Reintroducing cows milk....

[MamatobeFeb20]

Hi guys, just looking for a bit of advice.
I have a 6 month old EBF baby who started becoming unsettled around 6-8 weeks, really colicky, not regular with poos and really unsettled during the day. She was prescribed omeprazole for silent reflux and I was advised to trial a dairy free diet if it didn't help.
Long story short, I've been dairy free since, with the odd blip, which has matched up with DDs unsettled days.
I was advised by my HV to trial milk as weaning commences and she advised we give her some formula instead of me taking it in my diet as its quicker to get rid of the effects should she react to it.
The night before last, we gave her a bottle of it and no major flare ups but tonight after another bottle, she's been so unsettled. She was quite unsettled the days leading up to trying the bottle (maybe teething or the fact we've started on a little bit of solids?) so I don't want to instantly put it down to the formula.
My question is - when introducing dairy, should I continue on with it for a week or so to see if symptoms settle or not, or is that cruel/bad for her tummy?
Thanks in advance for any advice.

Hi Op,

I'm sorry to hear you've been having dairy troubles with your LO.
Have you spoken to your GP?

6 months is quite young to start reintroducing dairy if an intolerance is suspected. The advice I was given was that you should be DF for at least 6 months before you attempt any reintroduction, and usually not until your child is around 1 years of age.

With no disrespect to your HV "Quicker to get rid of the effects" sounds like absolute nonsense to me.
The re-introduction of dairy is usually done by following the "milk ladder" which gradually introduces dairy in ever increasing volumes and states of "cookedness" (making up words here). You can search on here for the many threads about it, but also on Facebook as there are several dedicated groups on there that are a fantastic resource. There are two ladders, a 6 and a 12 step one.

The general rule is that if it looks like a reaction, stop immediately and go back to the previous step. In your case, to being DF, until things settled and then try again in a few months.

If you want to formula feed, there are DF alternatives that your GP can advise on and prescribe.

HTH

Good luck xxx

HV aren’t qualified to and shouldn’t be giving out info about reintroducing dairy to a baby with a suspected allergy. You need to ask your GP for a referral to a paediatric dietitian. As a general rule the milk ladder is started when babies are 1 years old and 6 months after their last reaction. There is a 12 step milk ladder where the child is giving milk which less and less processed. Formula is at the top of the ladder and would be the last thing to give.

Thanks so much for your advice guys, I really appreciate it. I've been so reluctant to go to the GPs after the shocking experience I had with it all with my first. I ended up seeing a paeds consultant, by which point, my DD was labelled 'failure to thrive' before I got prescription milk and taken seriously. Although I'm breastfeeding this time, I would like some proper guidance how to go through the weaning process again and the milk ladder etc. I'll defo make an appt and this time, arm myself with knowledge (and a backbone) before I go.

@MamatobeFeb20 keep at it. It took several visits to my GP to get anywhere with a referral especially as my LO was EBF, but stand firm, you know your baby better than anyone else. If she is reacting to the tiny amount that would come through breast milk, it's no wonder normal formula made her feel unwell.

Thanks @SEE123.
My HV actually contacted me yesterday to ask how I was introducing foods etc and how it's been getting on so I brought up the formula issue.
She has advised me to introduce a little hut of dairy into my own diet now and if she reacts then to stop immediately and we'll know for definite that it's a milk allergy rather than a lactose intolerance with the formula? She's also putting in a request for a dietician appt and a GP appt for a specialist formula.
I'm thinking instead of introducing dairy now, while she's still unsettled after the formula issue, that I'll wait for an appt with the dietician as she'll be a lot more informed regarding the process?

Human breast milk has three times the amount of lactose as cow milk so if she is fine with bf then its not a lactose issue.

Oh really @lockdownseperation?! I didnt realise that. So babies that are lactose intolerant can't have breastmilk at all?

Shes been absolutely grand with breastmilk so it's defo not that. I think I'll wait on the dietician input!

It doesn't sound like your HV has any clue what she is talking about I am sorry to say. ALL animal milks, including human milk, have lactose as their main sugar, and as the PP said, human milk is particularly lactose rich. If your baby is not reacting to breastmilk, she is not lactose intolerant. Its very rare as a primary problem in babies anyway. Babies who are reacting to cows milk protein, or who have had gut infections can develop a secondary lactose intolerance as inflammation in the gut from any reason can damage the cells that produce lactase, the enzyme that breaks down lactose, but it is extremely unusual for an infant to actually fail to produce lactase totally.
The method your HV is suggesting to differentiate between the two makes no sense so I would be inclined to ignore anything else she has to say on the subject and wait for guidance from a paediatrician or dietician. There is no rush to introduce cows milk to your baby's diet. It is convenient of course, but its not an essential part of the human diet and it will do your baby no harm to wait. Potential allergens need to be introduced in a careful and logical way, so don't let the HV steamroller you into anything you aren't comfortable with.

My DS is dairy intolerant and is 20 months now, he can tolerate a bit of cheese or yoghurt in small amounts, but if given too much it will flare back up. I'm hoping in the next few months he will gradually be able to have a bit more.

Thanks so much @mrsAvocet - I think you're right in terms of ignoring the HV. She seems to be giving contradictory advice and it's really confusing me/stressing me out. I didn't understand the issue of introducing dairy before weaning - I'm happy to mix the initial veg/porridge with my own breastmilk and it's easy enough to avoid dairy nowadays and introduce it via the milk ladder in a controlled way once she's a bit older.

Sorry for the late reply @MamatobeFeb20

Thankfully other posters gave you some sound advice! Great HV followed up, not so great that she is mixing two separate issues. Good luck with it all. Your latest post on holding off on reintroducing dairy and speaking to dietitian is a really good plan. Let us know how you get on.

@MamatobeFeb20 definitely speak to a dietician before reintroducing dairy to a baby that young.
My now 7 year old was diagnosed at 6 months by skin prick test as allergic to dairy and eggs. He was so bad that just touching dairy brought him out in hives. I was off dairy and eggs for over two years as breastfeeding and strict avoidance. He was under the allergy and dermatology (bad eczema) team. We started the dairy ladder at 3 years after years of skin tests and by age 5.5 he was able to eat pizza. He can eat dairy ice cream but we have to give him antihistamine.
We just started on the egg ladder so hopefully we will get on well.

With weaning as we were unable to have dairy and eggs, we had lentils, quinoa, chickpeas, buckwheat, spirulina, lots of veg. His diet is varied and he is willing to try new foods unlike his non allergic brother.
Hope you speak to an allergist and a dietician soon.