Help!! Dairy free trial for possible CMPA

[Trina2244]

Hi everyone,

I have a 7 week old DS who has horrendous reflux. We use gaviscon infant, infacol and sit him upright for 30 mins after every feed. All of these help to take the edge off but the reflux is still distressing for him and he cries most evenings and looks to be in pain.

In desperation I've cut all dairy from my diet for the past fortnight in the event he had a cows milk protein allergy (CMPA). I told my GP but he didn't really give any advice about the process. So I've used the advice given from my local hospital re: avoiding all dairy based foods and products.

My question is - there hasn't been much change in DS's presentation. How long should I cut out the dairy? I've seen some ppl say they noticed improvement within days whilst others have said it takes 4-6 weeks. I'm not sure whether to try and reintroduce dairy now after 2 weeks or wait longer. I'm really doubtful that it's helped at all (yet) and I'm not keen to continue if it's not helping as I'm having to take supplements due to the lack of dairy (calcium) which I'm not keen on.

Any personal experiences and advice are welcome :)

I would expect some improvement in 2 weeks even if there are still quite a few symptoms
Have you also removed soya ? Half of babies are allergic to both dairy and soya as the proteins are so similar.
Has your GP suggested omperazole? My daughter has reflux and multiple allergies. To get her reflux to improve she needed me to start removing her allergens from my diet as well as being on high dose omperazole and as much gaviscon as I could get in her plus lactulose for the gaviscon constipation.

If removing dairy and soya does make a huge difference after 2 weeks of both being excluded I would keep a food and symptom diary for another 2 weeks to see if you can pick up and patterns. If there isn't any obvious out causes I'd do a test of going back on dairy for a few days. For the first day I'd just include one portion of something you are really missing wait another day and then do a few days of eating normally and see if symptoms stay the same or get worse.

Thank you so much. GP doesn't suspect an allergy, tbh he is totally unfazed by my son's symptoms and said it's "just reflux" and "he'll grow out of it". I took the initiative to eliminate dairy as we were so desperate and already having had a daughter with reflux I knew that my son's was a different level and much worse, although the GP ignored this reflection.

There's been barely any improvement since eliminating dairy and idk whether the minimal improvement is from the gaviscon and/or infacol. I have avoided concentrated soy such as soya milk which is what was advised in the hospital guidelines I used. However it didn't say to avoid anything with soya additives. I suppose I could try to do that for a further 2 weeks to see if there's any improvement but I'm starting to feel I am barking up the wrong tree. I did ask the GP for omperazole but he said gaviscon is the first line. I can book another visit this week to discuss omperazole although I imagine I'll just be told to increase the gaviscon first.

Having said all this I think I'll stick to the dairy elimination for now and increase the gaviscon dosage for a week to see if it helps and then return to the GP if it's the same. Surely he'll need to start taking it more seriously.

If you haven't had any specialist feeding support I would recommend seeking it out. NICE guidelines recommend a full feeding assessment before any prescription but this step is often missed.

If you’ve replaced products containing dairy with products containing soya then you might see no improvement because dairy and soy allergies often go hand in hand.

I assume that you are reading labels and checking that there’s no hidden milk in products. It’s not always obvious what products contain milk.

GP recommended Gaviscon before omeprazole here too. Gaviscon did nothing but Omeprazole worked a lot better for him. It also helped that I worked out what he was intolerant to (my son was much older than yours so fully weaned ) In his case he has intolerances rather than allergies but it’s a difficult balancing act for him in order to stay healthy. Luckily needing vegan options like plant milk is easier these days.

I agree with PP I would get a feeding consult with an IBCLC (go privately if you can afford it). Often it's hard to differentiate feeding issues from allergies in the early days.

My baby has confirmed dairy allergy (as well as allergies to other things). He didn't have the digestive side of the allergy (bar nasty poops). I can count on one hand the amount of times he spit up in his 16 months. But he gets rashes and hives even after touching the things he is allergic to, which leads to very nasty eczema.

It took almost 6 months to see significant improvement in his skin after I cut out his allergens from my diet. I feel the digestive side should be quicker than that. But I would persevere for as long as you can. I'm well over a year now and it gets significantly easier over time.

I would also look to cut eggs and soya from your diet.

Hi everyone, thank you so much for your responses. To clarify, I've been reading labels like a hawk to avoid all dairy and it's derivatives. I have mainly switched to oat and coconut based substitutes as I really dislike soya flavour. My son doesn't have any obvious rashes or poop issues, I think this is why the GP never considered intolerances and why I'm muddling through the way I am. He's also gaining weight as normal and is on the large side. This may be why GP also not concerned. But it's the projectile vomiting and purple screaming every single day and his general discomfort that makes me worry something is not right.

If the vomiting is projectile has pyloric stenosis been ruled out? https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/pyloric-stenosis/. Definitely worth bring up with the GP and keep a close eye on his weight gain in case it starts to stall.

FWIW my son had CMPA as well as soy & egg allergy causing reflux (but also bloody diarrhoea), after 2 weeks avoiding milk & soy he was 80+% improved.

Good luck, it's so awful for him and you :-(

My daughter has a coconut allergy as well as dairy and soya!

At the time of diagnosis my daughter didn't have any rashes or poo issues. It was only when her poos improved I realised they weren't good. She also had good weight gain but moved up a percentile after I started removing allergens. She ended up with 20 food allergies! Her paediatrician said it was unlikely to be allergies and her GP said it absolutely wasn't anything I was eating...it turned out to be everything I was eating!

Her main symptom was reflux and screaming and being unsettled for 16+h a day

My sister projectile vomited daily until 2, readmitted for force-feeding at 10 weeks less than 1lb over birth weight and continued to be frequently sick until aged 40 when she went vegan!

No nothing has been considered by the GP as he feels it's "just reflux/GERD and colic" and he'll grow out of it. I think DS healthy weight gain and lots of wet nappies would rule out pyloric stenosis. As yet there's been no issue with weight gain and he is on the 91st centile which is also what he was at birth. But the amount of posseting and vomiting and the high level of distress makes me concerned. GP is adamant it's normal, but DS doesn't cry - he screams, whole body stiffens, face goes purple, constantly seeking to choke on vomit, will vomit hours after his last feed which results in more screaming and distress, his lungs sound "wet" he wheezes and gurgles especially during feeds.