Milk allergy or silent Reflux, how can you tell? My daughter is suffering!

[Cookiemonster83]

Hi, my 10 week old was put on SMA Althera about 6 weeks ago due to suspected milk allergy. Her symptoms then were excessive bottom wind, constant crying and arching back, rash on face, watery green poo 5-6 a day.

She still 6 weeks later cry’s, absolutely refuses to lie down, when she does she gulps and swallows and chokes, started coughing, screams after bottles, when she cries she chokes on milk coming up, explosive poo which goes up her back. She gulps and swallows when drinking from bottle,Poo is thicker and green which I’ve heard is Normal on special milk. She sounds like a snorting congested pig and
sneezes constantly, especially after feeding.

The thing is this seems to me like silent reflux as she doesn’t projectile vomit but milk is always in her throat. I’ve switched yesterday to nutramigen as the doc said they like you to try 2 different dietary formulas and we are on the waiting
list for the dietitian.

We thicken the formula with Carobel as the doc would not prescribe anything.
Does this sound like CMPA or reflux? I thought if an allergy she would have more skin reaction as my nephew was allergic and he had a terrible rash on his face.

How can we help her until we get an appointment? We already tilt the cot but she is so unhappy led down and wants to sit constantly or sleep in the sling. When she is in the sling her breathing sounds so clear, when led down it’s wet and raspy.

It sounds more like CMPA because there are a fair few symptoms, and silent reflux can be caused by CMPA so they might be going hand in hand.

my DD had mild silent reflux and she would gag and choke and you could sometimes see the milk come up and then she’d swallow it back down. but she didn’t have the other symptoms as they do sound like CMPA but it’s so difficult to know.

It’s just so hard. My first dau

pressed too soon.

my first had reflux but she was a happy child and gaviacon helped. This one is just so unhappy most of the time.

Althera is an extensively hydrolysed formula, but still contains protein fragments. Neocate

sorry - pressed post too soon -

Neocate is the amino acid formula alternative, there are no protein fragments in that. Your GP could prescribe that for you to try.

My DD had severe CMPA and needed Neocate - and she also had silent reflux. Her first few months were not good. But it got better once she had omeprazole for the reflux and Neocate.

Sorry you’re dealing with this x

It could be both. My daughter had CMPA and silent reflux and had exactly the same issues as you've described.

She was prescribed Neocate formula with Carobel to thicken it as it's quite thin in consistency, and was a different child.

Sorry, meant to add. She was prescribed omeprazole for the silent reflux but as that was being caused by the CMPA, once she was on the Neocate, she didn't need it, just the Carabel to make the Neocate thick enough for her to keep down.

In the immediate term, you could maybe purchase a tin of Neocate from an online pharmacy (not cheap, but could be worth it) and see if the symptoms improve at all.

If nothing changes, then it’s more likely to “just” be reflux - but if the symptoms subside even a bit then you could be looking at severe CMPA instead of just plain old CMPA.

(DD is 2 now and happily eats cheese with no ill-effects, but we did have to be very careful till she was 18 months.)

I would go back to the GP and push for a trial of Neocate and also some reflux medicine. I would want to throw everything at the problem, get her settled and comfortable and then try working out if its allergies or reflux.

@berrypop

Hi there

Seen your response to this and would love to ask, what made you choose to try and allergen formula?

My 8 week old son has been on Omeprazole for 17 days now and we're not seeing a massive improvement. He fusses after most feeds and sometimes takes 2-2½ hrs to settle and even then, struggles to lay down. Is sick (even with Gaviscon to thicken the milk). He doesn't have a nasty rash on his face, but times it looks like a mild rash/small patches of dry skin. He arches his back, is so stiff, excessive wind. No blood in his stools and they're not green and doesn't seem to have any mucus in them.

He was on Kendamil Organic, which seemed to make his reflux worse, so about 10 days ago we switched to Hipp Organic which seemed to settle him a little, but not massively.

Our consultant suggested trialing Nutramigen for 2 weeks to see if we see any improvement - How long did you give the omeprazole before you then thought it might be an allergy? Also, what is the difference between Nutramigen and Neocate?

Any help would be appreciated!

Thank you

As they get older and their stamina improves, they’ll naturally use it less. Sounds like your son is already doing a good amount of walking, so I’d just follow his lead!

Hi @CNN91 I’m so sorry to hear your little one is having a hard time.
My dd had a fainting episode and hospital stay at 5 weeks due to the pain she was in from silent reflux. She also had circular eczema on her thighs and tummy which is a key indicator I think of CMPA. She was prescribed the omeprazole and Nutramigen at the same time by the paediatrician at 5 weeks so hadn’t ever just been on the omeprazole. She was symptom free for about 6 weeks before she reacted to the Nutramigen and ended up back in hospital and was prescribed the Neocate. The difference between the two, is that Nutramigen still contains milk protein, but it’s hydrolysed (broken down into shorter chains). This can be ok for some babies, but others can become allergic even to this. Neocate is an amino acid formula, so completely hypoallergenic.
Hope that helps and that you get your little one sorted.

Try keeping her upright after feeds and as much as possible. Sounds like reflux but could be reflux caused by CMPA. Look up feeding positions better for reflux too. Doctor could prescribe omeprazole and gaviscone.

This tool is great to assess CMPA - tell it you're a professional ;)
www.cowsmilkallergy.com/hcp/diagnosis-comiss-tool

My DS scored an 11 on the above. I’ve got him on comfort milk at the moment and he’s still so upset

Hi how's it your daughter now was she on neocate long?

My baby is on Gaviscon for reflux, it helps massively but is still sometimes sick with it. I don’t put it in every bottle, do max. 3 per day.
He has begun to get a red blotchy face at the start of feeds which disappears within 5 mins, GP has given SMA Athera to try today but he has been sick lots with each bottle and cries after every feed which is unlike him. I can’t add the Gaviscon to this milk as it doesn’t come out of the teat, unsure if others experienced this?

At a bit of a lost cause, going to give him aptamil tonight and ring the drs again tomorrow as the SMA is clearly not agreeing with him. Would love to know your thoughts and if you’ve had a similar experience ?

Thank you x