Hydrolysed formula - advice needed!

[StephanieRose]

My 16 week old has been EBF until recently where we have introduced one small bottle a day. He has silent reflux and suspected CMPA so have been eliminating cows milk from my diet for the past 8 weeks. His symptoms gradually got better but has always been very gassy and a little congested. The last two days we have introduced c.100ml of apatmil pepti syneo (on prescription from the Dr) and it looks like his symptoms have flared again. Poor thing is quite congested and uncomfortable lying on his back at nighttime. Could it be that he’s had a reaction to this little amount of formula? I had thought an extensively hydrolysed version would have been ok to introduce? Do I need to continue for a while before going back to the GP? I need to be able to give him a bottle and have had issues with pumping in the past.

[Whentwobecomesthree]

Yes, it's likely he's reacted to the protein. It's not eliminated in pepti just broken down. Some babies with cmpa tolerate it. Some don't. You will need an amino acid formula. Neonate, nutrimagen etc

[Whentwobecomesthree]

Neocate sorry not neonate

[Superscientist]

Breastmilk is sort of equivalent to extensively hydrolysed milk as they are getting the milk proteins after your body has had a go at breaking them down. It often, but not always, the case that babies that react through breastfeeding will need an amino acid formula. I would ask for neocate or alfamino.

Just a clarification for PP nutramigen have 2 formulas for amino acid you need nutramigen puramino. This contains soya that some babies can also react too.

On this note, if you have had an improvement but still have some symptoms and still have soya in your diet I would trial removing that too. Half of babies will react to both soya and milk as the proteins are very similar and why soya makes a good milk replacement

[StephanieRose]

Thanks @Superscientist I had also eliminated soy and eggs from my diet after suspected additional allergies. Slipped up a couple of times with soy recently though and suspected a probable reaction then too (to a lesser extent than with the formula) but good to know about the different formulas. Looks like I’ll be heading back to the GP.

[Autumn1990]

Has the formula got soya in it? I think nutramigen has. You may also need a very broken down formula. Which I think is neocate. It’s been three years since I was mixing hydrolysed formula!
I gave up with it in the end and stayed bf after the lost weight had been regained.

[Sparklediamondstar]

I've had 2 CMPA babies. I breastfed both and they reacted to any dairy I had so I had to eliminate it entirely. Their symptoms were crying a lot, very windy, reflux and projectile vomiting. Once I eliminated dairy for 6 weeks and continued they improved loads but if I slipped any tiny amount would affect them. Often there is an accumulative affect in their bodies so hydrolysed milk for the first 1 or 2 days would be ok but by the 3rd, 4th etc you get the symptoms again. My 2nd also reacted to eggs. They are now 7 and 5 and still can't have loads of dairy as one gets eczema from it and the other tummy aches

[Superscientist]

Going back to the GP sounds like a good shout. Don't let them fob you off with a second hydrolysed formula some guidelines suggest doing so but reacting through breastmilk already shows that they are sensitive little beans to diary. I would go for neocate or alfamino as neither contain soya.

I would also keep a food diary in case of other food allergies especially whilst your diet is in flux as you adapt to life without dairy, soya and eggs. I got myself in quite a pickle by replacing dairy and soya with tomatoes and coconut based foods and she was allergic to those too!