5 week old in pain but allergy milk isn’t helping

[Leash99]

My 5 week old wasn’t reacting well with kendamill formula, he was extremely constipated and bloated and would scream when feeding. My health visitor advised using ready made bottles instead, as the formula could be too hard on his tummy. This helped with the constipation but made him have dark green diarrhoea and he was still bloated and made his symptoms worse than the formula bottles. When I spoke to my health visitor again, I was advised to try infacol because it could be trapped wind and if this didn’t help, go to the doctors. The doctor prescribed him aptamil pepti 1 which initially helped. He wasn’t screaming whilst drinking a bottle anymore but the screaming would happen an hour after the bottle. His belly would still bubble, he was still bloated and his poos would be half green and half mustard and he would wake up screaming just to pass wind (which smelt like adult diarrhoea). I spoke to the doctor and said that he still seems extremely distressed and I was just seeking advice. The doctor said to try him on Nutramigen 1 even though he was only on the aptamil pepti 1 for a week. He has been on nutramigen for a week and no longer screams in pain after a bottle the same way his was with the other milks, but you can see he has trapped wind and he is now sick after every bottle but has never been sick with other formulas. He is also still very bloated and overall a fussy and unhappy baby. Sometimes I can be winding him for an hour after his bottle and he doesn’t burp once. Infacol doesn’t help this either. I spoke to the doctor yesterday as I needed more nutramigen prescribed and she suggested gaviscon because the milk could be causing reflux, it’s only been 24 hours and so far no difference. He is a chunky boy and putting weight on well.
I was wondering if anyone could help me or if anyone had struggled with the same issues?
My thoughts are that he obviously has a reaction to cows milk because if he didn’t, he would’ve been okay on the aptamil pepti 1, and the symptoms wouldn’t have lessened on cmpa milk, they would’ve stayed the same. Aptamil pepti 1 wasn’t trialled long enough to see any proper results and the same with nutramigen (which he’s on currently)
im not sure what I’m dealing with or how to help my baby, the doctors don’t seem to be helping and just keep changing his milk which will obviously give him a bad belly and take some time to adjust so I’m not sure what milk actually helps, if either of them even do. Whether he’s suffering from silent reflux and/or trapped wind (he has multiple symptoms of both). Please let me know if anyone’s little one had anything similar.

I can't really comment on the allergy possibility but I've had two DC with stomach pains and terrible problems burping. Even the oldest who's now at school still can't burp by himself.

Things that might be worth trying:

Gripe water was always better for us than infacol, similarly Dentinox colic drops have dill which can help relax the tummy.

Colief can help break down the lactose which I found stopped the tummy bubbling noise in one DC.

Tummy massage and bicycling the legs to release trapped wind.

Different bottles to minimise air going down.

Probiotics to aid digestion (biogaia or biokult are good ones)

You could give gaviscon a go in case there is some reflux going on. It won't do any harm to try. But long term can cause constipation.

I've come to the conclusion that there's multiple things going on with my youngest (now 2yo) even if we find something that helps, its only ticking one of many boxes. Until he can effectively communicate about his symptoms then I don't think we'll be able to solve it.

My nephew was like that, they tried him on goats milk formula and he was totally different overnight. He is 4 now and drinks normal cows milk with no issue.

Try a different brand eg Cow and Gate. Also try colic drops that are available at chemists and supermarkets. Your baby could be in pain due to trapped wind or constipation.

Pepti 1 still had cow's milk protein in.

You need to trial a milk which is for severe CMPA.

Join the CMPA support facebook group- there will be lots of good advice on there. I'm not sure of the names of the formulas to ask for because I breastfed and cut out the foods myself, but I know that they always try pepti first as it's cheaper. Most babies with true CMPA fail on it.

If it is CMPA, please don't panic. I have a 7yo and a 4yo who both carry epi pens but you do adjust and it does get easier.

Hang in there. Allergy babies are HARD WORK.

Reflux and allergies can be two separate issues. My daughter has both.
The formulas you are trying are still cows milk based, the milk proteins have just been broken down a bit which means that some babies won't recognise them as dairy proteins. The next step is an amino acid formula such as neocate or alfamino.

The hypoallergenic formulas are thinner than regular formulas which means they often need thickening as the will trigger reflux otherwise. Gaviscon is one option but there are others. The downside to thickeners is they can cause constipation. My daughter needed a stool softener alongside the gaviscon for a while.

The screaming could be due to a dairy allergy or might suggest that there is some silent reflux at play too. As I said my daughter has both and in addition to a diet eliminating her allergens and thickening liquids she has needed medication for her reflux too. Omperazole or lansoprazole are often the medication prescribed. These reduce the amount of acid that the body produces so that when milk is refluxed it doesn't cause as much distress. Just a warning if you go down this route the first week or two can be worse as the body adjusts to the medication. Initially it can try to override the demand to make less acid by producing more.

First steps for me would be to enquire about an amino acid formula and look into thickners.

Another tip for reflux (my daughter had it badly and would projectile vomit as a baby , hiccuping is one of the signs) is to slightly raise the head end of her mattress, in her cot and in her buggy. No more than an inch or two, you can buy wedges similar to seating wedges used to raise the level of your pelvis from your knees. If you can't buy a wedge, use a folded or tiled towel or tea towel . My daughter didn't lie flat until fully on solids.
Also when winding, be very gentle but very persistant. No bouncing or 'thumping' on the back, just very gentle taps but for up to 20-30 mins after a feed. You can also put her right up on your shoulder, so that her solar plexus is higher than you would normally hold her. This helps with the burps. And never feed her flat on her back, always seated or 45 degrees, and keep her upright for half an hour after a feed. Reflux means that their stomach valves aren't closing properly so the milk/stomach acids comes back up. Keeping the baby upright helps everything stay where it should.
This was all advice from a pro infant feeding specialist, and it really helped.

Thank you for all your advice everyone! I spoke to a dietitian yesterday so now theres some what of a plan in place to figure out what’s going on. I will try everything you have all suggested! Thanks again x