Is this cows milk allergy?

[Mumwards]

Spoke to my friend about some symptoms my EBF 6 week old is having and she suggested it may be cows milk allergy. Just wanted to see if anyone agrees. About two weeks ago she started with a rash on her face, neck and shoulders. GP via video call said it was baby acne. She also is super gassy- brings knees upto tummy, squirms when on her back, spits up frequently, vomits a whole feed up around once a day. She’s always passing wind and when she does she poops at the same time, her nappy is basically always dirty with really loose, watery yellow/green poop. She has nappy rash from always pooping despite barrier creams, frequent changing, nappy free time etc. Sometimes she gets really fussy and cries at the breast too, especially in the evening. She’s also quite congested and often sounds snuffly. Anyway I don’t know if this is all separate issues, I read only 0.5% of EBF babies have cows milk allergy so don’t want to alter my diet so drastically if not necessary!

It does sound like it could be, my baby had it and had all of these symptoms and more.

With us, it was so extreme that I was willing to try everything to get the screaming to stop so the elimination diet was not too bad for me to stick to. I had to fully cut out all dairy and soya though so it wasn't easy. But then again it was 10 years ago all dairy free stuff is so much better now.

The green poos were something that we had, within 3 weeks of no dairy through my breastmilk she was a different child honestly. She had to be fully dairy free into childhood and grew out of it by age 7. She was particularly sensitive though.

What I will say is that if you do this and trial it don't be surprised if you get zero help from your GP / health visitor about it. There is real ignorance about this issue and I was never taken seriously despite my baby ending up in hospital and on medication for her reflux.

I'd say give it 3 weeks and see where you are, drink plenty of water throughout. If it helps you have your answer.

Thanks for your advice. It’s weird that GPs and HVs are reluctant to help. I’ve spoke to two different midwives and my HV about her poops and all said it was normal breastfeeding poop behaviour. I’ve asked on other forums about her poop before she developed this rash and it seems loads of breastfeeding mums have this issue, that’s why I’m kinda between the whole “is it CMA or is it just normal breastfeeding behaviour and baby acne

We suspected for our LO too, had many of the symptoms you describe also silent reflux. Looked into CMPA and a recent study by Imperial indicates this is really very rare and unlikely to be the cause. Cows milk proteins were also found not to travel in breast milk.

Have a read: www.imperial.ac.uk/news/196813/milk-allergy-guidelines-cause-overdiagnosis-babies/

Not saying it isn't that and not worth investigating, but chances are very small.

It's worth a go OP! I'm in a similar boat, my little one had similar symptoms to yours from 3 weeks onwards. I cut out all dairy and soya, as well as caffine to see if that helped. Her skin cleared up within days and she is a different baby now - happy and content and no longer in pain.

This could 100% be a coincidence of course, she may have just become more settled in herself and it might not be anything to do with the dairy. But the few times she was really bad I had eaten a bucket load of dairy beforehand. I suspect its an intolerance to dairy and not an allergy, and eventually I will gently introduce it to my diet again to see how she reacts. Even though I can't say for sure that it was the dairy causing her upset, I was at the point where I'd try anything tbh as her constant grizzling was really getting me down.

I am a big dairy person normally, but honestly it's not been that bad cutting it out. I was so grumpy at first as I was sleep deprived, trying to figure out how to look after this tiny baby and then my chcoclate brownies were taken away from me! But there are some great vegan alternatives out there, and you'll still get to eat delicious things. It's worth a go for a few weeks. Good luck!

Thank you everyone for your advice! Glad to know it’s not just happening to my LO

It’s possible but there’s a whole number of things it could be.
My experience of my DD who had constantly lose stools. Dirty nappies 8 to 10 times a day. Fussy when feeding. Frequent vomiting. Irritable with prolonged crying. Struggled to nap. Frequent unexplained rashes. Constant severe nappy rash.
Basically a whole host of symptoms.
I was constantly dismissed by heath visitors, GP’s, pharmacist. Constantly told ‘that’s just what breastfed babies do’.

Started weaning at 6 months and instantly realised she had a whole host of allergies. Not diary surprisingly. But instant touch reaction to any egg products. Strawberries, mushrooms, orange, tomato gosh I can’t even remember them all. Touch reactions, hives, itching, vomiting. We didn’t even try nuts at this point.

After a long and painful process she was confirmed as having multiple allergies. Now carry 2 epi pens at all time. She’s severely allergic, so airborne particles will set her off.

The good news? She’s outgrown all allergies except nuts and eggs.
The bad news? Getting a diagnosis is an awfully long and difficult process. Identifying each individual allergen is an awfully long and difficult process. Lack of education and awareness even in the medical profession is something I still encounter years later.

As my DD is so allergic she probably was reacting the whole time I fed her but up until 6 months I hadn’t excluded anything from my diet because I had no idea.

I’d suggest keeping a food diary and corresponding symptoms. You could try excluding diary from your diet to see if there is any improvement. I was told the benefits of breastfeeding outweighed her reactions up to 6 months but I don’t know if I believe this. Get into the system now. Don’t wait. See your GP and start the process because it’s long and painful.

If you can afford it my strongest advice would be to get a private test now. I so wish I had done this. It’s approx £200 for bloods and 14 allergen screen. I did it with my second child and it erased all those questions and doubts. Good luck.

My friend is head of paeds at one of the main scottish hospitals and when we asked her if our baby could have a cows milk allergy or just bad reflux she said every well intentioned man and his dog suggests babies have a cows milk allergy rather than reflux these days but in reality the odds are very low.

If they are putting on weight and not shifting up their back the message was more likely to be reflux than anything else. Unfortunately as we are all desperate for a cure we look for any option that will fix it when we may just have to lump it for a while.

My DS had silent reflux caused by CMPA, he was mostly breastfed and symptoms were mild until we started introducing some formula. However, they disappeared completely when I cut dairy out of my diet.

There are babies with quite severe CMPA who do react to cow's milk protein in breast milk.

My advice is to do a dairy free trial, cut it out for 6 weeks and see if symptoms improve. If they don't you can obviously go back on the dairy. But I think it would be strange not to at least try if there's a chance it could help.

Lots of helpful on this website, specifically for CMPA and breastfeeding, starting with this
dilanandme.com/confirm-cmpa/

There's also general info here
www.allergyuk.org/information-and-advice/conditions-and-symptoms/469-cows-milk-allergy

Thank you for the resources and links to studies! It’s hard with lockdown to get seen at my GP, she has her 8 week check next week so I will bring it up then. In the meantime I’m going to cut the dairy out and see if it makes a difference. It’s probably worth mentioning she does have a tongue tie that I’m waiting for an appointment to get revised, so have been told her reflux and gassiness could be caused by swallowing air due to that. My lactation consultant also thinks I have a fast let down, as she coughs and splutters on the breast at times!

Yes my DS had tongue tie too. Might be worth waiting until it's been divided and giving it a week or two to see if there's a change in symptoms before going dairy free. Otherwise you won't know whether it was the dairy or just the TT causing it.

PS Tongue tie doesn't cause skin rashes though

You need to give it 6 weeks dairy free to see if it is. Don’t add soya into your diet because 50% of babies with CMPA also have soya allergy. I recommend either Asda own oat milk or oatley barista for you as it’s forfeited with both calcium and iodine. It’s worth getting little one checked for tongue tie.

@Cherry85

My friend is head of paeds at one of the main scottish hospitals and when we asked her if our baby could have a cows milk allergy or just bad reflux she said every well intentioned man and his dog suggests babies have a cows milk allergy rather than reflux these days but in reality the odds are very low.

If they are putting on weight and not shifting up their back the message was more likely to be reflux than anything else. Unfortunately as we are all desperate for a cure we look for any option that will fix it when we may just have to lump it for a while.

I’m not sure this is true. My oldest wasn’t diagnosed until she was 11 month and despite paediatrician saying DD1 definitely didn’t have CMPA, she does have CMPA along with soya and coconut.

But yes reflux, especially if they are a ‘happy spitter’ is a biological normal is newborn babies.

My dd had a lot of these symptoms, she was ebf too. When she got older and began to drink cows milk, she got very bloated after drinking it and would have an upset stomach after. She's never been diagnosed with an intolerance but I switched to lactofree milk and she doesn't have those problems anymore. I can tell right away if someone has given her normal milk because her stomach swells so much!

This is what her poop looks like (sorry if anyone has just eaten) 😂 I can’t really tell if it’s mucousy or not? But that’s how it’s always been, she does around 10-12 of that size poops in a 24 hour period

Good weight gain doesn’t mean not CMPA. DS sits between 70th and 80th centile and has CMPA (Ige)

Interestingly we were told that many babies are misdiagnosed as reflux when actually It is an allergy.

Reflux would cause many of those symptoms but wouldn’t cause the rash or nappy rash issues - classic cmpa signs.

My friend is a GP and all her children have been EBF and are CMPA which was confirmed by eliminating dairy from her diet and then reintroducing it. Also has nice chunky babies.

Trying excluding dairy from your diet (warning lactose free is not dairy free) and see what happens. Good luck!

OP that poo wouldn't worry me (I'm NOT medical but a mum, aunt, friend and ex nanny so have seen a few)

My baby with CMPA, her poo was literally green coloured, smelled of vinegar and had the texture of hair gel.

OP - it may be that she's getting too much foremilk not enough hindmilk. Foremilk is the start of the feed and is full of sugar (lactose) which can cause gassiness. The hind milk is fattier which slows down digestion. Are you feeding from both sides at each feed? If so try the first side for longer. Remember 6 weeks is the peak of crying/unsettledness so I'd give it a few weeks. My first had CMPA, so some of the symptoms are there but hers was more vomiting constantly (exorcist style) after a feed and diarrhoea type stools + relentless screaming

I only feed on one side but she only feeds for 5-10 Minutes, during day wants to feed 1&half hourly, goes 3-4 hours at night. Do you think that’s why her poops are like that? Thanks 😊

She sounds like my eldest. He had all of these symptoms. He was the crying, grumpy refluxy baby from hell and it wasn't really until he was weaned and put on ranitadine at four months that he got better.

He has asthma and has always had bad coughs every time he got a cold. When we went to see the consultant about his asthma when he was three, they asked what he was like as baby. We mentioned the symptoms that were classed as reflux and they said that he probably actually had a CMPA or similar.

@mumwards
Could be, the colour suggests it, the darker green/brown tinge. Does she fall asleep after 5/10 mins? Try and get her to feed for at least 15 by waking up, tickling feet, stripping off, changing nappy. She might go a bit longer then between feeds as the hind milk is more filling. It slows down the digestion and you might end up with a more yellowy poop (yum!) and a less farty baby. Something to try anyway and better for you and easier than cutting out dairy

Hi, I know this is an old thread but OP, EVERYTHING you describe applies to my 6w dd. Even the possible tongue tie.

Was it CMPA? If so, how did you know for sure? Is there a test they can run?

@Rzr422

Hi, I know this is an old thread but OP, EVERYTHING you describe applies to my 6w dd. Even the possible tongue tie.

Was it CMPA? If so, how did you know for sure? Is there a test they can run?

If you lo has the symptoms above and it is CMPA a then it’s a none IGE and the only way to test is for you to totally remove dairy from your diet and then ideally challenge by you drinking a full glass of milk. Don’t replace dairy in your diet with soya as many lo with CMPA are also allergic to soya. You will need a replacement milk for you with iodine (ASDA own oat milk and Oatley barista) and take a calcium and vitamin D supplement.

But tongue tie does also cause those symptoms.

Thank you! Starting the daily elimination diet today. The pediatrician says it’s a slight or possible tongue tie but I still have an appt with the ENT next month to be sure.

Now that I’m thinking it through, she seems to be in much better shape in the mornings. I wonder if it’s because I rarely have any milk or milk based foods for dinner.