advice for baby with reflux and poss cows milk allergy: changing to bottle feeding, weaning and new symptoms

[JPK123]

hi - can anyone help?

background: my DD1, now 19 weeks, was diagnosed with reflux aged 6 weeks after 3 weeks of awful feeding, screaming, arching, refusing to feed and projectile vomiting.

she was started on gaviscon which didnt help (bf, so hard to give, constipating etc) and ranitidine which massively did. she was much better but still puking until i cut out dairy which made me wonder about cows milk allergy - the gp gave me nutramegan for the one bottle feed we were giving (i couldnt seem to express enough) but she wouldnt take it so i have been exclusively bf.

now that i can express more we have tried to re-introduce bottle but she wont take it atall despite trying loads of diff teats etc.

In the last 5 weeks she has started slightly similar reflux behaviour - sometimes refusing to feed, sometimes having a few sucks and pulling off crying - not as bad as before but still v stressful. she feeds ok at night and oddly when i am lying down. she started to plateau on weight and dropped from 50th to 25th centile so we were referred to paeds day unit but as she fed better when there and had put on a few ounces they said not to worry. they did some blood tests whcih showed she was a bit anaemic. needless to say she got worse again a few days later and we are waiting paeds outpatients which isnt till June!!!

she doesnt have eczema but has v itchy eyes and odd rashes. both me and my husbands families have strong history of allergies.

My questions are:

1. cows milk allergy - does anyone think this is likely? do they always have blood in poo for this? is the only way it is diagnosed by excluding and the re-introducing? havent been that strict on dairy free...

1. could her new symptoms be reflux re-appearing? have been inc ranitidine dose in line with weight but might she need losec?

1. I really want her to take a bottle in a few months time when i go bak to work- is neocate anymore palatable, how have people got their babies to take this disgusting stuff?

1. weaning - the paeds said to try weaning her but am not sure if this is best advice - what have people found with weaning reflux babies?

imany thanks

re cow's milk. No blood in poo necessary, but if you've not been very strictly excluding then its unlikely.

the only thing I know about weaning reflux-y babes is that the vomit becomes multicoloured, and harder to clean up.

my advice is not to worry about going back to work, she'll be eating solids then and the whole milk feed issue will be different

1>) yes, cow's milk allergy sounds quite likely. doesn't need to have blood in poo, but if you want to control it you need to cut it out completely

2.) new symptoms could be just a build-up if you haven't been overly careful about what you eat? I found that ds2 was ok if i ate a small slice of cake for example, but if i ate one every day for a few days he'd start geting bad symptoms again. it was like it built up in him until he started reacting badly

3.) neocate is supposedly more palatable, but you might ahve a fight for a prescription. personally I would stick to just breastfeeding, I think it's best for refluxy and allergy-proine babies, personally. If you could express a little each day then you'd maybe have enough for a bottle a day once you were at work?

4.) no way i would wean a baby with allergies early! i wouldn't wean any baby early tbh, but def not if you have allergies in the family. i don't think it will make a difference with her reflux tbh

it's also absolutely normal for a breastfed baby to plateau at this age, and dropping centiles too... nothing to worry about unless she is losing weight

thanks for replies

• saw HV today and hasnt gained any weight again for 2 weeks. I dont really understand the plateauing being normal - if she never gained any weight this would not be normal - babies should be growing? I know they can drop centiles but she has gone from 80 at beginning to now 9 and still crossing in a straight line.

Anyway, maybe have got mixed up but am being referred to gastro outpts.

Husband (who like me is an adult doctor - as you can tell i know nothing about paeds)thinks its appetite suppression from ranitidine - anyone found this?

Im not sure about the new symptoms being a build up as i have been getting progressivley more strict about dairy since she was diagnosed and her eating has been progressivley worse, but will cut out totally and see.

thanks for opinions anyway, gotta go baby crying!