Colic, CMPA, reflux… Please help!

[Poppybloom55]

Up until 8 weeks of age, our baby who is formula fed took to the bottle really well. If anything he was always wanting more and gaining weight rapidly, above the 80th percentile.

At 8 weeks it all suddenly changed. He suddenly started refusing all his bottles, crying, arching, and getting hysterical if we continued to try. At first I tried to persevere but he started consuming less than half of his usual daily intake and at his next weigh in had dropped to below the 50th percentile so we went to the GP.

The GP didn’t feel it was colic since the crying was only happening whenever he had to feed and instead put it down to silent reflux. We spent a week giving him gaviscon with no improvement and he now had constipation so we went back. Oddly enough, he was now being sick after every feed so it wasn’t silent reflux anymore!!
The GP then gave us lansoprazole. Again no improvement after a week and he now had diarrhoea. By this point it was taking its toll on all of us because it was unbearable to try and feed him.

I wanted to try a different formula after friends recommended Kendamil but the GP and HV were dead set against it saying there was no reason that would make a difference.

Eventually the GP (who seemed to just be guessing at this point) suggested it was CMPA, but I wasn’t convinced. He wasn’t having any rashes, and I wouldn’t say he was screaming in pain, it was more a fussiness cry. They gave us the choice to try Nutrimegan which is a hydrolysed formula or basically just carry on a little while longer and see if it improves with age.

We chose the latter and by 13 weeks of age he seemed to be getting better and started drinking his bottles up to 7oz again. However a week later it started again and this time the crying was constant even when he wasn’t feeding. He is now easily crying more than 3 hours a day 3 days a week but he’s surely too old for colic, unless that’s what it was all along?

Anyway, I’m basically at my wits end and in desperate need of some advice.

Does anyone have any recommendations on how to help colic, should we go with the nutrimegan or just try a general formula change?
I really don’t want to put him through nutrimegan unless it’s 100% CMPA but there is no way of knowing really.

Thanks!

Argh it’s soooo tricky working out what the problem is! It sounds like it isn’t reflux? So the next two things to investigate would be CMPA or a tongue tie.

If he’s really dropping weight that much I would try going onto nutramigen. Does he have any other symptoms of cmpa? Whilst you’re doing that I’d get him checked for a tongue tie by an IBLC, NOT a GP or health visitor or midwife as they are rebound for getting tongue tie diagnoses wrong.

Odd for reflux to start at 8 weeks. I would expect it would be present from the start.
I’m I right in saying he symptoms are dropping from 80th to 50th centile, vomiting after feeds, crying for 3 hours a day. What is his skin and poos like?

Assuming you are paced feeding and winding him I would say it sounds like CMPA than just reflux.

The formula he is on has the cow’s milk protein broken down a but isn’t dairy free. In would be asking to trial a completely dairy free formula.

Thank you. His skin is fine which made me think it wasn’t CMPA. His poo’s are usually fine but he does go around 6 times a day which I’m not sure is normal at nearly months old? We do get the occasional green poo and tiny amounts of mucus, no blood though.
He winds well, almost burping on his own now and we do pace feed.
No sign of a tongue tie but we could ask for a second check.

How long did you try the lansoprazole for? I think it takes 2-3 weeks to kick in.

I think it could be CMPA with the other symptoms you mentioned. My boy had rapid weight gain at first too, I think he kept drinking to try to soothe the sore throat / tummy.

It could be lactose intolerance rather than CMPA which would explain the bowel movements rather than skin symptoms you say he doesn't have.

What’s the difference between lactose intolerance and CMPA? Would he still need Nutramigen for lactose intolerance?

Lactose intolerance is a deficiency in the enzyme that breaks down sugars in milk. It's very rare in young children.

CMPA is an allergic reaction to proteins in cow's milk. It's more common but still unusual.

I'm not familiar with nutramigen but if it's prescribed for CMPA, chances are it still has lactose. You'd need a special lactose free formula.

You don't always get bad skin with CMPA, my boy's symptoms are frequent poos with green / mucus / blood, reflux and silent reflux. I know another child who's only symptom of CMPA is constipation! If you do try a dairy free formula, you need to try it for at least 3 weeks, same with the omeprazole.

My little girl was cmpa and on nutramigen. She didn't have any rashes, her symptoms were fussying with every feed, sick after nearly every feed and runny poos after nearly every feed. No blood or mucus in it.

She was on the milk till about 1 year when we did the milk challenge, she's now 2.5 and no longer cmpa

I agree with either tongue tie or CMPA. Poops sway me to say CMPA as I think 6 times a day is quite excessive and especially the colour and mucus. No harm trying Nutramigen and seeing if it makes a difference. If it doesn't you could ask to trial an Amino Acid formula and then if that doesn't work I'd look in to the tongue tie.

My daughter had a posterior tongue tie. It's not as noticeable as an anterior one. Her latch on the bottle was terrible. Formula constantly spilled down her chin, she would choke on the flow and she made a clicking noise whilst feeding also. This caused silent reflux and colic and it was awful. Hopefully you can get to the bottom of it!