Lactose intolerance or reflux?

[Cloudsandrainbows]

Hi all, my DS is just over 1 year old, and has been sick every single day of his life. I am proud to say he is still a chunky little monkey on 25th centile, so the sickness has not affected his weight, unless maybe he'd be bigger still if he hasn't been sick so much 🤷
Anyway he was breastfed for 5 months then combination fed for a further 6 weeks and fully on formula just before 7 months. He has had CMP blood test that was negative. Which I expected as was sick on breast milk. However since changing from formula to normal cow's milk the sickness has got worse again, so now on lacto free cow's milk. I thought it had made an improvement but am yet to go fully lacto free, but am limiting other dairy. However, now wonder if I should bother as yesterday morning after only having lacto free milk, he threw up the whole lot all over my bedroom carpet 🤦
I feel he may have other allergies as have had several reactions of red blotchy and puffy face, which through food diaries, I believe is due to peaches and apricots, which have been cut out and had no skin reactions for a couple of months.
I was previously told it was reflux and he would grow out of it by age 1, and given infant gaviscon. The gaviscon made no difference, just was something else for him to throw up. Generally his sickness has improved since he started eating more solids and less milk, leaving me to believe the milk is the issue, as it must have been the milk as a new born causing the sick?
I have appointment will allergy clinic on Friday and don't know what to expect. Can they help with potential lactose intolerance, and is there a test? Or will they only be interested in the skin reactions and not the sickness?
May not be relevant or connected, but he supposedly is developmentally delayed, and expecting referral to peadiatrician after next health visitor appointment as still in the black on the repeat of the 12 month check 😢
Any advice or similar stories welcome.
Thanks in advance

CMPA is not the same as lactose intolerance. The former is an allergy to the protein in milk and the latter is an intolerance to the sugar in milk. Both can make you sick although lactose intolerance is very unusual in children - it usually is a short lived thing and can be the result of a stomach bug.

You can have CMPA while being breastfed as the milk protein can enter your milk supply of you are consuming dairy. My son had CMPA via my breastmilk so I had to stop consuming dairy until he outgrew the allergy at 12 months.

Try removing all dairy from your son’s diet for 6 weeks and see if that help. You also need to remove soya because the protein structure is very similar and can cause the same response.

You also say he’s chunky and on the 25th centile. You realise that’s not actually very big? That means that 75% of boys his age are bigger than him. 25th centile is actually quite small.

Percentile size does not matter as long as he is following his curve. What % what he born on? It is perfectly possible to have CMPA and maintain weight %. Both my children did.

Children with CMPA normally show some improvement on a lactose free diet but obviously it’s not solving the whole issue.

25th centile is not much? It’s on the lower side for weight. But at least it’s a healthy weight and not below what’s considered normal. Perhaps it’s a milk protein allergy, which is different from lactose intolerance. There is special milk for protein allergy. My son was on this for a few months until he outgrew it.

@Selfsettling3 children with CMPA do not see an improvement on a lactose free diet. Lactose free dairy products are just dairy products with lactose removed. It still contains the cows milk protein which the child is allergic to. It would be like putting a kid with a peanut allergy on a shellfish free diet and expecting to see an improvement.

He is not massive for his age but still chunky, what I'm saying is he is a healthy weight and gaining weight so clearly not affecting his growth as he was born on 9th centile so he's jumped up. He's has had CMP test which was negative so how can it be that? And how will cutting out all dairy prove anything if I already know he's not allergic to CMP?
I am at a loss. I'm reluctant to do a complete lactose free diet, as obviously he has thrown up the lactose free milk already, and other lacto free products are more expensive but still a larger quantity than he'd eat before they'd expire.
Anyone had any sickness issues not related to dairy? Perhaps there's something I've overlooked that he could have been consuming through my milk and now in his own diet? I know he's not celiac or allergic to wheat, com, nuts, eggs, fish as been tested

You can’t do a blood test to check for CMPA so not sure what your doctor has done. There are two variations of CMPA, non-IGE and IGE. The symptoms are different and only IGE can be tested for and the test is a skin prick test, not a blood test. The other you diagnose by removing all dairy (and soya) from the diet for 6 weeks and seeing if the symptoms go away.

Your son has thrown up after lactose free milk so you can rule out lactose intolerance. However, since lactose free milk is still essentially milk but with the lactose sugar removed, you have still not ruled out CMPA.

Do some reading online about lactose intolerance in children and you will soon understand why it’s almost certainly not that.

user1480880826 that’s not what my daughter paediatrician and paediatric dietitian said. They both said lactose intolerance can be sometimes be assumed to be the issue as children with CMPA do often show some improvement of symptoms on a lactose free diet.

I am well aware of the differences between CMPA and lactose intolerance.

Only iGE allergies can be tested through skin prick tests. The only way to test for none iGE allergies is to remove them for a minimum of 6 weeks and then reintroduce while observing any reactions.

Bloods for CMP will be negative if the allergy is non-IGE. IGE only will show in bloods. It's likely the allergy your lo has us delayed reaction non-IGE. I had this with both of mine, neither could have any dairy or soya and had Alfamino formula. My eldest is still allergic to pure milk but ok now with hidden and baked milk, my youngest has outgrown it.

Self setting- lactose free will not help a CMP child. CMP is allergy to protein, lactose is the sugar.

I didn’t say it would solve the problem. I said a child with CMPA can show a reduction in symptoms on a lactose free diet and this can cause an incorrect diagnosis of lactose intolerance.

My gosh this is clearly more complex than I thought. CMP can definately be tested for in blood, as we've had the test! However as some said there are 2 types then I guess we can get tested for the other kind too. I will just have to see what today's appointment brings and hope I get some answers

You can not be tested for non-IGE CMPA. The only way to diagnose is to remove all dairy and soya from the diet for 6 weeks and see if there is an improvement.

You cannot be tested for non-IGE.

In simple terms-

Anaphylactic immediate allergy is IGE and shows in bloods, usually some skin reaction immediately too.

Non-IGE, delayed reaction/reflux/tummy pain/gut reaction/vomiting /eczema. This can't be tested for- the only way is to remove the dairy and/or soya too.