Breastfeeding a CPMI toddler, and sleep!

[ilovetosleep]

DS2 is 18 months and we are both dairy/egg/gluten free. He is still breastfeeds all through the night and I feel these are 'proper' feeds rather than for comfort (although obviously they have become a sleep aid too)

I have carried on with this as a way to ensure adequate calcium intake, but obviously it is bloody hard work and I' exhausted, and he is exhausted, and I would love to night wean,, can't see it going down well AT ALL.

Anyway it was suggested to me yesterday that because of my restricted diet (I have lost a lot of weight over last year) my milk may not be calorific enough and this is why he feeds so much. also that there is nothing quite as filling and calorific as full fat milk, so he is probably hungrier than other kids his age. Has anyone else thought this/had very hungry at night CMPI toddlers? During the day he eats very very well, better than most, the only difference between him and DS1 at the same age is that DS1 had 2x150ml cups of cows milk each day. DS just has one or two small breastfeeds in the day - I can't seem to get him to drink more in daylight hours.

I guess what I'm asking is if you had a CMPI toddler how did you make up those extra calories that other kids get from dairy, and does he 'need' 'milk' of any kind to thrive? And would my milk be less than brilliant with a restricted diet (my instinct says no, its fine) As I'm writing this I am realising that I'm sure I know kids who don't like milk and still sleep all night long!!

I don't really know what I'm asking. Just feel I need to do something about sleep and don't know where to start. I somehow feel his diet is to blame for sleep being so bad. Sorry this is a pretty pointless post and probably in the wrong place anyway!

ilovetosleep, we had a similar pattern, however i found that in our case it wasn't the calories, but turned out to be pain, and he just wanted a cuddle in the night (i stopped BF at about 12 months). DC2 didn't sleep through the night until he was about 18m.o. At that point, i realised that wheat was causing him pain and when i cut it out, he started sleeping through immediately (though, obviously, it could be anything; wheat happened to be (almost) the 'last' of our multiple allergies that i identified).

if you're concerned about calories, you could speak to your doctor about getting something like neocate spoon, if you want the 'milk' alternative. Spoon is kind of a yoghurt consistency so wouldn't reduce his breastfeeding. Personally, we didn't really use neocate, we just used milk alternatives and calcium supplements. there's some yummy coconut milk based yoghurts, and a bit of avocado and banana pureed then mixed into porridge give good oils and a nice creamy consistency/taste.

Whilst they are 'proper' feeds in the night, you may find that more calories in the day means more sleep and he gets out of the habit?

Alternatively, you could express and only feed him bottles in the night - might take away the comfort factor and get him feeding better during the day?

best of luck x

I breastfed DS on an elimination diet for 2.5 years and the main reason I fed him so long was to get all those extra fats and calories into him because his diet was restricted.

Don't worry about your milk being deficient in any way, people say all sort of nonsense about breastfeeding. Breastmilk is amazing stuff and an elimination diet won't effect the nutrients available at all. Breastmilk is actually higher in fatty goodness than either formula or cows milk - even more so in the second year of feeding.

Totally agree that nights waking are probably about comfort. DS is a rubbish sleeper and a lot of that has been down tummy ache. I realised when he was 2 he was also allergic to eggs and things improved a lot when we cut them out.

Thanks for both of those replies. I think I know deep down that the wakings are about comfort. I wish I could do something about it but sleep training isn'y for me. I don't know how I could figure out any thing else to cut out of his diet. He doesn't appear to be in pain to me but he does go apoplectic when I unlatch him before he's fast asleep! I tried to not feed him once and he screamed in my arms for an hour :( Awful.
We are currently doing the milk ladder (day 3 of the first step, seems to be ok so far!) but like I said we're also off gluten and egg. What else could I try?
I should also mention that while on holiday last month he slept amazingly well for 5 nights straight! We were self catering so fairly similar diet to normal, so maybe its not food related at all. The only thing we can think of is that he had less tomato based food while away. We've also just re started him on omeprazole (under GPs advice) to rule out that reflux could be waking him so frequently. He's been on that a week now with no noticable differnece to his sleep.

ilovetosleep, first time my son slept through was holidays too! I thought it was just jetlag (other side of the world), but turned out that he'd just not had any wheat as i didn't have what i normally have in the cupboard (ie egg free, gluten free, etc).

Our 'problem' list is egg, dairy, soy, wheat, corn, barley, peanuts, some tree nuts (not almonds, but not tested all nuts yet), legumes, and gourds.

soy is a common allergen for cmpa kids, i seem to hear tomato a lot too from other mums.

is he getting ear infections?

No ear infections as far as I know. I might try eliminating tomato but its so bloody hard as 90% of my meals contain it! And I could just go on and on... how did you figure out all of those things? He has had clear results from skin prick tests for all of those things, so its just an intolerance thing. I used to cut soy out too but noticed no difference when we went back on it so I don't bother with that anymore...

My DS slept through the night at 18 months old, immediately after I cut soya out of our diet.

I was going to suggest soy as well although I find it by far the hardest as it's in almost everything. DS is super sensitive so soy lectithins are triggers for him as are any 'may contain traces of' type foods. May be worth trying it again?

How much soy was he having trixy? Because we are not giving soy as a dairy supplement, he only has it in the odd pre packaged snack (not every day) or Tamara sauce in a stir fry every couple of weeks. Actually his gf bread has soya protein in but I would say he eats about half a slice every other day. Do you think cutting hay small amount out could make a difference? Like I said I did cut it out until he was about 10months and noticed no difference when I re introduced it...

Re the holiday... I just wrote out from memory our entire itinerary and in actual fact he did have song bol one night and still slept well, so that rules out tomatoes...

Ilovetosleep, some kids can't tolerate ANY soy.

It might not be a strong reaction, but it might be that only a tiny bit causes whatever reaction it is. Skin prick tests are like that; the bigger the weal, the more likely there will be a reaction. However, WHAT the reaction is, is entirely unknown (unless you've seen the person actually react before). Might be a huge weal (so almost definitely the person will react), but the reaction might be as mild as a bit of eczema. Might be a small weal (small chance of reacting), but potential anaphylaxis if they do actually react.

Oh, and a clear skin prick doesn't necessarily mean it's an 'intolerance'; it's very confusing, but there are 2 types of allergic reactions. Only one of those shows up on a skin prick test. EG wheat doesn't show up on our skin prick, but gives DS burst eardrums within 4 days, and really poor behaviour aside from the eardrums. Also, he wasn't growing (in height) properly until he stopped eating wheat, tho he suddenly shot up when we stopped. It's classed as an 'allergy' not an intolerance. Mind, we also have other positive skin prick allergies, so perhaps they err towards allergy rather than intolerance when describing my DS.

I'm so confused. How did you all arrive at your own conclusions? No one seems to believe us and I'm trying to work all this out alone. Well, I do have an official diagnosis of CMPI but the paed just nods and smiles when I say he's reacted to gluten etc. The dietician is even more useless and clearly does not believe in such things (without a +ve allergy test). They think that sleep alone is no reason to suspect an allergy. I'm not sure - he seems in discomfort and his tummy gurgles - but is this normal, am I imagining things?

So Soy. Is it possible for him to be allergic to Soy but not dairy? We have now done a week on the milk ladder first stage and he seems to be fine BUT I guess if he's intolerant to something else it could be masking a reaction?

We have been sitting here all evening discussing his diet while we were away and he slept so well. He did have soya, the only things we can think of that he didn't have are chicken, citrus fruit (he LOVES satsuma) and egg.

But he hasn't had egg since we got back and he's worse than ever so I doubt its that.

TBH i swing from fretting about all this to thinking he's just a shite sleeper and I'm being too soft by attributing that to some kind of pain or discomfort.

Am going to see GP this week as she's pretty supportive. She has suggested we try phenergan though!

he's right; sleep alone is not a reason for an allergy test, but you can present more info if you need.... the 'gold standard' is food trialling - which you can effectively do by diarying - you can google for detail, but basically every single thing that is eaten (and when), and every single reaction written down (and when) - including things you might not think are reactions (such as bad behaviour). Sometimes you can spot a culprit when you go back through the diary; sometimes just the act of writing it down makes it more clear. Cut out anything that is 'suspect'; see if things get better (keep it out of diet for at least 2 weeks). Reintroduce it after that and see if things get worse. Keep going until you can't find any more suspect foods, or the symtoms go away. Show your paed the book when s/he questions you. EG: here; food x is eaten ... then he vomits for 4 days following. Again, here same food eaten, then vomiting for 4 days again... etc etc. Foods can take days for the reactions to show up. DS's eardrums burst about 4 days after eating wheat. Takes several weeks to heal, then if he eats wheat again, about 4 days later, they go again.

entirely possible to be allergic to any given thing and not others..... re satsumas; i've come across lots of people whose kids are citrus allergic. Try cutting them out and see what happens. hide them so he doesn't see them and want one (and you don't give in)... keep him off them (and all citrus fruits probably) for 2 weeks, then reintroduce.

as an aside, 'gluten' reactions are usually coeliac disease - quite different from food allergies. you can, of course, have both, but it's unlucky. you may want to consider if it's an allergy to, say, wheat, which is more likely. You can buy gluten free products which do contain wheat (if you wanted to test). We react to both wheat and barley, but i'm pretty sure it's the proteins, not the gluten in our case. hard to actually tell without food trialling and/or coeliac biopsy/test.

PS. my gp categorically told me it wasn't allergies despite me questioning all the issues right from 2 weeks old. amongst the (wrong) advice she gave me... 'can't have an allergic reaction to foods through breastmilk' & 'he can't have allergies as he weighs too much'. I googled my life away, cut out things from my diet and he improved enormously. I then started going to all the training conferences (for GPs/dietitians etc) that she wasn't going to, so I didn't have to rely on her. When DS completely puffed up from something (still don't know what it was i ate) at 8 months, she finally gave us referral to allergy clinic. She is now adamantly telling me that my DC3 can't have allergies (breastfed, etc). I pointed out she said that last time and she refused to change her mind. Easier to do it myself. Can use big brother's epipen if need be in emergency. If we have a major allergic reaction we will finally get on the system, but until then it's a wait and see approach.