5 month DD - allergy to formula?

[littleduck]

DD has been exclusively BF until now and I have just managed to get her to take a bottle of EBM to prepare her to take bottles at nursery when I return to work in just under 5 weeks time. We had a mammoth struggle at first but over last few days she has happily accepted the bottle of EBM as long as I make sure it is nice and warm.

It will be very difficult for me to express at work (will be taking short lunch hours to get home in time for DD bedtime plus nowhere to sterilise breast pump equipment and bottles), plus I sometimes have to travel and/or work long hours so was hoping to move her on to formula when I go back.

I have today added a small amount of formula into her EBM bottle (10/15 ml in a 180 ml feed) and I think she detected it, she was reluctant to finish feed and cried, she became very sleepy at the end of the feed which is unusual altho she only had a very short lunchtime nap which might explain it. Above all I noticed that about 2 hrs after her feed her little eyelids had become very pink and puffy and she was rubbing her fists into them as if they were itching. Nothing like this happened with the bottles of straight EBM.

I tried a full formula feed (ie no mixing with EBM) a few weeks ago and she completely rejected it and would not take any at all. In addition I noticed a red rash round her mouth and in places where the formula milk had soaked through her clothes from spitting out/dribbling and some small raised white bumps in the rash. Mentioned this to HV who said the rash was nothing to worry about but this combined with the red and puffy eyelids makes me wonder if she is maybe allergic to the formula.

Based on the above, if she is allergic what should I do, is there anything else I can give her? HV said she MUST have milk during the day and it is not enough to just breastfeed her morning and evening for the 3 days per week when I am at work.

I would really appreciate any help, I am trying to introduce her to bottles now to make the transition to nursery easier for now but am so worried that my good intentions may have harmed her.

Many thanks

It does sound like an allergy to formula.

you can get hypoallergenic formula on prescription. I would make an appointment with your GP and try and get a referral for allergy testing.

What age is your DD?

5 months trixy

Can you not try to build up a supply of breastmilk in freezer? From now until you return to work.
Take sterlised bottles to work, sterilised pump, have lots of 5min breaks to keep supply up and express milk for DD (think you are entitled to something like this to express??)
Sorry dont know about allergy, best seeing doc.

littleduck - I'd be suspicious, too.

Your HV is being very, very dogmatic in saying that for 3 days a week a 6 mth old baby must have milk in the day.

You might want to use some common sense alongside this - you are continuing to bf when you are with her, and she will clearly need fluids at least when you are not. She will be starting solid foods, so these foods could be a) more liquid b) mixed with milk/formula or be naturally milky such as yoghurt or fromage frais

If you feel this would not be enough, then you have the option of expressing, when you can, so she can have a bit of ebm, when it's available.

If there are any 'rules' about all this, I would have thought number one is 'don't distress the baby'.

Sounds like it is probably a milk allergy to me. My DS1 has the same and it showed at 6 months when I first tried him with fromage frais (his first cow's milk).

Excluding dairy from her diet does have potential health implications though so you need to be sure. You should ask your doctor to refer her to the paediatric dietitian at the hospital so that she can be preoplerly checked (she may have other allergies too) and to make sure she gets any extras she might need, eg dairy allergic children need Calcium supplements - the extra in soya milk isn't enough.

I had to be pushy to be taken seriously but I was proved right. Good luck!

Oh, and 5 months is too young for oridnary soya milk, so you would need to use a saya formula. Doctor can prescirbe one so you get it free.

*oops re the spellings!

Yes - my ideas of fromage frais and yoghurt are no good if she really is allergic to cows milk.

On the other hand, some babies who are intolerant, rather than allergic, can cope with yogs and fromage frais.

Good idea to get a diagnosis.

There are concerns about soya formula - babies should only get this if there really is no alternative, IMO.

Yes, I agree with tiktok on the soya formula, but I know lots of people use it.

My son wouldn't even try it because of the smell (he was a bit older, 8 months, by this stage) so I kept plugging on with BF.

Thanks for the thoughts, the last thing I want to do is distress her or make her ill.

HV said that babies of 6 months need 20 fl oz milk per day and it would be unlikely she could get this just from 2 breast feeds per day and extra milk in foods.

I have been trying to build up a supply of EBM but it is proving difficult. I pump all of the milk I have in the early afternoon to give her a bottle at about 2.30 but even doing this I can only get about 3 oz out so am also pumping after her early morning feed to make a bottle up to 6 oz. Pumping after any other feeds seems to have affected the amount available at the next feed.

I can sterilise a pump and bottles at home but they will surely not still be sterile by the time I get to work? There is nowhere at work to sterilise pumping equipment so even if it were still sterile when I arrived it would not be sterile after the first pumping and subsequently.

As work involves a lot of meetings the practicalities of expressing on an ongoing basis are a nightmare, ideally I would be looking to stop BF within a month or two if starting work if a safe alternative source of milk can be found. Would a hypoallergenic milk be adequate?

I still think the HV is being unnecessarily text-book led here.

Your daughter may get loads more than 20fl oz on the other days of the week.

Lets say a typical bf amounts to 5 fl oz - this is very rough, but you can take a look at a paper which reports on findings that show feeds can be of anything from 0 mls to 240 mls

KENT, J. C., MITOULAS, L. R., CREGAN, M. D., RAMSAY, D. T., DOHERTY, D. A. &
HARTMANN, P. E. (2006) Volume and Frequency of Breastfeedings and Fat
Content of Breast Milk Throughout the Day. Pediatrics, 117, e387-395.

I think it's on the web.

Anyhoo.....5 fl oz is about 120 mls so I just went for the mid-point. If she gets 6 of those on the 4 days you are with her, my maths tells me you have more than covered the 'gaps' in the days you aren't with her.

It all seems to be adding up to a whole pile of angst which you can surely do without!

Littleduck, I recently returned to work leaving a 7mo who I recently also found was cow's milk protein intolerant.

I stressed for ages as I found I couldn't express much at home; the freezer stash I had was unusable because the cow's milk was coming through my milk, and I was so worried the little one wouldn't have enough to eat...

In the event tho, the baby decided (the very day I went back!) that she would rather not bother with milk much at all in the day, was happy with solids and water from a cup, and only about 3oz of ebm between 8am and 5pm, and just made up for it in the evenings, night (we co-sleep), mornings and days off.

I express really easily at work - 6oz in 15 mins with a manual pump - much to my surprise as at home it had always been really hard going at home, and I wash & (occasionally) sterilise my pump each evening, and allow to dry before taking to work in a tupperware box. I and lots of others on here find too much sterilising to be a waste of time!! ;)

Re formula... as far as I know the formula that you would need (if you want to avoid soya and have a cmp intolerant / allergic baby) would be Neocate, which I think is only available on prescription.

Hope some of that helps.

Thanks so much for all your messages.

Tried a tiny bit of formula in EBM bottle again yesterday - no swelling of eyelids but DD did develop a rash all over her trunk and limbs as well as around mouth and neck where the formula had spilt. The reddened skin was hot to touch. This convinced me that there was definitely a problem so called GP this morning who phoned me to discuss the symptoms and then arranged to see us within the hour!

GP agrees that based on these symptoms it appears that DD has an allergy to cow's milk protein and has prescribed Nutramigen which he warned tastes horrid and will make DD's poo green. We have been referred to the local paediatric dietitian also, he spoke to the dietitian briefly in my presence and she agreed that Nutramigen would be appropriate given the symptoms.

I asked if I should try to introduce the Nutramigen by mixing with EBM like I was trying to do with formula and he said no - just give her a full bottle but I can't imagine she will take it so was wondering if it would be a good idea to mix little bits in as I intended. Any thoughts much appreciated.

Needless to say I am very worried about poor little DD but trying to keep a lid on it. My mother is very gloomy about it ('Oh, it was all going too well wasn't it, there had to be something, I'm so worried, I think she's going to be a very sensitive child' etc etc) which is really not helping - I am trying to normalise things I think and say it's not an uncommon allergy, at least we have a way forward, lots of children grow out of it and so on. I really hope that this is the case and that DD will grow out of it.

I am really confused that she has the allergy as I thought one of the things about breastfeeding was that it was meant to prevent allergies?

Posting this on allergies also for any advice

Glad you have got some decent info and support, littleduck.

The evidence about breastfeeding and allergies is not very strong, and no one should claim it 'prevents' allergies...people can be born with this tendency and breastfeeding exclusively with no other 'foreign' items for several months appears (in some research) to reduce the risk that this emerges as an issue. As you say, this is something many babies grow out of.

I am still unconvinced your baby needs formula at all, especially formula which tastes horrible!!

Thanks Tiktok but she is going to have to start taking formula at some point as it is not going to be realistic for me to continue to breastfeed beyond Christmas as I will be working more days and will have to start travelling (including overnight) and am only able to express tiny amounts so will not be able to bank enough to cover my absences.

I can't think of any other solutions which will cope with my work commitments. Unfortunately I need to work to be able to pay the bills as DP's business has been very badly hit by the recession and there is almost no money coming in apart from my salary. We have been living off savings to enable me to stay off work until DD is 6 months and can't afford for me to remain part time after the end of the year

Ah, I see - yes, she is going to need formula if not now then later...hope you find something that works out ok for all.

I'm glad you've got somewhere with your GP.

Tell your mum that a dairy allergy is really not the end of the world. It is annoying and inconvenient, and it means no chocolate or ice cream or other fun food, but on the plus side it does mean that your daughter will have a really healthy diet (at least until she hopefully grows out of it) and you can avoid all nagging for sweets as she gets older by saying that she's allergic to them!

Good luck with the Nutramigen. That was the one I tried unsuccessfully with my son, but he was a few months older and it is easier to introduce it the younger they are. If she refuses, I would try mixing it in gradually. What have you got to lose? The paediatric dietitian might have some good ideas too.

Anyway, after a year your daughter can have regular soya milk, which tastes fine. (I'd use the sweetened one though.)

Good luck with it all. I know how difficult it is to start with, but it will get easier.

Oh, by the way, 8 years on, my son still doesn't have a sweet tooth. Another plus!

The only sweet things he will have are fruit, soya yogurt and his Calcium supplement.

(yes, he's still allergic unfortunately - but he's very much in the minority)

littleduck - have you seen this thread?

discussion on neocate vs nutramigen

Lots of people talking about their experiences with either or both.

HIH

Hiya - we had the same situation with an allergic DD1, and I just want to say - don't panic! Nutramigen (or Neocate) is fine - we just gradually mixed Nutramigen in to the EBM and within 2 weeks DD was taking 100% Nutramigen with no problem. She loved the stuff once she got used to it (is now 2 and is now on soya milk).

If you do want to express at work, it is possible - I used to take in all the stuff, express at lunch in a separate room whilst eating lunch (took about 20 mins once I was used to it, with a double pump), and stick in the fridge with a cool pack until I went home. Then can wash it all and sterlise it later. But I only did this becuase it took months to get a referral to the allergy specialist, so had no choice. TBH, it was a PITA. If it would be too hard and you don't want to, then I'm sure the formula will be fine.

PS you can get soya ice cream, dairy free chocolate and all manner of nice things. Just takes a while to build up your knowledge of whats OK and what isn't.

PPS tell your mum that one of the advantages is that you'll get free formula on prescription!

Many thanks for your ongoing replies - they have helped a lot. It had struck me earlier that DD was going to have a really healthy diet simply as a result of the things which will need to be excluded so that made me feel a bit better about it.

My mum absolutely dotes on DD and cheerfully admits to being something of a mother (or should that be granny?) hen so it is not a surprise I suppose that she is panicking rather at the word 'allergy'. I think that the healthy diet angle will be the way to go to convince her that it really isn't the end of the world and may actually be beneficial for DD as she simply won't be able to eat much of the processed rubbish around these days. It will probably improve my own and DP's diets too so could be a winner all round - was wondering how to get rid of the postnatal spare tyre!

Erm - hate to burst the bubble littleduck, but I'm currently off dairy as BF DD2 (who seems to also be allergic, sigh), and no sign of the pregnancy pounds disappearing!

Could be something to do with the really nice dairy free chocolate Kinnerton do

(PS - you're right about the healthy diet - DD1 just refused a jam tart after lunch today in favour of more broccoli )

Hi Littleduck I'm sorry to hear about your dd. It does sound like an allergic reaction so I would advise not trying it again. With some allergies the reaction can worsen with each exposure.
Sometimes having one allergy can make it more likely to have others so go carefully weaning. Your GP can refer you to an allergy specilaist which I founfd very helpful.
The allergies topic here on MN can be a great source of information.
my own dd1 has several allergies and at first it feels overwhelming. You will get used to it though and it becomes second nature to check food. Good luck!