CMPA and breast feeding

[CharlotteMai]

My baby boy is now 2 months old. He regularly is sick multiple times after feeding and has been like this pretty much since birth. Sometimes this is instantly after feeding, other times it can be some time after. He doesn’t seem to be uncomfortable or in any pain at all, sometimes laughing whilst being sick!! It isn’t projectile vomit, more like spit up but in quite large volumes. Doctors have alluded to it potentially being CMPA and said I would need to cut out dairy for 2-4 weeks. He does also have a rash which comes and goes. Has anyone had experience with reflux/CMPA with their breast fed babies? I’m happy to cut out dairy to see whether this helps, but everything I see about CMPA the babies seem to be in extreme discomfort with it, which my boy does not at all

Yep, the allergic reaction can often get worse over time.

Is he gaining weight? What made you talk to the doctors about it?

Yeah gaining weight well never had a problem with that. I had gone to the GP for his 6 week check and mentioned it. They’ve prescribed a cream for his rash and said if it didn’t work they’d try a steroid cream and then would ask me to cut out dairy to see if it was CMPA. The cream does work at settling the rash but it’s never fully going away or if it does it comes back in a day or two.

Try it and see what happens. My baby stopped screaming within 24 hours of me stopping dairy. Yours may be accustomed to discomfort and therefore not scream.

CMPA is overdiagnosed (according to my health visitor, that is!) and GPs are not trained in infant feeding. Sicky baby will make them question CMPA and then they will send you down the rabbit hole of elimination diets.

You just sound like you have a sicky baby with sensitive baby skin. It’s normal for such young babies to get a bit spotty and flare up as they react to new environments.

Mine vomited exactly as you describe after most feeds. By the time they could sit up it had all calmed down. Some need a bit more time for their gut to mature.

i would speak to your infant feeding team about your concerns. When I was worried about my sicky spotty kids, they came to check my latch to make sure they weren’t gulping down air. They weren’t, nor did they have a milk allergy- just refluxy kids.

in the mean time watch his weight and double up on muslins!

Two of mine were CMPIntolerant. Reflux, puked if they laughed too hard, rashes. They were breastfed with occasional formula. Unfortunately we did not identify the problem until we started giving them actual cows milk at 12m. One would throw up the whole meal within 20min, the other cried with colic within 20min (having not had colic for several months) and had bleeding nappy rash within the day. I unfortunately thought it was lactose intolerance because I am lactose intolerant, so stopped ordinary milk but continued giving them hard cheese and yogurt. The puking and nappy rash stopped, so I thought they were fine. But the reflux and patches of eczema-like rashes continued. The older one had also developed glue ear, perpetual catarrh, and asthma, none of which changed.

When we cut all dairy very strictly from our diets, the transformation was amazing. The breastfeeding toddler's reflux and 'eczema' cleared up within days (and reappeared within hours of a breastfeed if I ate any dairy). The older one's 'eczema' also cleared up within days, the catarrh took a little longer, and the glue ear took several months to clear up. The reflux remained, though vastly reduced. She is hypermobile, though, and I wonder whether the reflux is related. She grew out of asthma, which I'm not convinced was related as I never saw any variance between when she had dairy and when she didn't.

Symptoms of cmpa can be quite varied and change with time.
At 8 weeks my daughters symptoms were mostly spitting up, feeding aversions and, not identified at the time, frequent loose stools. By the time she was diagnosed at 17 weeks she screamed all day and night.
My biggest regret was not trying dairy free earlier. I would have taken removing dairy for a couple of weeks unnecessarily over an additional 9 weeks of a baby that became utterly miserable and unbearable. It was also a contributing factor to my pnd and psychosis.

I've known babies have full on projectile vomiting without cmpa and babies with very subtle symptoms have multiple food allergies. My friend has two cmpa babies, one massively unhappy then next the happiest little thing!

Given the rash and the vomiting I'd be tempted to look into cmpa. My daughter has multiple food allergies and it wasn't necessary for us to do long elimination for most of them. Removing the food for 5 days or so then eating it to see if we had a return of symptoms whilst keeping a detailed symptoms diary usually was enough to have an idea if fully eliminating was worth it. I'd be tempted to keep a symptom diary for 3-4 days so you get an idea of their baseline then remove dairy for a week (don't use soya dairy or meat replacements during this week as they are very similar proteins to dairy) and then go back on dairy and keep the symptoms diary up for another week and see if you get any changes in symptoms. If you do find the symptoms were better in the week without dairy it might be worth doing a longer exclusion.

My CMPA baby was breastfed and her symptoms cleared up within a day of cutting out dairy. I’d say you’ll have a reasonable idea quite soon after cutting it out of your diet, although I appreciate all babies are different!

My breastfed baby had CMPA. I had to go dairy and soy free which is hard work but it stopped ALL episodes of sickness and all rashes. He also started sleeping a lot better. Dr didn't believe it and said CMPA is overdiagnosed and it's extremely rare for them to react to dairy in breastmilk. Well, I did it anyway and it was life changing.

Mine was in obvious discomfort though, it wasn't just some spit up and rash. He was wriggly a lot, during and after a feed, and clearly had stomach pains. He was never projectile sick but he was sick quite often.

We confirmed the allergy at 6 months - I gave him 2 teaspoons of yogurt and ended up in hospital as he couldn't stop vomiting after that.