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Infant feeding

Aptamil pepti vs Nutramigen

52 replies

Impossibletofindausername · 04/06/2019 20:35

So my daughter got given Nutramigen when she was 11 weeks old she point blank refused to drink it even by doing a scoop of each milk so the consultant said put her back on aptamil and keep going with the reflux meds however she’s getting worse so been given aptamil pepti to try is that as bad a Nutramigen? Should I do few scoops of each again? I’m praying she drinks this and fixes this nightmare feeding because she just refuses and screams

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MumUndone · 04/06/2019 20:56

The aptamil is sweeter so tends to be better accepted, providing baby can have lactose.

mightymouses · 04/06/2019 21:00

We had success with aptimal Pepti but my baby wasn't very fussy.

If fussy suggestions are to add a drop or two of vanilla essence (it is very strong so not too much!) or a small amount of nesquick powder to the bottle, gradually reducing the amount until they accept it with none. Nesquick powder is dairy free.

If your child is accepting normal formula you can also wean on to the dairy free by doing a half n half bottle, then a quarter / 3 quarters etc gradually moving on to a bottle that is 100% pepti. This will obviously depend on symptoms, as you wouldn't want to do this with an anaphylactic baby.

mightymouses · 04/06/2019 21:04

Just wanted to add... if she doesn't improve with pepti go back and ask for an amino acid milk.

While my baby initially was ok with pepti after a while the CMPA symptoms returned and we had to move on to neocate.

Pepti and nutramigen both contain cows milk but broken down, while neocate (and a few others) are completely synthetic and made with amino acids.

GPS are often reluctant to prescribe as amino acid formulas are so expensive.

Also, you'll get much better advice and support on the CMPA support group on FB than on Mumsnet. It has about 30k members, mostly parents of CMPA kids that really know their stuff. It is the best resource I've found and most people are very keen to share their knowledge to help other parents, so you'll get heaps of replies if asking for help.

Impossibletofindausername · 04/06/2019 22:29

Thank you, yes they think she’s just cows milk protein intolerance

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Impossibletofindausername · 04/06/2019 22:33

Thank you for your advice I’ve got a bad feeling I’ve got a fuss pot on my hands after the Nutramigen strike she put up. So going to slowly introduce this she’s had normal aptamil for 4 months now half the feeds being force fed I’m praying she will drink this and it helps. It seems so thin I just made a bottle up to assess the smell and smells just as bad as Nutramigen anyone else find there baby vomits it up being so thin? Debating on adding a bit of Carobel or to try without. I will have a look for that Facebook page thank you for your tips think they are going to be needed.
Did you little one have reflux caused by normal formula?

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evilharpy · 04/06/2019 22:39

My daughter refused nutramigen and I wasn’t surprised, it smells and tastes vile.

We also tried neocate but ended up keeping her on SMA Alfamino which is another amino acid, dairy free formula.

mightymouses · 04/06/2019 22:44

We used carobel as a thickener as he was being sick a bit without it.

My baby didn't have reflux, just CMPA.

mightymouses · 04/06/2019 22:45

I do know a baby that loves nutramigen 😂 so they are all different and have different tastes!

QuestionableMouse · 04/06/2019 22:47

Try adding vanilla flavouring to the Nutramigen. The doc told us to do this and it worked.

Iirc we used Dr otker which is alcohol free.

GlamGiraffe · 04/06/2019 22:59

Try mixing your current milk with the nutramigen . Start with a small amount of the nutramigen and gradually amend the ratio. They do get used to it. Remember babies woth CMPA know milk is their enemy and any new substanstance is instinctively regarded with suspicion.
Nutramigen is said to be the more palatable of the amino acid milks( neocate is more often refused). I am assuming you are on puramino?
It's really not worth going into an amino acid formula again as ultimately the baby will be in pain and not thriving. Your child will also need weaning onto a dairy free diet so you need to be prepared to negotiate the fuss now to help baby in the long term. Once your baby has some of the nutramigen they will realise it doesn't hurt them and be a different baby I promise you. Check it's the puramino formula though. I wouldn't thicken it. Its a life changed as it is.

Impossibletofindausername · 04/06/2019 23:19

She’s got aptamil pepti to try this time I’m praying it works and helps should I maybe not bother with Carobel in it?
Thank you for all your tips think I’ll definatly have to do half normal aptamil half pepti to start with

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QuestionableMouse · 05/06/2019 01:12

Honestly try the vanilla. I've been through this twice and it really helps.

evilharpy · 05/06/2019 06:55

GlamGiraffe it's the other way round - neocate is more palatable. Nutramigen isn't an amino acid milk, it's hydrolysed and hypoallergenic but based on cows milk. And it's minging. Some babies can't tolerate even the hydrolysed milk, hence the need for amino acid milk.

Aptamil Pepti is also hydrolysed. If you continue to struggle with it and weaning your baby onto it, it might be that she is not able to tolerate it, in which case I would advise you to try an amino acid formula like neocate. Unfortunately it can be difficult to get doctors to prescribe them as they are very expensive, more so than hydrolysed formulas.

This is going back a while so I might be misremembering, but I think all the prescription formulas were very thin and we ended up switching to a slower teat (i.e. one designed for younger babies) to slow down the flow a bit, rather than thickening with carobel. We definitely did this with nutramigen but I think we also did it with the amino acid ones.

mightymouses · 05/06/2019 07:30

@evilharpy yes that's right we had to go down a teat size for a few weeks too. I forgot about that.

Impossibletofindausername · 05/06/2019 09:07

Thank you for your replies well she didn’t drink it any better or worse still had to force her. Debating on just gaining her pepti with no normal aptamil on the next bottle incase it feels nicer on her tummy. I’m going insane with it all feeding is a nightmare. When did anyone notice a difference if it helps? Defiantly is very thin . Carobel wouldn’t cause any other issues would it? It literally just thickens the bottle?

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evilharpy · 05/06/2019 09:22

Carobel should just thicken it and not cause any issues.

To be honest we had lots of other issues at the same time, it wasn't just the feeding, but we never managed to get nutramigen into her at all. We persevered for about five days before demanding neocate and she did take that much easier from the start.

mightymouses · 05/06/2019 09:24

We noticed a bit of an improvement after 24 hours and a huge improvement after 4 days. Think it took a week to feel that all CMPA symptoms were gone.

Some people can be allergic to carobel but it's not very common. I'd try without carobel for a week or so and if she is still bringing a lot back up then I would try the carobel.

A smaller teat should help, plus stopping half way through the bottle and winding and giving a little break before offering the rest.

I wouldn't try to force feed at all tho I know it is very hard when you just want them to drink. Eventually she will learn there is nothing else on offer other than the pepti.

Impossibletofindausername · 05/06/2019 09:46

Thank you for your help, I’ve tried so hard not to force feed her but for the last 11 weeks I’ve had no choice some days she drinks okay some are a nightmare. I couldn’t get Nutramigen in her either she drank 6oz in 18hours I’m hoping she realises this pepti will help her tummy if this is the issue . Is Neocate easier for them taste wise?

Mightymouses what milk did your little one have?

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mightymouses · 05/06/2019 10:40

Pepti for a few months then we had to move to neocate as his CMPA symptoms came back after a few months on Pepti.

In my opinion Pepti tastes better.

Please please don't force feed, it might help you feel better today about how much she has had but it will be detrimental in the mid and long term as she will come to dread feeding. If she is resisting a dream feed might work? So pick her up when she is asleep, move about a little to gently wake her slightly then feed in the dark. Quite often they take a whole bottle that way as they forget they are meant to be resisting and should just automatically suckle. Ensure baby isn't in a very deep sleep tho or they won't swallow and will cough/splutter.

QuestionableMouse · 05/06/2019 12:59

@Impossibletofindausername

I'm tagging you because you're either not seeing my advice or ignoring me.

The consultant at the hospital told us to use vanilla extract because it masks the taste of the milk. Give it a try with the Nutramigen and stop messing about mixing milk.

Impossibletofindausername · 05/06/2019 15:03

Sorry I hadn’t seen it we are not using Nutramigen that was 3 months ago we have aptamil pepti. But I will try the vanilla thank you

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Impossibletofindausername · 05/06/2019 15:04

Thank you, I know but she’s been force fed near enough 11 weeks now or she would drink nothing I do live with the fear she will hate the bottle but each feed she does open her mouth to start with. I’ve tried dream feeding but she won’t . Because that was my hope she would and I could get at least one bottle in

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Impossibletofindausername · 05/06/2019 15:33

Vanilla extract is that just the stuff you buy to make cakes? I’ll go buy some just unsure what to get. Don’t they need to be alcohol free

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mightymouses · 05/06/2019 17:23

Yes vanilla extract is in the home baking isle. There is no need to get alcohol free tho as it's such a tiny amount you use. Literally 1 or 2 tiny tiny drops. It's really strong so make sure you don't add to much

Impossibletofindausername · 05/06/2019 18:22

Okay thank you that’s my last hope for her to drink this milk on her last bottle if not I can’t physically get it in her today’s been a fail so far x

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