formula for a baby at risk of allergies

[vivie]

Ds is 19 months and has eczema, asthma and allergies to egg and dairy. He has had Wysoy soya formula since I stopped breastfeeding when he was 14 weeks old and he loves it and has always thrived on it. I'm now 23 weeks pregnant.

Breastfeeding ds was an absolute nightmare - basically ds failed to gain weight - and I only stuck at it so long because his eczema was so bad I was terrified of giving him 'ordinary' formula and making his skin worse and it took that long to get a referral to a paed who prescribed the Wysoy. The relief I felt when I stopped bfing was enormous and the thought of breastfeeding baby 2 makes me feel sick. I know that baby 2 has a high risk of allergies and atopic disease and I know the best thing for him (I know he's a he!) is breast milk so I am going to try again and who knows? maybe it will be better this time. But maybe it won't be.

I have an appointment with a paed dietician in a couple of weeks time to discuss what milk my children should be having. My feeling is that ds shouldn't be having Wysoy any more, as I say he's thriving, and can probably move onto cartons of soya milk from the supermarket. My real question is what to feed the baby if bfing doesn't work? From what I have read / heard soya milk isn't the first choice for babies because it's so sweet, because children are often allergic to cows milk and soya, and because of the oestrogens. I want to be as informed as I can be when I go to the appointment so if anyone has any idea what questions I should be asking or has any ideas as to the best kind of formula I'd love to hear from you. Thankyou!

my dd aged 3.10 months has only just stopped having wysoy-it was her decision,she couldn't b/f as a baby but ds who is now 20 weeks old took to b/f like a duck to water, in fact have the opposite problem he will not take a bottle and i have a freezer full of ebm!!!

If I were you I's see a bf counsellor before giving birth for advice to give yourself the best chance of bf working.

Message withdrawn

vivie, do talk to someone about why bf was such a difficult experience for you.

There are hypoallergenic formulas available and the paed can prescribe them, but I think he/she may advise trying with cows milk formula first.

If the main reason why bf was difficult was because your baby failed to gain weight, then it is likely you need to get off to a better start this time round. It may be that seeing breastfeeding work for you, you may feel better about it.

Good luck whatever you decide.

You can get extensively hyrdrolysed formulas which are based on cow's milk and these are available on prescription. They are essentially hypo-allergenic formulas. Basically the milk protien which causes the allergy/intolerance has been broken-down. My ds is b/f and dairy intolerant so I use one of these formulas (Nutramigen) in his breakfast etc and he's fine with it. He'll also drink it from a cup. I believe Nutramigen is broken down to peptide level. There are some that are broken down further to amino acid level such as Neocate.

A lot of people comment on the palatability of these formulas. With the nutramigen it definitely smells worse than it tastes. It has never bothered my ds though. I did attend a seminar recently where a Prof in Child Health was presenting. Apparently babies who have hydrolysed formulas from birth are less likely to have a sweet tooth because of the taste of the formula - they're more likely to favour savoury tastes.

We've been to a paed dietician and she was great and I was clueless before the appointment. Perhaps the dietician will want to discuss challenging your ds on dairy? Has he had any kind of allergy testing?

Have you considered taking probiotics in your last trimester and in the first few months if you do decide to b/f? There has been research done which shows that taking probiotics reduces the likely-hood of allergies developing, specifically eczema. I'm afraid I'm a bit tight for time so I don't have any links available but I do remember that one of the probiotics was lactobacillus GG. It's available from nutricentre and manufactured by VRP (Vitamin Research Products). If you google you'll get the info. There's also a bit about it in the BMA Guide to Eczema.

HTH and good luck.

vivie, my dd is like yours and had to have nutramigen as a baby (has now outgrown the milk problem but is still allergic to egg and has asthma and eczema).

Hopefully this will make you feel better - my second child, ds, is completely fine. No food problems at all, no eczema but he does have mild breathing problems (I think caused by severe bouts of bronchiolitis when he was a baby so hopefully he may outgrow these breathing problems).

However, I must say, when he was a baby, I bf as long as I could (around 4 months when I just ran out of milk). For the next 8 weeks, I tried Wysoy (because I was worried, like you, after having dd and her food problems). At 6 months I tried a milk based formula to see his reaction and he was fine so from them onwards, he had SMA gold. To be honest, I think he could have had SMA from 4 months but I was worried about any possible allergic reaction.

He's now 2 and can eat anything. Every child is different - both dh and I have asthma and eczema (I had it as a child, dh still has both today quite badly) so I really thought both kids would have some sort of problem but so far, only dd has suffered.

Wait and see how long you can breastfeed and then maybe try the soya formula for a bit until you feel confident enough to do the milk-based stuff. Hope that helps.

oh and nutramigen is foul. I had to do the 'starve your child till they are so hungry they will eat anything' policy to get dd to take a bottle and it broke my heart. It took a few days to get her to take a bottle but then she never looked back. I haven't got a tin anymore but I think nutramigen had as much sweet stuff in as the soya ones (and dd did have an intolerance to soya and milk and it is quite common).

Somebody will no doubt come on and say nanny (goat's milk) but I know nothing about it and never tried it with either of mine!

Thanks for your messages everyone. Foxinsocks, I'm very encouraged to heat that your ds is so well and free from allergies. I'm taking probiotic supplements (Viridian ones) so maybe they'll help - it's easy to worry when you're pregnant!

Portree, ds has an 'nettle sting' reaction if milk touches his skin, and the one time he had egg he was violently sick and came up in the nettle rash all over his body. Both these allergies have been confirmed by skin prick testing. TBH I'm not too worried about him as he eats pretty much anything put in front of him (like his mum ) and is full of energy. Why does your ds have nutrimigan rather than neocate? I suppose Wysoy was the paed's first choice for our ds because it's cheap - or maybe I'm being cynical....

tiktok, I saw an NCT bf counsellor regularly when I was bfing ds, and she was wonderful, really supportive, but apparently we looked as if we were 'doing it right' - the position was right, he was sucking, etc. Looking back, I never felt a let down and I never heard ds gulping or swallowing, which I know are signs that the milk is flowing well, but I was told that this was normal and not all women experience this. It was only when ds started on formula and had a complete personality switch, from crying skinny boy who wanted to be on the breast all day to plump smiley boy who played and slept (!) that I realised I had been starving the poor mite. I guess what I'm saying is that even with good advice I really screwed up and my confidence to bf again is totally non-existant. I still feel guilty about it. I will have another chat with her and I will be seeing her when my baby arrives, I owe it to the baby to give it my best shot.

Vivie, there was a thread about soy formulas the other day that you may want to have a look at, you can find it here

Vivie, you didn't screw up and you have no reason to feel guilty. Except that you are a mother and we all feel guilty about something ? my own mother tells me this is the universal lot of mothers... Please don't beat yourself up about this. You did your very best for ds and for some unknown reason b/f just didn't work out. Not your fault, just one of those very frustrating and sad things.
It's not a simple equation where breastfeeding is 100 per cent guaranteed to kill all allergies stone dead. And bottlefeeding didn't cause your son's allergies; that's genetics/poorly understood environmental changes over the past 40 years. One of those changes may be declining rates of breastfeeding but it's not the only one by a long chalk. There really is nothing for you to feel guilty about.
Sorry things didn't work out for you last time. Hope you have a much better experience this time.

Vivie, the Nutramigen was suggested by the HV who told me to go to the GP. My ds's reaction sounds similar to your son's so I can do my own crude test by rubbing some of the milk on his wrist. He's OK with breast, Nutramigen and soya. I wasn't aware of Neocate until our visit to the dietician. She said that Nutramigen is tried before Neocate as Neocate is even less palatible than Nutramigen. I guess there will be an underlying cost consideration as these formulas are very expensive and the more processed, the more expensive. The dietician favoured the Nutramigen over the soya but that's covered in the soya thread.

as foxinsocks said, someone will mention Nanny formula, so here goes

Many people who are allergic to cows milk are fine with goats milk. so likewise many babies who are allergic to formulas based on cows milk are able to drink goats milk formula like Nanny. If you compare the different milks, goats milk is more similar in content to breast milk than cows milk. I know other MNers will disagree with this but I have a BSc degree in Nutrition and we were taught this as being an established and definate fact.

I used this formula with both my children after bf. We used it as a precaution to (hopefully) prevent or lessen any future allergies as lots of dh family have quite severe allergies (his nephew has to carry an adreninlin pen). So far both kids are thriving and dont appear to have excema (apart from the odd patch now and again) or asthma, although the oldest is only 2 so perhaps it too soon to say for sure.
The other reason was that it contins no additives or sweetners which many mainstream brands seem to contain, i haven't tasted them but one of my customers said the regular formula taste very sweet.

I have contacted Nanny via their website and they sent me some very informative information and research about the use of Nanny formula in babies. i can find the www if you want.
There have also been quite a few threads on Nanny too (sorry i dont have time at the moment to browse for any of them).

I suppose at the end of the day when/if you need to use a formula you will have to try a few and see which one suits your baby best.

Gloworm, hope I'm not hijacking but I so wish that ds had been OK with the Nanny. It would have been my absolute first choice, nutritionally. Of all the formulas I rubbed on his little wrist it was the only one that smelled good. BTW, I read something recently that research is being undertaken in mare's milk as a base for formula ...have you come across this?

havent heard about the mares milk, sounds interestng.

Thanks for the mesages everyone. The FSA article about soya was really interesting and relevant - soya doesn't seem to be the first choice for babies who can't bf, and I feel pretty annoyed that the paed who prescribed it to our ds made no effort to discuss this with us. Very interesting too about the Nanny formula, I hadn't thought about using that, or mare's milk.
thanks for your post edam, I apreciate your kind thoughts.

Hi Vivie, not really answering your problem directly but just another comment to add to the list ... My DD is 4 months old now and I failed completely at the BF stuff. She screamed the place down each time I tried. I felt such a terrible failure that I have been expressing 4 or 5 times a day since about day 4 or 5. This way, she is getting my milk and therefore (hopefully) some allergy protection (is that the right way to put it?) It has eased my conscience considerably and hasn't been too much of a pain. Then again, she is only my first - not sure if I'd manage the same a second time around. I bought an electric pump from Ameda which also made the whole business as easy as poss. Just a thought - if you really hate the idea of BF so much. I would agree that, for different reasons, I would be pretty anxious about BF if I had another one. I originally thought I'd express for a couple of weeks and then it became part of my routine - not sure how / when to stop now!

vivie, you might find this interesting, it's from the latest Cochrane Review (evidence based research publication)

Soy formula not a good choice for infants at risk of allergies
Soy-protein based infant formulas have been used to treat infants who have food allergies or intolerances. This raises the possibility that soy formulas might prevent food allergies in children at high-risk, such as an infant with family history of allergy. A recent review of the available literature, however, concludes that there is no evidence to suggest that soy formulas are any more effective in preventing allergies than formula based on cow?s milk. In addition, the research showed that there was more risk of developing allergies if a soy formula was used rather than a hydrolysed protein formula. As a result, soy formulas cannot be recommended for preventing allergies in high-risk infants.
Review title: Soy formula for prevention of allergy and food intolerance in infants
Reviewers: Osborn DA and Sinn J.

Rowlers, expressing is a really good idea and I think it's great it's going so well for you. I didn't manage to get much milk when I expressed last time, but maybe if my problem is latching then I would have better results this time. Is the Ameda pump really good?
bundle - thanks a lot. Sounds like hydrolysed formula would be a better alternative to soya.

dd is intolerant to dairy, soya and egg, I had to eliminate them from my diet when I was bf. She now has nutramigen formula and it does smell and taste foul but she is doing fine on it. My paed said soy formulas are not the way to go because of the oestroegen issue. On the subject of breast pumps, do get an electric one, I still have RSI on my right hand from using a manual one.