Advice needed for 4 month old

[Charliezzzz]

Please can anyone offer advice, or share personal experience of baby with possible allergies?
Lo is EBF, symptoms started at 4 weeks; green mucousy liquid nappies up to 12 times a day/ streaks of blood in stool/ eczema/ reflux/ pulling of breast with arching back/ fishy smelling stools. However he sleeps really well, is gaining weight, happy and other wise healthy. I have been dairy & soy free for nearly 6 weeks, the only real improvement is frequency of nappies dropped to 3-5 a day. I also decided to cut out wheat/eggs/chocolate (nearly 2 weeks now) as these are the other foods that I mostly consume that thought could be possible allergens. Again I haven't seen a great deal of improvement, the colour of stools is slightly more yellow but same slimy consistency and have a few nappies that look just like snot (sorry tmi). Have seen gp and pead dietitian who wasn't clear with advice and I don't feel supported. My queries are:

• should I drink milk and see how it affects baby? (dietitian seemed to think this was ok to do)
• should I offer baby formula to see how it affects him?
• should I start weaning now and offer fruits/veg (again dietitian said would be ok)
• is there any other reasons for mucousy poo that I should be considering? (I do have Ulcerative colitis but this was dismissed by two GP's)
• should I push further for a referral to peaditrian or allergy clinic? (GP's don't think this is nessisary as LO is gaining weight)

Sorry for long post, appreciate anyone's input as I'm confused as what to do for the best.

Sorry can't answer all of your questions but yes, p,ease do push for a referral to a Paed, if you think they won't listen take your DH, if you have one. Sadly my GPS only too me seriously when DH came too.

Could you film LO when he is doing the back arching and screaming?

Don't wean now unless advised by an allergy specialist. I'd challenge - drink a big glass of milk and see what happens. Although have you been cutting out all dairy including hidden dairy? Because I wouldn't have listed chocolate separately to cutting out dairy (although I despise dark chocolate so you may just mean that)

Do you have oversupply/fast let down?

Thank you both so much for replying! I'm driving myself crazy trying to figure out what is/isn't upsetting him, and totally obsessing about food and labels! I have been really strict with all hidden dairy too but I guess I could have slipped up a few times, it's a lot to get used to. I was meaning dark chocolate and coco powder which I was using to replace milk chocolate from cutting out dairy.
It's worth a try bringing DH with me next time to see GP thanks for the tip.
I think I did have bit of fast let down as LO used to choke a bit when milk let down. Seems to have improved and I did try bloke feeding for 2 weeks before cutting out dairy & soy, which didn't make a difference.
I think I will challenge the milk, at least then hopefully I will know for sure one way or another. Any idea how long after me drinking milk it would show in LO?

Sorry had to at Bloke feeding. Do you earn much doing that?

Charliezzz

I'd follow WHO guidance on weaning and wait til 6mo. Your DS has enough going on in his gut without adding in food!

as per the other thread where we were chatting on here- it sounds like your DS has FPIAP, an allergic condition, which - while it is likely to clear up by itself around a year - should be seen by a hospital paediatric allergy clinic rather than just a dietitian. Your DS should also be guven a full microbiological screen just to check it's not actually Shigella or Giardia or something (doesn't sound like it, but worth checking).

Look at soy content in stuff like chocolate - almost all will have soy or dairy in it, often both.

This paper gives an overview od FPIAP (in case the GP needs a refresher - ours did...)
www.ncbi.nlm.nih.gov/pmc/articles/PMC4405595/

as does this
www.ncbi.nlm.nih.gov/pubmed/25956013

and this paper describes a typical case
www.ncbi.nlm.nih.gov/pubmed/17584315

(PM me if you want PDFs of the paywalled papers)

I assume you're being really strict re: dairy and soya (ie reading all labels?) I have to say DD's nappies didn't really improve until she started solids, and this is apparently reasonably common with allergy children. Hers didn't sound quite as bad as your baby's, but they were explosive, mucousy and frequent until she was eating good amounts of food.

Sorry just saw your reply that you are being obsessively careful Previous post sounds like a good route to explore - I've never heard of FPIAP!

Again thanks for the responses, haha that should read "block" feeding.
I think the same about weaning, surely it's just adding more for his upset tummy to deal with but the dietitian thought not. Thanks for the info on FPIAP, I never knew any of theses things existed- I nievely presumed by breastfeeding I was doing "best" for baby and there wouldn't be any issues past getting them latched etc. Can I ask, are you under hospital care for FPIAP with your baby or GP managed? I'm going back to the GP 2moro to explain things again and see if they will refer me. The dietitians report suggested this was the course of action if he was still symptomatic. I'm pretty sure I haven't had any dairy or soy, I was having free from chocolate cakes and moo chocolate that is dairy and soy free until I cut out chocolate and egg (in the cakes). So if it is FPIAP then it should only be dairy and maybe soy that he would react to? And I reading the info right?

FPIAP is just a description of symptoms — he could be allergic to anything. However dairy and soy are the overwhelmingly likely allergens so I'd assume those first then if no change (and it may take more than 6 wks to see a change) explore other allergens.

We have a paediatric allergy clinic at our local hospital, and hopefully have got an appointment there soon (after GP referral went astray 4 times in a row). This could be managed by a GP but they are unlikely to have time to do it so should refer.

I think there is no evidence of a link with ulcerative colitis but that is probably because noone has looked. FPIAP was only described as a veey rare thing in 1982 so there isn't long term data to say that this doesn't correlate with adult gut issues (short term data says no problems in 10 year olds). FPIES has been known longer (it is in a general baby care book from the mid 70s for example) but it seems to be a different thing.

Ok that makes sence, thank you very much for taking time to reply and share your knowledge of it. Will definitely mention to gp and ask for referral now. Will stick with dairy & soy free for now then and see if things get any better, did some more reading last night and found corn could be an issue- I never really consumed that much but think by cutting wheat it's become a replacement and DS had a bad night with 3 bad slimy nappies through the night, extra fussy and disturbed sleep- I ate popcorn and corn flakes during the day so could be more than coinsidence perhaps.

Yep rice is abetter replacement than corn— we had the same thing last weekend. Living on rice and rice cakes is getting old quickly though...

As a nutritionist, what would be recommended would be to take a food diary, and record what your baby is eating. You can also track the time-lag between meals and symptoms. This may help the dietitian decide what exactly is going on. At least then you can be sure of what is definitely exacerbating symptoms. A good app that is built for just this is www.alliapp.com and is recommended by the NHS. Hope it helps!