Newborn in distress on formulas

[Hubbard93]

Hi, our DS2 (now 5 weeks) started as formula fed on SMA, but was always hungry and had constant reflux. We made the change to SMA Extra Hungry as he didn’t seem satisfied, but it made him constipated, was causing pain, and then the reflux became worse. We called the Health Visitor and 111, both said to go A&E because he was throwing up whole bottles. The doctor in triage said they wouldn’t give anti-reflux medication at such a young age unless he was ‘crashing’, and advised changing the bottles and milk and sent home.

So we changed our Tommie Tipee anticolic bottles for MAM anticolic bottles, and bought Hipp Organic. Within the first 24 hours, the reflux stopped and he began to poop normally again. The reflux didn’t come back, but the poop progressed to diahrea (LITERALLY 10+ watery stools a day), which left him screaming and in pain again. We visited the GP, who advised to try SMA again and if there wasn’t improvement in 7 days we’d be referred to be paediatrician. I asked if it sounded like an allergy/intolerance and they said no.

So he’s been back on normal SMA for the past 12 hours - we’ve only had 1 loose poop, but the reflux is completely back, he’s irritable and in distress crying with the pain again.

I will keep pursuing with healthcare professionals, but in the meantime, does anyone have any experiences with anything like this?

Just to add, bottles are properly cleaned and sterilised, and feeds are made fresh - we’ve become freaks about this, so we know it’s nothing resulting from laziness on our side. Just feel so bad for him being in a discomfort ALL the time no matter what we do x

Thanks x

It could possibly be a cows milk protein allergy (CMPA). Are there any other symptoms?

You could ask to trial a "milk free" formula.

Hi @Hubbard93 this sounds horrible - I’m sorry.

My experience is that the NHS is shit for feeding advice - can you pay for a private infant feeding consultant?

Can you try a third type of formula? DS was colicky and neither HIPP nor SMA worked well for him at all (he is now seven months and fine on SMA by the way). He went onto a lactose free formula and it cured our problems.

@Cosywosy it’s just swinging between the extremes of constipation or diahrea, and reflux or no reflux with one of the above depending on the formula. He hasn’t had any rashes etc, it’s seems to be all gastrointestinal x

Mmm. I hate the hungry baby formulas, because they basically con babies into not feeling hungry for longer by being harder to digest. I'd happily ban the damn stuff so desperate parents didn't get conned into buying them. Rashes tend to be cows milk protein allergy, but if it's cows milk protein intolerance then you just get symptoms. If there's reflux and constipation/diarrhoea, then I do tend to suspect cows milk protein intolerance. First step is usually a hydrolysed formula, which is where the cows milk protein is chopped up into smaller pieces, so the gut is less likely to recognise it as alien and react. Most babies with CMPI improve considerably with that. A few need to progress to an amino acid based formula, which is where the protein is broken down all the way to basic building blocks. And tastes disgusting. Most CMPI babies you find the reflux improves by removing the irritating protein. A few do need reflux meds as well to help the gullet heal up.

@RandomCatGenerator Thanks - we’re really starting to hit a wall with it. We’d definetly look into private if we wasn’t getting anywhere. Unfortunately we had to go private with DS1 on a different matter because the NHS couldn’t give much support, so frustratingly we know it might be an option

This sounds like either a lactose or cows milk protein intolerance.

@wanttomarryamillionaire

This sounds like either a lactose or cows milk protein intolerance.

This

It's very unlikely to be lactose intolerance. Primary lactose intolerance in babies is incredibly rare. We wrongly used to think it was more common because there were loads of babies with untreated cows milk protein intolerance, which can give a secondary lactose intolerance. CMPI affects about 2-3% of babies, so is incredibly common. This is extremely likely to be CMPI.

Rough rule of thumb:

-If a baby only has reflux symptoms, treat the reflux
-If a baby has reflux symptoms and either constipation or diarrhoea, it's cows milk protein intolerance
-If a baby under 6 weeks of age has allergic looking rashes, or eczema looking rashes, even if they don't have much gut symptoms it's cows milk protein allergy

Roughly speaking, an allergy is where your body makes chemicals to overreact to an alien protein, which send messaged to other parts of your body making it overreact too. An intolerance is where only the gut is affected.

Thanks everyone. Ended up in A&E with him this morning as Drs has no appointments and didn’t want to leave him in pain over the Easter weekend. The Dr didn’t think it looked like cows milk allergy, although it kind of bothered me she kept using allergy and intolerance interchangeably. Decided I was over feeding him (he isn’t overweight) and was advised to dilute the formula, 1.5 scoops of formula to 3 ounces water every 3 hours, for 3-4 days, then come back to reassess, which I thought was NUTS.

Ended up at the next nearest hospital for a second opinion, the pediatrician agreed we could try Neocate milk, so just hope everything improves.

Thank you for everyone’s advice on here x

The first doctor told you to dilute the formula? That's nuts. It can be appropriate to restrict the total volume of intake if a baby has eyes bigger than their tummy, but reducing the calories whilst keeping up the volume would do nothing to help the reflux and could lead to problems with low sodium levels. That advice went out 20 years ago at least. Glad you went for another opinion, neocate sounds like a sensible choice.

@Hubbard93

Thanks everyone. Ended up in A&E with him this morning as Drs has no appointments and didn’t want to leave him in pain over the Easter weekend. The Dr didn’t think it looked like cows milk allergy, although it kind of bothered me she kept using allergy and intolerance interchangeably. Decided I was over feeding him (he isn’t overweight) and was advised to dilute the formula, 1.5 scoops of formula to 3 ounces water every 3 hours, for 3-4 days, then come back to reassess, which I thought was NUTS.

Ended up at the next nearest hospital for a second opinion, the pediatrician agreed we could try Neocate milk, so just hope everything improves.

Thank you for everyone’s advice on here x

God that does sound dodgy! I hope the neocate works for you.