Ebf baby - red rash on face immediately after formula bottle?

[Cakeismymaster]

Hi
My dd is 17 weeks and ebf. I have recently started to (try) and give her one bottle a day. I put 4 oz of aptamil (powdered) and she only ever takes 1-2 oz. almost immediately when she has it she gets a red rash on her chin, cheeks, upper lip - I'm guessing all places where milk has dribbled. Could this be a milk allergy? Or an allergy to the teat of the bottle? The rash is not raised and goes away again by about 3 hours later. Worried to persevere with the bottle as if a couple oz cause this what would a full bottle do?
She also has very runny poo the next poo after the bottle.
Could anyone share any ideas or have any similar experience? The formula is aptamil first, powdered. Same problem with cartons but poo's even more runny and explosive.

Watching with interest - exactly the same problem, also only tried Aptimel but interestingly got same reaction with mozzarella (mine is a bit older and weaning)...sorry! No help but have sympathy!

Is the rash hives? If so it could well be a cow's milk allergy. My DD has a milk allergy and would get hives round her mouth after having cow's milk (EBF until weaning age). Strangely she didn't get it with formula but that did make her throw up. If it continues I would speak to your health visitor and/or your GP.

Thanks for replies - the rash isn't raised like hives are, it's just red and then fades - but like I said it's only ever been a couple of oz.
I'm remembering her being very unsettled after a milkshake one day, and also over night when I had an omelette for dinner...linked or not? It seems wierd like it is the milk contact with her skin. Perhaps I should try some expressed milk in the bottle instead and that's pretty conclusive (am crap at expressing though)

Is there a history of any allergies in the family? It's so hard to tell if they are reacting to something unless its a dramatic reaction, isn't it? I ended up paying privately to have DD tested as I was fobbed off my everyone. I would be a bit concerned by the rash, followed by explosive nappy as that can be a symptom. You can get diary free formula but it is expensive so perhaps you could try that as an alternative or to see if the same thing happens with that.

Or it could actually be that the milk is too hot

If lactose intolerant bad nappies n wind normally follow almost immediately

I do suffer from bad hayfever...I'm thinking I will try the same teat tomorrow with expressed milk instead of aptamil and see what happens (will update thread!) and if no rash then that's pretty conclusive - will also make the decision for me to continue bf until she is 1. She's not keen on bottles anyway to be honest but obviously want to know if there's some allergy etc before I start weaning.

Definetly not too hot - had same problem when using ready made carton of aptamil at room temp (ie not heated up at all). In fact I think the ready made caused a more severe rash than the made up formula. Definetly caused a bigger nappy incident, within 30 mins

lactose intolerance is not the same as dairy intolerance as lactose intolerance is associated with the sugar in milk (including breastmilk) whereas dairy intolerance is associated with the protein in milk. Sounds like an issue with cows milk protein rather than lactose

I think you're right to try with expressed milk, to help rule out anything bottle-related. Ds had a dairy intolerance was ebf til weaning so I first noticed when introducing foods. He had a red rash on his face similar to what you describe. I didn't notice dodgy nappies, but he was always unsettled which looking back I didn't link. He only got urticaria with other food he was allergic to, not dairy.

Update - had a bottle this aft with 2oz expressed milk...no rash at all..so eliminates the teat/silicon as the problem..it's really looking like cows milk protein intolerance/mild allergy isn't it?

Have you tried her on sma? Not saying that it's any different but it's worth a try and if she is reacting exactly the same then you know it's all formula. You can get the sma in carton form so at least you are not shelling out on a tub.

Good idea, will get a couple of other brand cartons and see, all good info for if I go to GP.
Does anyone know if a cows milk protein intolerance could also go hand in hand with an egg intolerance?

Yes! But obviously not always,it's just something to be aware of.Why are you concerned about eggs?

Is there a hurry to move on to formula? My breastfed son at around seven months reacted badly when given cheese - his first dairy. I was advised (don't know if correctly) by the HV that persisting could exacerbate any potential allergy and to wait a couple of months and try again. Anyway, I did wait and when I reintroduced cheese it was fine. If breastfeeding is going well, and moving to bottles is not urgent, I would be tempted to wait till your baby was a bit older before trying any other formula.

waltons I wondered about that as I had a pretty hefty omelette for dinner the other week (probably only time since she's been born) and she had a really bad night following that, very unsettled tummy wise. At the time I didn't think about the egg thing.

catepillar there is absolutely no rush re bottles, formula etc just feeling very pressured as 6 mths approaches by mum, family, friends etc that it is expected she stops getting bf'd..am very much a solitary bf'er in amongst others especially anything past 6 mths. If I'm honest I'm only doing the bottle thing for others, not for me or her.
So any potential allergy actually gives me ammo to tell people actually I am still bf'ing as it's the best for her..happy to give her ebm if she really must have a bottle!

Other people can be so annoying! Easy for me to say, but work to your own timetable. I am hoping to pose as a medical professional (am not one!) if the "I advise you wait" advice would be useful.

Saw gp this morning, he said to try another brand and then go back if same.
Got some sma gold, could only persuade her to have an ounce - some rash there round chin/neck already but milder than when she had aptamil. Has only been 20 mins though.

Ok so only a very mild rash with sma..shall await the nappy now. Am now confused - do I then take it that the problem is only with aptamil?

I feel fed up that you are being pressured into giving up. I am blessed with fellow bf friends- and yes it helps hugely as we are all into the years not months ages now!
My Dd2 has dreadful allergies, we are both on restricted diets - no dairy soya nuts wheat gluten eggs oats! The breast milk has saved her I believe, her consultant and dietitian have been so supportive about extended bf .
Have the courage to shrug them off-do not justify the comments with an answer and they will get the message.
I would not give my baby anything if the result was a rash, mild or otherwise.
Good luck.

Smile sweetly at your DF and say your going to carry on BFing her for six years!

(DD2 actually carried in slightly longer than that, not faintly planned, she just hated bottles so carried on into toddlerhood and then just loved a snuggle and a feed at the end of the day. Meanwhile being 6 going in 13 during the day.)

Can't help with the allergies, DD2(now 12) still won't drink neat cows milk, but she happily drinks milkshake and chucks it on cereal.

DFamily

Thanks all, I actually do want to carry on as I know it's best for her - it does make me angry that it's even an issue really.
Am not finding the dairy free thing too hard so good start at least

You must be very glad you breastfed! you have prevented your daughter from a lot of discomfort and misery.

My kids ( breastfed) never liked dairy at all- so never had formula or cows milk. They don't eat butter, cheese or yogurt- my oldest is 6'2" and still hates dairy.

DS has a dairy allergy and egg allergy, the two co-occur quite often (probably because they are the two most common allergies in infants). Just like your DD he goes red where there has been skin contact and incredibly itchy. He's thankfully never digested enough to have a reaction beyond the skin reaction and also doesn't seem affected by dairy in my diet.

Keep a food diary, photograph any reactions, get some piriton in (if your LOs is going to nursery then hassle the doctor for a prescription and you can give that bottle to nursery). If there is any reaction then monitor for two hours afterwards, sometimes there is a secondary reaction a bit later. If your DD has a reaction wash her face and hands immediately to remove the allergen then give her piriton.

If you suspect an egg allergy as well (you could try some skin contact with a cooked omelette for some evidence) then return to your GP with the photographic evidence and demand a referral to an allergy clinic. They should take a blood sample to do IgE testing (don't pay for private IgG tests, there is no evidence they identify food allergies so you're just throwing away your money) or a food challenge in the paediatric day unit. If she does have a milk and egg allergy you should then be referred to a dietician for advice on making sure she gets enough calcium (in particular) and protein (if she's vegetarian this would be a particular issue).

All the HCP I've spoken to about DS's food allergy have been very supportive of natural term BFing (best thing for CMPA kids) and I've also found the family members who are not BFing supporters tend to shut up when I tell them it's his only source of calcium (not strictly true but never mind). BFing is a relationship between you and your daughter so if you are happy to continue BFing then keep on doing it and remind all the people who think you should stop at 6 months that the WHO recommends BFing for at least 2 years. Even if you have no intention of feeding that long it will hopefully shut them up a bit.

Sounds like cows milk allergy. Ask the dr for a referral for further testing.