had a different gp who like yours refused so we had to struggle until paeds appt came through.

My dd is on enfamil and I have found it to be very good, it turns solid in the stomach so the idea is it doesn't travel back up.

As far as the cold water is concerned, we make up a batch of them and then put them in the fridge and bring them out in a cool bag until we need to heat them. It is no different than normal formula except you can't mix it until the water has cooled. I know the advice these days is to make up one bottle at a time but for me that is totally impractical.