Reflux and milk allergy link

[cazzy2]

Hi

My 7 week old has been diagnosed with reflux by gp and is waiting to see pediatrician. My feeling is that he is allergic to cows milk and this is causing his reflux. Has anyone been in a similar situation? Is the hospital likely to try eliminating cosw milk or will they just try to treat his reflux symptoms.

You are lucky to have been referred so quickly by your GP :-) Many have to fight for months to get taken seriously. So thats good news.

Normally the first line of attack should be to change the milk to a hypoallergenic formula like nutramigen or neocate (often combined with thickener like carobel) and i would push for this first - assuming you are bottle feeding of course. If you are breastfeeding then obviously its a matter of excluding dairy from your own diet. If this doesnt work then there are various drugs to try (ranitidine, losec). Some babies may be better on the change of milk and thats all thats needed, others need the drugs as well.

You might find this useful reading
www.paediatricgastroenterologist.co.uk/development.htm

hth
alice

Hi Alice

Thanks for the advice.
I am bottle feeding so I will push for the change of milk and thickener.
I was wondering are they likely to change his milk without any other noticeable allergy symptoms such as a rash? Although having said that he does have slightly dry skin on his face with small red spots from time to time.
I guess my fear is that the pediatrician will just treat his reflux symptoms without getting to the real cause.

thanks for your help

reflux can just resolve itself as the baby matures - it isn't always caused by a milk allergy so it can just be a case of treating the symptoms until the baby has outgrown it (or the stomach area has matured enough for reflux not to happen).

if you mention your concerns to the paed, I'm sure they'll look into it

Reflux is a condition in its own right as far as I am aware and not 'caused' by milk intolerance or allergy.

BUT

It is very common for reflux babies to have a milk intolerance or allergy apparently.

My DS1 had silent reflux which was not discovered until he was 3 months. Had medication which helped HUGELY.

It wasnt until he was 2 that we realised he also had a milk intolerance. The HV (who had been our HV all along) said
'oh yes, its very common with reflux babies' to which I replied 'you could have told us that earlier'

do you know this makes so much sense now i have read this!! my ds2 is 6mth and has milk allergy. he is still bf but has pepti junior mixed with his food, he also has some reflux which my hv has said will go by 8 months but maybe not then if its milk related?
i have cut milk out of my diet as he seems to get really mucuosy and you can hear it gurgling in his chest/throat when i was still drinking milk.

maybe i should ask to be refered also.

Since my son has had reflux I have done lots of research on the internet and found that as many as 80% of doctors according to a survey miss milk allergy in infants altogether and diagnose colic or reflux instead.

There was aslo some information from a study of babies with reflux suggesting that as many as 45% had symptoms of reflux disapear when milk was removed fron there diet

my dd3 had milk intolerance. when ff for the first time at 6 weeks she had bile come out in her nappies and became dehydrated from vomiting as well (rash too) and was inconsolable. we were given neocate, but didn't use it much because i was bf. we also discovered she had the same prob with goats milk and soya. so i had to cut all those things from my diet until she was tested in hospital for the day after she'd reached a year old. she can eat anything now luckily (she has a great uncle who is still allergic to dairy products and he's in his 60s) after i cut the dairy from my diet too she seemed more settled. btw my hv was worse than useless telling us it was lactose intolerance! good luck

Hi there all
I have a 7-month-old daughter, born a month prem and who's struggled to stay on the 0.4th percentile all along, who has had reflux since she was about two weeks, though it was only diagnosed 3 weeks ago despite numerous concerned visits to GPs. Her reflux gradually got worse and worse till she was projectile-vomiting up the whole of every feed. After my pushing for a referral she's now on ranitidine twice a day and domperidone 4 times a day. This worked a treat for the first week and she seemed SO much happier (and so was I), but now it seems to be wearing off - she's up to at least one big projectile a day. Am wondering whether there may be an element of cows' milk intolerance in this. Has anyone in this situation had good results by switching to goat's milk formula or one of the low-allergy ones like Pregestimil, Pepti-Junior etc that I've been reading about? Thanks so much...

Hello. My son was similar. He was 3 weeks early and is still small. He also struggled with reflux, although we didn't get on with gaviscon and didn't get any further. When I weaned him he turned out to be allergic to cows milk. So I'd say its possible and worth trying, although our paed was very scathing about goats milk.

DS doesn't get on with cows milk and is on gaviscon for refluc. Well done for getting a referral, I have only just got one to a nutritionist and that was with pushing at 9 months.

I know, it's very hard to get a referral. I have been really cross with how dismissive - and ill-informed - the GPs at my surgery have been. We're using Gaviscon at the moment, though it doesn't seem to be making a lot of difference. Every feed time is stressful, though I try hard not to show it. She takes a bit of food and milk and then starts crying, and the rest of the feed is a struggle. It's very wearing for everyone.

My son is 13 weeks old and was diagnosed with milk intolerance after 6 very stressful weeks. Finally Neocate sorted his poo out and he bagan to regain weight. Fortunately he was a big baby at 9lb2. Feeding has always been a challenge but at 8 weeks it became a nightmare with him showing signs of obvious pain after just 2 oz of milk, afterwhich he'd refuse food. My paed hasnt been terribly helpful and it was a friend who suggested silent reflux. On mentioning this to the paed, she agreed completely as he shows all the symptoms in their extreme.Silent reflux is where they dont bring the milk up, but unfortunately he then isnt relieved. He's on Domperidone 3 times a day and Omeprezole once a day, ive just increased his dosage of this to 3.5ml. We've also been going to a Cranial Osteopath which seems to have helped. However in the last week things have got worse he's only taking between 17 and 21 oz a day, practically force fed, and is only 14lb at his weigh in last week. He's not napping during the day as he's hungry and is now waking 2-3 times a night hungry, but only takes a few ounzes! Im very concerned, stressed and exhausted - and totally dread feeding time. Have left emails and msgs with Paed and Paed Dietician but havnt heard from them. Please help, any advice welcome!!!

Paula

Cazzy, it's definitely something to watch out for - especially if treating the reflux doesn't seem to help. Usually there is something like eczema or mucousy poos which suggest a cow's milk intolerance/allergy.

Paula, I was in your position a year ago - it was unbelievably stressful and depressing. DS fed best at night when he was less aware, so took in most of his milk then. I also dreaded feeding times because he just wouldn't. Weight gain was awful, but he was healthy, bright and alert which made a huge difference. Another side effect was sleep disturbance and this was always worse the weeks after he had vaccinations.

It's very difficult - not much advice but lots of sympathy. Things changed for us at 7 months when I stopped breastfeeding and put him on Neocate - hopefully they will change earlier for you since you've already put him on Neocate. (I tried Neocate earlier, but it didn't seem to help at 3 months).

It went in phases - some days and weeks were better or worse than others. Basically, I just had to soldier on and luckily had wonderful supportive family, friends and an amazing paed. He still has issues, but it really is so much better now. Also, I've learned to relax a bit - he's still a bit skinny but I no longer worry about how much he weighs as long as he's healthy.

Hi just been prescribed nutrmigen 1 and the tin has finally arrived but is in Polish!!! Please can anyone tell me what ratio of water to powder I mix it?!!!

sorry don't know about nutramigen - try typing instructions into an online translator, start a special thread or ask the pharmacist.

Anyone else with a baby with reflux may want to look at the wedges and positioning aids that are sold as sleeping on a slope is helpful.

I had the same idea when my baby was diagnosed with reflux. But it has nothing to do with milk allergy. I stayed on Aptamil and the reflux got treated (domperidone and renta-something), homeopathy and osteopathy and went away. It can be extremely stressful so good luck and remember, it doesn't last long!!

Now I'm thinking my baby has silent reflux, will not take his bottle, unless at night or half asleep. If he does, he screams once he has finished? But he is 5 months old, can it suddenly develop or was it there all along?

It might well be silent reflux. My little boy cried constantly, refused to feed, was in such distress it was horrendous. We were told by at least three docs that he had reflux and we just had to live with it - he would grow out of it etc.
In the end I got him referred to a Paed gastro specialist, who recognised straight away that his problems were severe. He had an endoscopy at 8 weeks old, and had nasty acid burns in his throat and oesophagus. We tried all sorts of formulae for him - Pepti, Soya, Nutramigen etc, but this doctor put him straight onto Neocate, thickened with Carobel. Over time it's been established that he has a bad cows milk protein allergy (and can't tolerate soya either as the proteins are very similar). The Consultant has said to me that he has seen an increase in the numbers of children with both reflux and cows milk protein allergy in recent years, though it's uncertain why.

Many children will grow out of both the reflux and the milk protein allergy. My son unfortunately has not so far. He's 17 months old now, but is absolutely fine as long as he is medicated properly and has a totally dairy and soya free diet. He takes domperidone and omeprazole (ranitidine didn't work for him) and still has his neocate and carobel. He eats a good diet of meat, fish, fruit, veg, pasta etc - but if we even slightly go off track (eg a few chocolate buttons) we know about it.

Thank God we found this doctor - he changed our lives in a matter of weeks (it took 5-6 weeks for the acid burns to heal and the neocate to take effect) He took my baby seriously from the offset, and we still see him every 4-5 months along with the paed dietician, who makes sure my son gets all the nutrition he needs.

I suppose there are steps to go through - first my GP prescribed infant gaviscon which did nothing, then he referred him to the paed day unit at the hospital where a general paed prescribed ranitidine and changed his milk onto nutramigen - again no luck. I took him to A&E once as I was so upset with his condition - they admitted him to children's ward where very little was done. Nobody even told me about this paed gastro bloke - even though he works in the same hospital!!! I found out by chance through a neighbour who works in social services, and I went to my GP and demanded that we be referred to him. The rest is history.

I hope this is helpful - what I'm saying is that not all doctors recognise silent reflux, or realise the severity of it. I dread to think where we'd be now if we hadn't pushed to see the right person.

Good luck. x

HI ladies thanks for your replies. Its great to know that its not just me being neurotic! Had his third jabs last week so may be having a bad affect. Has been refusing feeds through most the day but taking three feeds - 18oz at night. Thought it might be taste of neocate, so decided to experiment and tried to go back to Cow and Gate comfort last night. Disastrous results, had very restless night and diarrhea today, poor wee man. So we-re straight back on neocate. Have been flavouring neocate with a few drops of vanilla. Have read that it comes in banana flavour, so will contact paediatrician. I think the best advice for me would be to relax and stop getting stressed. As long as hes gaining weight and hes happy thats the important thing.

I think the banana flavour is for one year plus. The neocate DOES have a yukky taste to it, but they really do adjust to it, and now my son loves it. In fact, on the odd occasion he's managed to get a hold of his twin sister's ordinary cow and gate formula, he pulls a face and spits it out. I would say just persist - when he's hungry, he will take it.

Your baby sounds very like mine in that his intolerance is very quickly apparent if he takes something that disagrees with him. I went through the same thing with the milk - as DS had got to love the taste of the super-sweet soya formula when the doctors tried him on that. I thought he would never get used to it, but he did, and like I say he guzzles it down now. If you stick it out, I'm sure he will settle wonderfully well on the neocate, though it might take a few weeks to clearout the effects of the cow and gate comfort.

I don't want to sound like a know-all, but if my boy, who was just so hideously unwell (the doctor said he'd only ever seen 2 or 3 kids as severe in his 35 year career) can come through so well, and turn into this gorgeous huge strong boy, then so can yours. Best of luck to you both. x

dd had severe reflux and did indeed turn out to be cow's milk intolerant... unfortunately i had no MN back then and never realised that simply not drinking milk myself (bf)would probably have alleviated alot of her problems

Hi My DS was diagnosed with Reflux while still in in hospital at about 5 days old. Looking back I think the severe projectile vomiting was also caused by the formula he had after birth. (long story but he should of been in SCBU but no room so decided to keep him on ward but treat as they would in SCBU ie same obs and feeding regime but without the benefit of DBM for the first few days). He did have Reflux that got so bad he was vomiting blood regularily and had to go to hopsital several times. An endoscope confirmed serious Reflux that had damaged his oesaphagus. He was put on Omprezole and continued on this but his vomiting comtinued and got much worse when he was weaned.

Doctors finally suggested he may be dairy intolerent at a year old and a dairy free diet gave almost immediate relief. A later X-ray confirmed he still had Reflux, and as you will know you are constantly told they will 'grow out of it' as many babies do, but the thing is for some it does still go on

DS is now nearly four (in Jan) and still has Reflux and is still dairy intolerent, any hint of me eating dairy (still b/f) and it causes him discomfort at night. We have been told that 'when he goes to nursery and is around others he will probably grow out of his intolerence'

Right now I'm not willing to risk it frankly DS is under a well respected Gastro Pead but will still get a lot of '"well we dont knows" "were not sure's" and "well he'll grow out of its"

Sorry think I went a bit ranty there

My DS2 5 weeks has allegy to cows milk (suspected) - rash, excess wind, runny nappied all day and upset at night, now on Nutramigen, and symptoms cleared up mostly. (Also bf but have cut out dairy also) Now he seems little unsettled during the day (not screaming thank fully) but after food doesnt like to be put down (I just thought still wanted cuddles) also waking middle of night for what seems like tummy pain? wind? curling legs up and straining. He will appear to have finished feeding but then put him down and 10 mins later still hungry. These symptoms seem to be gettingworse with a little sickness now and again, do you think these are reflux symptoms? off to docs tomorrw but want to make sure im armed with some knowledge so cant be fobbed off! thanks for reading

CMP allergy and reflux do often go hand in hand. My DS is allergic to milk and had prolonged reflux until the age of 2, even though he had no dairy in his diet from approx. 6 mths. Something to do with the lining of his oesphagus being inflammed by his allergies I believe. At 5 wks old I'd suggest it could be silent reflux (meaning without the characteristic projectile vomiting) but it could equally be colic. With reflux, babies will often 'fuss' during feeds, latching on hungrily for 30 secs or so then come off screaming, arching back etc as the acid builds up in their throat. Have you tried colic drops at all? The symptoms you mention do sound very like colic but I definitely think it's worth discussing with doctor.