CMPA or Reflux?

[Boymama22]

Hi, so DD is 10 weeks old and has always had a congested nose, cough, sicky baby etc. went to out of hours when she was 5 weeks old as she had a red rash like little bumps on both sides of her head and neck however they said it wasn't that bad and sent us away, the rash improved thankfully. about a month ago she started to feed less and has stayed around the 20oz per day mark for ages, she's formula fed. Cannot force anymore into her. Seen a GP at 7 weeks and they said if her weight gain is fine then all good. It was. However last week she got weighed by HV and she had only gained 5oz in 2 weeks. Went back to GP who prescribed gaviscon. Intake came up to 22-25oz but the last day or so it's dropped and she's not interested. She's also had some green slime in her nappy too. Im waiting on a phone call back from the GP but im not sure whether it's bad reflux or it's CMPA. Any advice is appreciated.

It could be either or both. My daughter has both. Trialling a dairy free formula would be a good start but you might need to also try omperazole and then test going back to normal formula and stopped omperazole once you hopefully are symptom free and see if either return.

My daughters reflux is made worse by allergies but she has reflux on its own too and is still on high dose medications at almost 4!

Thank you! Aww bless your daughter! Bet it was a rough ride at the time. The GP kinda fobbed us off so we'll just have to see how she goes!

My daughter was 17 weeks by the time we got proper help. My daughter had mild-moderate physical reflux as well and this was the only bit our GP dealt with. The silent reflux wasn't picked up properly and it was much worse than her physical reflux and her knowledge of cmpa was actually wrong. I was breastfeeding and I was told that if she was reacting to my breastmilk she would be in hospital and not gaining weight. Which is true for lactose intolerance and less true for cmpa!
We only got joined up help when we happened to see a paediatrician for something else.

Aww I hope your daughter is doing much better now! It's horrible isn't it. I feel like GP's just fob us mums off a lot. But we're the ones spending all day with them. My son had zero problems so its all new to me but my daughter was only 8lb 11 (born 4lb 15oz) when weighed last Wednesday at 9 weeks 6 days bless her. Hopefully despite her problems she's managed to put some weight on.

Have you checked to see if she’s tongue tied?

How would I do this? I've bottle fed both my kids so this isn't something I've considered

Ok so look under her tongue, when she laughs or smiles is probably easiest, and you may be able to see if the little bit of skin underneath joins right at the tip of her tongue. If you google pics you’ll see what I mean. If not sure then tell your midwives and they’ll be able to tell you.

I think you're onto something! She looks quite severely tongue tied to me! Hv is coming tomorrow so I will ask. Can it effect bottle feeding that much? I thought it was a BF thing more so!

Oh yes definitely, because they can’t latch so they take in so much air. My son was 10 months old before we got told he was tongue tied, and that’s only because i asked a specialist, other doctors told me he was fine! Babies are misdiagnosed with allergies ALL the time.
I think since my son 3 years ago, I’ve told coming up to 10 people their babies are tongue tied, it’s so common and when they get it snipped it’s life changing! Good luck! x

Thank you so much! I'll ask the hv tomorrow and then if she agrees hopefully we can get it snipped for her! X

It's still a battle but as long as we aren't doing a test reintroduction and her reflux meds are working things are good. We have to have the meds reviewed regularly to get the doses readjusted.

I had my mum for support but only remotely has she was caring for 3 of my grandparents. My sister had severe projectile reflux so she had been through that with her. Given her birth weight that looks a promising weight as she's starting to move up the percentiles. Hopefully this continues at the next weigh in. That's 25g a day weight gain which is pretty good for a little one and that's with no weight loss in the first week. Normal is 25-30g. My sister was 6lb13 at birth and just 7lb10 at 10 weeks!

*and that's assuming no weight loss in the first week. Factoring in a bit of weight loss that will be closer to the 30g a day value

@Superscientist yeah I can't imagine how hard it is and it seems you don't have a huge village of support either so props to you! It's hard enough being a parent but factoring in a child who has medical needs too! And that's what I thought initially to be fair, she did drop to 4lb 10oz. But the hv seems to think this is slow weight gain🤔.

@Superscientist she has been weighed sooo regularly too and she seems to be jumping between the 1st and 2nd centile so apart of me thinks if she hadn't been weighed weekly they would be happy with her gain from birth, 6 weeks and now🤔 it's confusing to be fair!

Holding a percentile is great but a 2nd percentile baby will always have extra monitoring until they are sure it's right for them. My daughter is on the 1st-2nd for height having dropped from the 25th for length some time between 1 and 2. We had a few extra measures around the time the drop was found but she has held this line since so everyone except she just small. It's sounds like there is steady gain. When's the next weigh in?

Have you had any paeds involvement or had their length measured? I know there's huge errors on lengths at that age but if it shows they are relatively in proportion to would offer reassurance.

It might be worth pushing for a trial of dairy free formula. My daughter was on the 9th for weight until I started reducing and removing foods from my diet and then she moved up to the 35th! I had the opposite from the HV and midwives though "weight is good she's just a low percentile baby"

How did you get on with the midwife OP?

@Superscientist yeah definitely! My son had quite a few weighs in the beginning as he was born on the 2nd. I don't grow my babies very well and they're both SGA babies. But my son shot up to the 50th so this is a new experience for me my daughter staying so low! And drinking such small amounts of milk. Weigh in was today! No peads involvement since we left hospital as she had jaundice therapy. I do think she is reacting abit to the milk so gonna discuss this with the doctor at her gaviscon review
@Twelve8Ts she had gained 9oz, which puts her up to the 9th centile apparently. She was 9lb 6oz! They're coming back out next Wednesday and the following week on the Friday and we're gonna see how she's going. She drinks about 21-22oz a day so not far off what she should be drinking for her weight. It's such a trying time the fourth trimester! It feels like a guessing game lol!

@Superscientist oh and she's 50th centile for height! So shes just long and skinny atm 🤣🥲

@Twelve8Ts hv also seems to think no tie, but I'm not so sure! So maybe gonna see about getting a private place to look at her!

It's great that she is slowly making her weigh up the charts. If she's now 9th for weight and 50th for length she is now just about a normal weight which is amazing!

Normal is classed as within 2 percentile groups so for a 50th percentile length normal is between the 9th and 91st percentile

My daughter is the exact opposite - 1st-2nd for height and 35th for weight. Short and robust looking. Her drs aren't concerned about her height as she's within the 2 full percentiles (just)!

My sister took a year to get to the 0.4th line after dropping off the bottom as a newborn. And then another year to move to the 50th. She was so similar to my daughter I'm almost certain she also had a cmpa too

@Superscientist that's useful to know thank you! It's reassuring! She's doing a lot better now as we've got abit of a feeding routine going that she's got herself into. She's still quite sicky and hiccups soo much, so hopefully the sick isn't effecting her gain! Sometimes it just keeps coming and coming🙃

Your daughters seems to have come so far considering the set backs she's had bless her!