What is going on with my baby?! Allergies, reflux, normal?!

[doingitalllagain]

My 10 weeks old was born 3 weeks early. Is EBF and gaining weight really well.

Sleeps all the time, day and night, very short wake windows.
Has smiled a handful of times but is mostly unsettled or asleep
Feeds well but can sometimes fuss, pull on and off etc
Poos a lot, usually mustard seedy but occasionally green, had blood in twice
Cries a lot, generally very unsettled, arched back, pulls knees up etc
Strains, grunts and groans a lot
Coughs a lot, had a course of antibiotics that seemed to help but it came back within a few days
Cradle cap and mild red rash on face, dry patches of skin on body

So far I've been to the GP a few times
First they said reflux and prescribed Gaviscon, made him constipated so stopped. They prescribed omeprazole

Was a delay in getting the omeprazole as pharmacy needed to order it in, in this time I ended up taking him to out of hours who didn't think the cough was reflux and was told to hang fire starting the omeprazole and prescribed antibiotics (amoxicillin) we completed the course and I saw an improvement but then the cough has since come back

I've asked about CMPA and been told no his symptoms would be worse and would be the same level day and night not worse at night. I'm not sure whether to try cutting out dairy, to start the omeprazole, to just carry on as we are and give him more time. Can anyone relate to any of this? Has anyone had a baby who presented similarly?

Do you have any other kids in the house, or other potential sources of infection? My second had a near constant cough from very early due to her older sister bringing home respiratory viruses from nursery all the time.

Otherwise I'd guess the cough and unsettledness at night is indeed reflux. The skin things - cradle cap, dry patches etc. - are probably unrelated and pretty normal, no need to do anything unless they seem to be getting sore. A tiny bit of blood in poo occasionally can be normal though should be mentioned to GP.

Do his symptoms sound anything like this?

My Baby is fussy! Is something wrong? is a useful article which much help you to try and determine what's going on

It could just be immature gut or it could be CMPA. As your ebf your in a good position to try and remover dairy and or soya from your diet and see if it makes a difference. Around 50% of babies with cmpa are also allergic to soya so don’t replace dairy with soya. You will need to make sure you get enough calcium, vitamin D and iodine. Lots of alternative milks are forfeited with calcium, vitamin D and iodine.

There are really good CMPA Facebook groups and one specifically for breastfeeding Mums.

Do you have any concerns about oversupply? Some of these symptoms could be caused by that. CMPA is another option. Do you have an infant feeding team or breastfeeding counsellor nearby you could have a chat with?

https://breastfeeding.support/oversupply-breast-milk/

I suppose I should try cutting out dairy, it's not the easiest thing to cut out so wanted to feel more assured that was the cause before going that far but I would like a more awake, alert and happy baby so perhaps it needs trying.

Would a baby with CMPA sleep so much though? Everything I read online suggests poor sleep but sleep is all this guy does!

What would I try first? Cutting out dairy or the omeprazole prescription? I can't try at the same time or I won't know what helped

Have any of the links that posters have provided been if any use?

Yes It's difficult as there are similarities to CMPA symptoms, reflux symptoms and just being normal so I'm finding it hard to gauge where he sits. I feel like on its own none of the symptoms are bad enough to need treating and I could pass off as a bit of colic but the amount of sleeping and lack of awake/alert/happy time makes me feel like I need to try something?

Do you think the latch at breast is ok?
And what's your supply like?

I'd start by thinking about these basics.

GPs jump to a diagnosis, often reflux but an ineffective latch can cause a host of symptoms and also an oversupply of milk which can cause the things your describe.

I had significant over supply which caused us some struggles particularly at the age you're at now but we worked through it.

If it is supply related there's things you can do to help.

The occasional green poo can be because of high levels of lactose when there's an oversupply of milk.

Ime for my son, cutting dairy stopped the reflux symptoms, sorted his frequent nappies to a normal number and improved his mood.

If it is dairy you should see some improvement within about 3 or 4 days. If no improvement after a week then it's not that. Yes, dairy can take 6 weeks to clear from your system but zero improvement would indicate it's not dairy.

If it is dairy there's a higher chance of other allergies, eg about half of cmpa sufferers are also allergic to egg.

I cut dairy for first 7 months and have managed to introduce it to my diet again with no problems. Egg is still causing some issues.

From what I've read amongst the allergy community GPs and HV notoriously misunderstand and misdiagnose cmpa.

However, before I got to the bit in your post about the nappies I did wonder about tongue tie or other oral restriction. Frequent feeding and tiredness could be because he's struggling to get a full feed each time. You say he's gaining well. My son also gained well until 8ish weeks when his tongue tie stopped him getting what he needed as his energy needs increased.

Try to get a second opinion if you've had it checked already (another thing that is often incorrectly dismissed!)

He does also spit up a lot, I forgot to add that!