HELP! 7 month old - Reflux/ CMPA/ Sleep issues

[NB96]

Hoping for some help with my 7 month old little boy who has awful feeding and sleeping issues and is now dropping centiles :(

bit of background, he was EBF for 4 months, had lots of issues, colic, arching back, unlatching, in lots of pain & did not sleep well at all. went to the drs, tried all sorts of things so eventually just moved him onto formula… had the same issues. Couldn’t finish his bottles, seemed in a lot of pain, mucusy poo’s crying constantly, eczema, rashes and sleeping terrible!

I can safely say he’s slept through probably twice in the whole 7 months and the rest of the time he wakes every 2-3 hours. Safe to say the sleep deprivation is taking its toll especially when every other mum I know with a 7 month old is sleeping through :)))))))!

anyway, drs decided he had a diary allergy so put him on prescription formula which he’s been on around 6 weeks, tbh I can’t see a huge improvement, he still is really unsettled and won’t drink more than 4oz.

Hes dropped from 50th to 20th centile and still wakes constantly and seems in pain. I’m not sure if the sleep is linked but I’ve always been quite gentle with him, sometimes I rock him, sometimes he does self settle. I’ve tried the Ferber method but he just gets inconsolable which I just can’t handle.

anyway, the dietician has now put him on a new milk which is for severe milk allergy (SMA Alfamino).

I’m starting to think is this not CPMA and could it have been Reflux all along???? Or could it be both! He doesn’t spit up but seems to have all the silent reflux symptoms???

has anyone experienced anything like this? All I get from people is “is he teething”, “he might have separation anxiety in the night”, “he might have a bug”, but it’s been 7 months now and not seen a single bit of improvement.

sorry this post is a bit allover the place going from sleep to feeding issues but I feel like it must all be linked!!

hope someone can help or share their experience woth something similar xx

Oh I’ve been where you are! Hang on in there. One day this will all be a distant memory, as is for me now.
Great they’ve swapped to alfamino. Give that a good six weeks to see the changes. I got an allergy/intolerance test done at the hospital which also showed for my LO an allergy to egg. Which was super helpful to know. Is he weaning now? As they get older it does become easier when food intake starts to slowly replace the milk.
ask to see dermatology for an assessment on his skin. They’re so much better than the GPs on what creams to use. how often do you bath? I bathed only a couple times a week, just water, pat dry don’t rub, then moisturise.
Have you heard of scratch sleeves? They can wear them at night to help stop scratching and waking. helped mine sleep more.
“Main group - cmpa support” facebook group is fantastic

Sorry it’s tough and I agree it sounds like silent reflux. Could be caused by CMPA or by another allergy, has it changed since you started weaning?

however I do think your expectations around sleep are maybe unrealistic, I know loads and loads of babies who don’t sleep through until way over 1. None of mine slept through until age 2+ I’m currently awake with my 15mo who woke up for maybe the 3rd or 4th time tonight; I’ve lost count. It’s tiring but it’s just how it is sometimes. I just try to go to bed early!

Thanks for coming back me! They don’t offer allergy tests but I was considering paying privately to see what else it could be! He is weaning now but isn’t loving his food as much as he used too!

I bath him every other night as I feel like it helps with his tummy pains but tbh the exczma is probably the mildest symptom I’ve never known him scratch or anything with it.

The biggest issue I have with him is more the feeding and how much he struggles with taking a bottle! He seems in so much pain!

I have some baby gaviscon but I’ve heard it causes constipation so I’m a little reluctant to try it!

Thanks for your reply :)!
Yes the drs do think he has CMPA and I’ve only weaned him onto diary free and everything is still the same. I have some baby gaviscon but reluctant to try it as I’ve heard of some bad side effects!

in reg to sleep.. I’m certainly not expecting him to sleep through or anything but between 7pm and midnight, he wakes every 45mins - 1hr and it seems like pain rather than just waking so just want to get him sorted. After midnight he usually goes 2-3hrs at a time before waking!

Yes we gave gaviscon and the side affects it gave were worse than the symptoms we were trying to alleviate. The constipation was awful!

I paid privately for a test and it was one of the best decisions we made in the journey. It helped so much!
Have you also tried different bottles? Different feeding positions - as upright as possible?

If he does have a dairy allergy then you may also need to cut soy from his diet which can be tricky as it's hiding in a lot of things.

We used baby gaviscon and it was useless, gave slight respite from the silent reflux symptoms but then caused constipation so just replaced one issue with another. I'd push to get a review for omeprazole.

Poor you, I've been there and it's awful. Is he on any medication for the reflux?

The consultant gastro made us wean him quite aggressively but carefully, introducing only one food at a time and waiting a good week between introductions in order to make sure he wasn't allergic to them. But moving on quite quickly to animal protein, in order to help with muscle wastage.

So we gave squash puree, waited a week, then added chicken, then potato, and so on alternating between veg/fruit (but choosing the more calorific ones first, starchy veg and fruit like bananas) and meats. Everything organic to minimise the risk of chemical residues being responsible for allergies. It really really helped with his reflux, the solid food gave his tummy ballast which meant that he didn't spit up his milk anything like as much. We were giving him food before milk every time.

Also, keep him upright for at least half an hour after he has milk every time, better an hour if you can manage it. It's a pain when they get sleepy, but really helps. Try to time feeds so that he has time to stay up after.

I went through this too for the first 4 months. Tried the prescription formula which made my son worse, then gaviscon, then omeprozole - only thing truly helped was getting his tongue tie clipped. Was told it was only minor and wouldn’t affect him as I was bottle feeding but he was a completely different baby after I got the tongue tie sorted.

Yes tried different bottles and weirdly in regards to feeding positions, if I feed him slightly reclined in his pram, he most of the time will finish his bottle

Yes the dietician mentioned soy actually but she said to just see if there is improvement on this new milk in the next 2-4 weeks and if not, then cut out soy! Seems to be a case of elimination!

I’ve seen a few people have omeprazole for their babies but heard it has side effects and to not have them on it long term!

they have given us gaviscon but I wasn’t sure whether it was reflux or CMPA so was reluctant to give him it as I’ve heard of the constipation it can cause!

he used to love his food but the past 2 weeks he just cries around lunch time and he wasn’t well at all last week having 9-10oz per day so they said to just hold off on the food and prioritise his milk intake! I’ll definitely keep this in mind for when he’s back onto his food properly so thank you!

my cousin had a baby with terrible reflux and she said getting him on food was the best decision !!

Hello I was in your position too
My daughter had mild-moderate physical reflux, severe silent reflux and multiple food allergies. Unfortunately for us weaning made no difference at all and in fact in some ways made the reflux worse.

You haven't mentioned any reflux treatments. I'd strongly recommend speaking to the GP about some. My daughter needs (not outgrown the silent reflux aged 4!) high dose omperazole, infant gaviscon and domperidone. I would ask about omperazole my daughter has been on it since 8 weeks but we only felt the benefit at 18 weeks when she was put on the highest dose.

In addition she has 20 food allergies! These are in addition to the reflux although the allergies made the reflux worse, as did the allergy formula as it's quite thin so she needed it thickening with gaviscon. She has been on and off gaviscon since 6 weeks. It did cause her constipation and we tried for months to find a dose that helped that didn't cause constipation but failed so at 20 weeks we accepted a prescription for lactulose. She only needed this for 2-3 months after this she could handle the gaviscon without getting constipated.

Also OP I really don't mean to make you feel bad but why did the doctor advise you to stop BFing? It's a shame as most breastfeeding specialists would have advised to continue and to try to treat the reflux firstly through positioning/latch adjustments and then if that didn't work, treating medically (gaviscon, omeprazole etc) rather than muddy the waters by switching over to formula and then have the hassle of trying to get them to drink dairy free formula which is often not well accepted by babies especially if they aren't used to it from birth. It would have meant eliminating dairy and probably soy from your own diet if suspected CMPA but those are the only allergens that are proven to cross from maternal diet into breastmilk (and they do so in much smaller quantities than if baby ingests them directly) and then you would have been able to wean him and try to treat the reflux without also worrying about milk intake. I'm really not sure how the GP thought that stopping BFing was going to help in any way?

Sorry I know that doesn't really help you at all at this point as you are where you are but I thought it worth mentioning in case anyone else finds this post in future!

Has he had an oral motor assessment? Does he have a tongue tie? Poor oral motor skills sometimes due to tongue tie, sometimes not, lead to reflux symptoms and the classic picture is baby who struggles with breastfeeding, goes to formula doesn’t see improvement and bottles get tricky too , reflux meds and allergy milk formula are tried but without sufficient improvement (or any). Might be worth a check

@BigRenoLittleBudget dairy and soya are far from the only allergens that pass through to breast milk! Nearly all of my daughters allergens were identified through reactions to me eating them and me breastfeeding her! She has 20 food allergies!
She is unusual in the number of allergies she has but you can have reactions to other allergens through breast milk including foods not included in the top 14 allergen list. There's nothing unique about dairy and soya proteins that allow them to cross into breast milk compared to proteins from other foods.

If it is an allergy it’s a none IGE allergy and there is no testing for you. You can only remove the allergen and then reintroduce to check the reaction.

I was also keep him soya free for 6 weeks to see if that makes a difference.

Apologies I see that it can be associated with other food allergies but this is very rare in EBF infants and LLL advise that it is not usually necessary to stop breastfeeding: Breastfeeding and Food Allergies - La Leche League GB

It would still make more sense to try to treat the reflux and eczema medically prior to giving up breastfeeding rather than give up BFing first.

@BigRenoLittleBudget I agree with not stopping breastfeeding for as long as possible! I managed 10 months before my body gave up due to the highly limited diet I was on with only a handful of safe foods this is far from the normal situation. It's just hard enough to get help with multiple allergy babies without being told that only dairy and soya proteins can pass through to breast milk. I spent a lot of time feeling like it was all in my head with little personal and professional support. I was just thinking of any other women reading your post and thinking they must be making up their experience as only dairy and soya pass through to breast milk.

For most women removing dairy soya and occasionally eggs is more than enough to get their allergies under control and much better to keep breastfeeding if that's what they want to do I agree with you there!

I’m only now thinking could it be reflux as the GP’s always said CMPA. Been to GP today and got some gaviscon! He usually won’t drink more than 4oz and he had 8oz in 1 sitting earlier!!! I’m hoping he doesn’t get the constipation but will keep an eye on it.

Wow 20 food allergies must have been so hard! Bless her.

Hey, dw no you’re not making me feel bad at all. The dr also didn’t advise to stop, I went to many feeling clinics, latch was perfect, no tounge tie and absolutely no health professional mentioned reflux to me until very recently.

I had an extremely strong flow and I tried all positions to help but it would just go everywhere when I just took my bra off! Absolutely crazy! & can’t have helped with all of this. I decided to stop bf due to some personal circumstances as well as the issues I was having with him. Absolutely loved every minute of breastfeeding and very proud of myself for doing 4 months :)

also he took to the diary free formula absolutely no bother so I was lucky in this respect!

I got him checked for a tounge tie when I was breastfeeding and they said he didn’t have one although he could have a lip tie so I might get that checked.
Started him on Gaviscon today so going to see how he is fingers crossed

The drinking of 8oz could have been a consequence of the reflux. Reflux causes overfeeding as feeding soothes the reflux and bit causes more reflux so then want to drink more. It's better for reflux babies to have smaller more frequent drinks.