Baby still reacting to breastmilk

[Khalilsmama]

Hi

I am about to give up breastfeeding my 19 week old baby boy. I exclusively breastfeed and have done with my previous boy for 15 months. I noticed quickly that he was showing signs of cmpa (first boy had it too and was fine once i cut out dairy eggs and soy). So I did the same from week 2 which made a small difference.

however he is still in agony (especially at night) they called it colic. Cant be as hes getting worse and is 4 months now. He has green mucus poos and gets hives every now and again.

i’m being pressured by GPs to put him on neocate or alfamino which tbh I would rather not as I don’t agree with the ingredients in these formulas and he’s already on omeprazole for reflux which these formulas are known to make worse. so ive been keeping a food diary instead to pinpoint his other allergens. Can’t seem to work it out though.

any way to test for intolerances? I know only IGE allergies show up but I’m desperate to figure it out so I can continue breastfeeding him. He is in agony when its time to sleep he cant distract himself bless him. Or is there any other common allergens? Should I just give in to the formula. He doesnt even take a bottle (I’ve tried😭).

would really appreciate some guidance on this because i havent had more than 2-3 hours sleep in 4 months and I’m exhausted.

Don't give up yet. My DC2 was similar and once we started solids it became harder to identify trigger foods. He was always unsettled so I had no idea if one food was worse than another. I fed him for 18 months and stopping the breastmilk made no difference. (Sorry to say, he's 2 now and still has digestion issues)

We did however discover he has problems with wheat, citrus and anything greasy.

I'd suggest cutting out wheat, gluten and oats first. Those are the next most common allergens.

You could also try probiotics

Elimination is all you can do for non-ige allergies. Keep going with breastfeeding if you can - you’re doing brilliantly, I think the other milks and stopping would be way more stressful, personally. Can you take what you eat back to basics? Gluten worth stopping, as well as nuts.

If hives are present then there might be an IGE element too. We paid for private skin prick testing for my son at 8 months old after weaning brought on reactions, it cost about 500 in total I think.

You’re only 5-6 weeks away from food introductions, when things will become a lot clearer. My DS was allergic to a long list of stuff - dairy, eggs, peanut, most tree nuts, sesame, lentils and peas.

Good luck.

Just to add - pp said that weaning made it harder to identify triggers. To combat that I’d introduce single food items and leave a gap of a couple of days, Start with vegetables then try to get through allergens fairly quickly but individually at a slow pace and know that the second try is the one that will provoke a reaction so try twice at least. Things like yoghurt, porridge made with water and fruit, tiny bits of peanut butter on a spoon mixed with water, scrambled egg.

You need really detailed food diaries including absolutely all ingredients and all behaviours in the day.
My daughter has 20 delayed allergies which she reacted to through my breastmilk but to get that list I probably removed 2-3 times the number for foods trying to identify the causes. Learning about food groups she's allergic to all alliums, nearly all nightshades and a couple of legumes. She's allergic to more vegetables than top 14 allergens.
We found that we had issues with feeding, she needed to be held and paced more and was harder to keep occupied in the hours after I had eaten something she reacted to. The screaming and loose stools tended to come 1-3 days after me eating a food so it was a lot harder to identify the foods she was reacting too when we only had these symptoms to go on.
It got a lot harder once we were weaning. We learnt the hard way with red peppers that it was a bad idea for us to both have the same lunch she reacted both directly and through my breastmilk. After that I kept her a day behind me so we saved food I had eaten the day before her for to eat the day after if there was no sign of a reaction. I.e. she had food on Tuesday that I had eaten on Monday.

Ultimately breastfeeding was untenable for us and at 10 months after I was admitted to hospital with poor mental and physical health we had to switch to alfamino, the only formula compatible with her allergens. I had lost 16% of my body weight and collapsed with very low blood pressure and sugar the day before I had to stop breastfeeding. My daughter did ok breastfeeding but really started to thrive on the formula and it allowed us to finally get her to symptom free at 15 months. She didn't properly engage with weaning until 13 months which also meant we had weight gain issues between 7 and 13 months when she only gained a 200g in that time!

In your position I probably would be looking at modifications to my own diet first. Try to see if you can identify early warning signs of a reaction in terms of behaviour. Delayed reactions can take 2-72h to appear which can make identifying them tricky as there's a lot of food you might have consumed in that time. Look at the main allergens but not exclusively, consider beef too, about 10% of babies with cmpa react to all cow and can't have beef. My daughters strongest reaction was to beef, it was only the first time I had eaten it since she had been born and half way through the first feed after I had eaten it she started screaming and refusing to feed.

If you don't make progress with the elimination diet, and there's a great Facebook for women breastfeeding with cmpa and they were a great source of support for me, the formulas can make a huge difference and help you get to a good neutral place to start figuring out patterns.

Has the reflux been properly reviewed? In addition to her allergies but it has proved quite tricky to treat. Omperazole has to be on the highest doses for her to see the benefits, she needs her milk thickening with gaviscon and she needed another medication to help speed up the emptying of her stomach to reduce the time her milk is in her stomach to reflux. We needed to tackle the reflux and the allergies together as the allergies made the reflux worse and the reflux made it harder to pick apart the allergies as that was also making her scream.