Relux or colic........advice needed please.

[bettieblue]

I posted this in Health by mistake.....

DS is 7 weeks and is suffering I think from one or other. He takes his feeds fine but after an hour and a half he starts screaming and writing around in agony. He also brings up lumpy milk (not posseting) but milk that looks like its half digested. Hes on Dr Brown bottles and Infacol. Hes very windy (huge burps/ farts- im guessing infacol helps bring those up).Strangely though he sleeps at night and doesn't exhibit these symptoms when i feed during the night.

I went to the doctor for his 6 week check up and mentioned it. I asked if I could get colief on prescription as was going to try it to see if its was lactose intolerance that was causing the pain but was told no they wouldn't as they didn't know if he had a lactose intolerance . DS was screaming in appt and bought up lumpy milk so I think doctor felt obliged to do something and he prescribed nutramigen - I thought he was just prescribing me a lactose free milk, it turns out its for babies with total cows milk allegies?!!- I obviously want to find a solution that works but feel that we' ve jumped several stages.

It doesn't help that I don't know if its colic or reflux which means its difficult to know whats the best route to take. I have given him the nutramigen milk tonight because his earlier feed left him in so much pain but don't feel comfortable doing it. Am I being silly?

I had thought about trying colief in his milk (Aptamil first) or moving to Aptamil comfort (which has about half the lactose of normal milk) and perhaps using colief with that? Am I better bypassing that and just using Nutramigen. Im so confused. Im seeing a cranial oseopath at the end of the week. I just want a diagnosis and then a clear plan of action.....i guess that wishful thinking.

any advice gratefully received.

very similar to our experience: bringing up curdled milk after an hour and a half, screaming etc, started at 7 weeks (though may have started earlier but she wasn't bringing anything up). Breathing problems, too, and bad skin. Long story short, paed diagnosed reflux and cow's milk protein allergy. Prescribed Ranitidine and Pepti 1 (which is like Nutrimigen but apparently its taste is less often rejected by the babies). We're bf so haven't used the formula but have it 'just in case'. My paed was clear about the allergy vs intolerance. He said we had allergy not intolerance. Not all allergies cause a life-threatening response. Personally, if you can get your baby to take the Nutramigen I would go with that. If the problem clears up within 3 weeks then you know it's probably cow's milk in some way whether mild problem or proper allergy and then you can take it from there. From what you've said, it doesn't sound like colic to me (but I'm really not experience with colic).

Have a look on this thread www.mumsnet.com/Talk/breast_and_bottle_feeding/1024071-Support-thread-for-all-parents-with-reflux-babies

post your questions to the ladies there, they are real experts on reflux.

Get thee to the - crying over spilt milk website ASAP. If the paediatrician I saw was to be believed there is no such thing as colic, just varying degrees of reflux.
Cows milk intolerance is a major cause of silent reflux, so if your LO is taking the milk then I would perservere for at least 2 weeks to see if it makes a difference. However I would go back to GP and ask for ranitidine as if your LO responds to this after a few days you will know for sure. It is an ant-acid, basically forms a block to the acid coming back up the oseophagus.
Although cows milk intolerance can cause the reflux so the acid blocking drugs will help until all traces of cows milk out of system IYSWIM.

Agree with others, this sounds like a totally classic case of cow's milk protein intolerance/ allergy to me - the bringing back curdled milk hours after a feed is typical, as is the bad skin and breathing problems.

Your GP actually sounds like a keeper - not many know about cow's milk protein allergy although it's actually quite common, and it sounds like he or she could very well have arrived at the right diagnosis. It is great he or she prescribed Nutramigen, quite often it takes months to wrangle a prescription out of them! Why do you feel funny about giving your baby nutramigen, out of interest? IIRC, it's made from cow's milk and has the same nutritional content of other formulas, but has had the cow's milk proteins almost completely broken down so the body cannot recognise them and mount an allergic reaction.

If she will accept the taste, then really I would give it a good 2 weeks on solely nutramigen - normal formulas like aptamil need to be completely excluded during this time in order to see whether she does have a problem with cow's milk.

It is very, very, very unlikely to be an issue with lactose intolerance. Don't waste your money or hope on colief . Lactose intolerance is actually extremely rare in young babies - breastmilk is packed full of the sugar, lactose, and if babies routinely couldn't deal with it then the human race wouldn't have thrived! Lactose intolerance leads to chronic diarrhea, weight loss, and sometimes dehydration. Cow's milk protein intolerance/ allergy is actually much more common. The body sees the cow's milk protein as foreign matter and mounts an immune attack, hence the symptoms associated with it (breathing issues, skin probs, feeding probs, vomiting, constipation...... etc).

Sorry, he, not she .

Hi

Im very confused as I had read thatnot breaking down all the lactose in milk was a major cause of reflux- ie; its not an intolerance as such but babies not producing enough lactase to break down the lactose...

I didn't realise that nutramigen was cows milk, i thought it was a subsitute. I guess i thought the most logical way to do it was to see if colief works and its a lactose issue if not then see if its a cows milk allergy. He doesn't have any other symptoms such as bad skin or breathing problems- he is snuffly like hes got mucus in his thought but i thought thats the norm with babies. I think he looks a bit flushed- DS skin is`quite pale but DH doesn't! d

The other thing is that hes isn't bad after every feed, surely if it was a cows milk allergy he would react after every feed...

Lactose intolerance is not a cause of reflux. Like I said, congenital lactase deficiency in babies is very rare, and if your baby truly had it, you would know about it - see here. Some babies born prematurely will be deficient in lactase, but lactase production steps up as they ingest lactose-containing liquids.

I wouldn't worry about giving nutramigen, really! Babies are not designed to digest unmodified cow's milk formula after all, so that's no more 'natural'.

Mucus and flushing can be symptoms of cow's milk allergy. It's not necessarily the case that the problems would present after every feed - but one thing is for sure and that is if it is a cow's milk issue you do need to get it sorted because over time it can lead to feeding refusal and failure to thrive.

Hi

Thanks- here is where i read about lactose, not an intolerance but more an overload.

www.refluxbabies.co.uk/information/lactose-intolerance.php?cat=2

Sometimes there is too much conflicting info on the net...no wonder im confused!

Not sure about lactose overload.... I suppose it could be a problem but I think it is actually more common in babies who are breastfed and whose mothers have an overabundant supply of breastmilk, or in bottle-fed babies who are being significantly overfed. I presume your baby's not drinking gargantuan quantities of milk per day?? Generally they need something like 2.4 to 2.7 oz per lb of body weight in a 24 hour period. Some need slightly more, some slightly less than this.

You could try colief if you really wanted to, but it is expensive and also needs to be added to room-temp milk 30 minutes before a feed IIRC. If it shows no results in a few days, then do think about trying the nutramigen again.

My ds was lactose intolerant and vomited a lot. Another two had reflux and were in almost constant pain and vomited.

'Colic' is a myth.

Reflux. Arched back after feeding, angry sucking, hard to settle, crying A LOT, pain, vomit.

Lactose intolerance: Vomit vomit vomit.

I agree with the last two posters!

My DS doesn't vomit after a feed but he has gone through many periods and distress and crying a lot. At first I thought it was colic as he kept drawing his knees up which is a sign of colic (if it does exist) but then I put him in a routine and this disappeared; the distress and crying didn't. I eventually gave up and asked a health visitor who suggested comfort milk, which did seem to make a difference. However, the crying has started again. He is on Infacol and that seems to help, the comfort milk seems to have got rid of the explosive and painful sounding farts. You definitely need to leave him on the new milk for over a week, probably two, so it has time to take affect. I have been advised on another thread by yogamummy to look at silent reflux and see if he has that, which I am going to do asap. You are definitely not alone