CMPA or silent reflux?

[SarahDay1990]

Hi - my LO is 4 months. As a newborn she would scream after feeds and had terrible wind. She was diagnosed with reflux. She was prescribed medication but the screaming after feeds just stopped so we never gave her the medication. However my LO has been an awful sleeper she’ll wake frequently crying overnight so I contacted my doctor who said it sounds like she has CMPA. But i’m not sure? Her symptoms are

1. very very very dribbly - non stop dribble!


2. bubbles around her mouth


3. very congested/sniffly when feeding


4. sometimes sneezes after feeds


5. dry skin eg cradle cap that only recently developed but generally has dry skin


6. eyes are quite dark and puffy


7. terrible sleeper! Frequent waking which isn’t hunger

what do you think? I’ve been prescribed specific formula but don’t really want to switch formulas if it’s actually reflux? Only because I’ve heard that switching formula is tricky as it tastes and smells so bad. My LO can be fussy with feeds so I don’t think she’ll take well to the change. Thanks

I should also add that she’s generally a very happy and content baby - which makes me think it’s not CMPA?

It’s a tough one as a lot of the time babies with reflux have it as a result of CMPA. It’s like the body’s way of getting something back out that it doesn’t agree with.
A lot of those symptoms definitely could be CMPA and my baby who has a milk allergy had all of those too.
The thing about treating reflux if it’s a result of allergy is that you’re not addressing the underlying cause just masking it.
I completely understand the formula change is daunting. We fed our baby Hipp Organic initially, so one of the sweetest milks out there, and to then go on to Nutramigen which absolutely stinks was really scary.
In fact I remember with the first bottle, I went outside and walked up and down my street whilst my partner fed him because I was so scared he wouldn’t drink it and he would cry and I’d crack and say just give him the standard stuff. Well he drank it all! Absolutely fine. We have now been moved onto a complete synthetic amino acid formula but the difference in feeds from then to now is amazing.
The tip we were given is make sure your baby is really hungry so they won’t mind as much but the paediatrician did say it might be hard but if it is an allergy, the right thing to do.
I’d say give it a go. What have you got to lose?

Yes that’s true! Thank you. We’ve been prescribed neocate. I think she’s a bit tricky with eating anyway and she’s only little sleep I just worry that it’ll take her some time to get used to it and I worry about her weight etc. was your LO generally a happy baby? I would think a LO with an allergy would be quite sad and restless?

I’ve heard really good things about Neocate. It’s one of the ones I’d have been happy with if put on it (we’re on Puramino). Just to say there’s new research out that shows amino acid formulas like Neocate and Puramino make babies put on weight at a slower rate than standard formula and more at the rate of breastfed babies. Something to do with the free amino acids telling them they’re fuller sooner so don’t worry if you’re LO isn’t putting on weight as fast as they were.
As soon as we switched over my baby dropped from 50th to 23rd and I really panicked but he’s always put on weight, now just slower and like I said he’s still super active and happy.
Hmmm no I will say he was a very unhappy and miserable baby in the beginning. Mostly due to the reflux symptoms I think, but that stemmed a lot from the allergy which did get better following the amino acid formula switch.
I guess you could enquire about reflux meds too. A lot of the parents I’ve spoken to about CMPA are also on reflux meds as well. Only a change in formula feels like a better choice then putting your baby on unnecessary medication. I know the formula change might be unnecessary too if she doesn’t have an allergy but like us I would have thought at some point the doctors will get you to challenge this by reintroducing standard formula and seeing if the symptoms return, so you might not even have to have her on the formula for long maybe 4-6 weeks. The other thing is, these formulas are much much thinner. Most parents have to thicken with something like carobel or use gaviscon to help keep it down. This may seem like the reflux isn’t being solved as they still sick up but a certain amount of reflux is to be expected in babies, it’s whether it’s causing any pain that you may need extra things to help out.
It’s an absolute minefield I know! Feeding is still the thing I dread the most even though it’s much better than it was and I still obsess over his weight even though it’s fine!
when you say she wakes frequently, have you noticed it’s after a specific time? Is she unhappy when she wakes or just wakes and needs help getting back to sleep?
our LO is going through the 4 month sleep regression and before he’d sleep 4-5 hours straight. Now he stirs and wakes every sleep cycle 45 mins and I have to stick the dummy back in because he’s upset it’s fallen out. It’s an absolute pain!!!! But I know it’s to do with his sleep maturation not discomfort because it occurs at the same time and as soon as you pop the dummy back in he’s fine.

Good to know - thank you! Sleep has always been a challenge - now at the point that after 3am waking every 10 mins or so. Frequently wakes before 3am and shouts out. I was very very desperate so got a sleep consultant and it was them that suggested there was an underlying health issue as after 2 weeks with the SC LO just wasn’t responding and still sleeping terribly….