Does this sound like cmpa?

[twinkydink]

My little one has been ebf since birth and is now just over 4 months.

I've tried formula on 4 occassions and each time he has been sick but the last two times he has been extremely sick. Today he had about 10ml of aptamil and didn't stop being sick for over an hour.

I am going to take him to the doctors on monday but i was hoping for advice before i go. He has always been a windy baby and suffered badly from trapped wind when he was tiny. He has on occassion had constipation too but has never really been a sicky baby.

Do you think this sounds like a cmpa? Obviously we wil be thinking about weaning in the next few weeks so i want to be prepared for it.

Any advice would be greatly appreciated

Yes it does to me, but he's obviously less sensitive to it through your bm. You'll need to ask for dairy free formula or keep boobing (most advice suggests cmpa babies need bm or formula until age 2).

The gp won't be able to tell you much. They can test for cmpa but there are 2 types and 1 (non-ige mediated) won't show up in the tests so you'll only know through food challenging like you've done with the formula

Thanks for such a quick reply that's really useful. I'm happy to keep bfing for a while but I was planning on doing some part time work so wqs hoping to give formula. Is it hard to get the gp to presribe the dairy free formula?

Im thinking about cutting dairy out of my own diet to see if this has any impact on his wind. Would I need to cut out soy to or just dairy?

Well many cmpa babies are allergic to soya so it's wise to, cut both out for 6 weeks (including all hidden dairy in breads and biscuits etc) then 'challenge' by drinking a glass of milk (for dairy), see if symptoms return, then wait and do the same for soya. If you get symptoms back with the challenge then obviously continue to exclude the allergen until the baby is at least 9 months but safer 12 months.

I've heard it can be tricky to get dairy free formula Prescribed but the key issue is getting them to take it, I've heard it tastes absolutely vile, particularly compared to your bm and particularly for babies over 6 months who are wise to it.

There is a fab Facebook group called cmpa for breastfeeding - loads of advice on there but be warned things can be conflicting and there are anti-vaccers and a lot of tripe about gut health on there so take everything with a pinch of salt

Thanks tato, been out and got a few dairy free bits today. It's scary how much food has dairy in!

In all honesty I personally feel a lot better today from not having any dairy. I usually suffer from quite bad smelly wind and today I haven't really had any. Could it improve in me that quickly? It's honestly never occured to me that dairy might not sit well with me but this is making me question it!

Ooh could well be. I recommend oatly barista (grey box) for milk, it's not calcium fortified but works well in tea. You'll need to be taking calcium and vit d supplements. Don't bother with fake cheese they all taste gross. Aldo so a white bread that is soya free if you need that, and jacksons loaves from Morrisons are also soya free. The Facebook pages have loads of advice about where to find df sf treats

Aldi

I felt much better when I went dairy free. I realised I had a problem with lactose but had just lived with it thinking it was normal!

Tesco do a farmhouse loaf which is soy free and most part-baked bread are soy free too.

Thanks again! I think I found the farmhouse loaf yesterday in Tesco.

Cheese was a huge part of my diet so that will be a big change for me. I'm the same eerry i just thought i was a windy person, it didn't occur to me that it was my diet!

I've joined the FB groups and it does sound like my lo is not a severe as others but I will still be seeing the gp because I need him to start taking formula and there is no way I am giving him a normal one again.

I will get some supplements today! Thanks again for the advice, it's such a big change to make I will need all the help I can get!

Don't be too sure. I was adamant that my dd was non-ige mild allergy, then I gave her some direct and she came out in hives in 5 mins so think she is ige. I've never tried her on more than a biscuit though and not had skin prick testing but I suspect it's more severe than I'd thought

Hi Twinkydink, it sounds like FPIES, which (without wanting to be a scaremonger) can be quite bad- and can go with other allergies like soy, rice, oat etc. It is typically not seen in exclusivrly breastfed babies so seems to require direct ingestion of allergens, so it's not necessarily relevant to consider what you have been/are eating - the problem will be with the cow's milk antigens in the formula. You should talk to your GP as FPIES can get out of hand quickly. A GP who knows what this is would probably NOT recommend doing food challenges unsupervised because there is potential for very severe dehydration and associated severe problems if your baby reacts strongly.

There's a good review on it here:
www.ncbi.nlm.nih.gov/pmc/articles/PMC4405595/

As I said above I dont want to be a scaremonger but talk to your GP as this is potentially serious.

also, PM me if you want access to research literature. I joined the CMPA fb group & found many people there are a bit confused, so I found it easier to just read the literature. My DS has allergic proctocolitis, much less of an issue than FPIES.

Hi parents

I saw the gp this morning who said it sounds like cmpa. Sorry to be dense but looking at the sites you have recommended how is it possible to know if it is cmpa or fpies and what is the difference? The gp has recommended we tey aptamil pepti so i will be collecting that from the pharamacy today.

I can't find much about fpies on the NHS. Is the treatment that different from how you would treat cmpa?

fpies stands for food protein induced enterocolitis syndrome. In your case the food protein is one or more cow's milk proteins. FPIES is one of many different ways cows milk protein allergy can present. The point of knowing this is Fpies rather than some other manifestation of cmpa is that fpies can be very serious so it is really important not to do challenges at home. Because fpies may also be caused by soy and other things this is something you need to think about when weaning. You should talk to the gp about this and take the paper i linked to above in case the doc doesnt know that fpies can be caused by other proteins, isnt seen in breastfeeding, etc

These allergies are really rare which is why they're not written up on the nhs website but actually i think fpies is described there but not named, will look when i get a sec.

to clarify -cmpa is not that rare but fpies is. Nhs website diesnt seem to have fpies on its cma page which is wrong of them. I think it is on the food allergy bit somewhere, just so you know it is going to be something recognised by the nhs!