Breastfed baby - reflux, CMA or just normal newborn?

[Springbaby2023]

My DS is four weeks old and EBF. Gaining weight really well but is very windy and sicky which is getting worse the older he gets.

Wondering if it’s just normal newborn behaviour, reflux, or CMPA. HV has suggested a GP appt so looking to book one this week, but just interested in any other views too.

Symptoms:

• Sick after every feed and regularly in between
• Lots of poopy nappies (maybe 10 in 24 hours?) although normal consistency etc for a breastfed baby
• Very windy and seems uncomfortable with it, even with being held upright for ages
• Fussy in evenings, constantly wanting to feed on and off (aware that’s normal for a baby anyway).
• Feeding every hour through the night (used to be more like 2-3 hours jnt the last week)
• Very very noisy when lying on back - sounds very snotty and congested, lots of gulping and gagging, sucking in breath… making it very difficult for us to sleep. This is probably the most annoying/ difficult symptom for us to deal with to be honest and what is causing me to seek further help and advice.

Any thoughts and experiences welcome, thanks in advance!

Sounds like CMPA could be a strong possibility.

The sickness/reflux could be as a result of swallowed air but equally due to an allergy.

I don't mean to undermine you with this but when you say "normal consistency", how do you know, what are you going off? I too thought my daughter had 'normal consistency BF stools' because they had always looked that way, until I went dairy free and they were quite obviously different afterwards.

The congestion is also a good indicator that an allergy is present.

You could see the GP or speak to the HV but the gold standard would be to trial going dairy free and monitor for any improvement, which is likely what you'd wait to see someone to be told.

Failing that (or just additionally to rule it out), you could consider having an oral function assessment by a qualified professional such as a tongue tie practitioner.

Happy for you to message me for further advice if you need, my daughter experienced both a TT (reflux) and CMPA.

@jacquec Thank you that’s helpful! I had no idea these were signs of an allergy until I spoke to the health visitor and she suggested it, I always assumed with an allergy there would be a rash.

By normal consistency I guess I mean the same as DS1’s who was also EBF with no allergy or reflux issues (he was never sick which is why I am also struggling to tell if this is just a normal amount of newborn puking or something else).

I think I may look into tongue tie as well. I love daily and eat a lot of it so I think it would be hard work for me to cut it out (obviously would do if I had to, but would probably rather try to rule out other things first, I’ve heard it takes quite a while to get the dairy out of your system?)

The six weeks to clear your system is a myth, you'll begin making hypoallergenic milk within a few days. Definitely worth a go for even just a month as you should see a noticeable difference by then. I too lived on dairy previously but I've been dairy free for a year now, the right alternatives do make it bearable.

I wouldn't jump to cmpa at all of the above. Most of them sound like reflux, rather than specifically cmpa and the lots of nappies can be completely normal for a breastfed baby.
Has your baby been checked for tongue tie, I disagree with the above poster and get this checked first and also your latch as that can improve things reflux wise and then potentially could eliminate some of these. By all means go DF at the same time, but would be surprised if that eliminated all of these.
My first had cmpa, she also had reflux so eliminating dairy did not improve the reflux but resolved the disgestion issus (mucusy/acid nappies). My second had some of these symptoms, I initially assumed it was cmpa but it was reflux and once we resolved the tongue tie and latching issues and worked out a better way to wind her, she's such a settled baby.

@BabyB2022 Thank you, I’m leaning towards tongue tie too because he is sometimes a bit clicky on the boob and have introduced a bottle this week which he’s been very clicky with. He’s also never had the deepest of latches, although has been fine from a pain point of view for me and for allowing him to feed efficiently. I have a HV appt on Tuesday so waiting to discuss it with them but have researched private IBCLCs who offer TT division ready if we want to contact them next week.

Following this with interest as sounds similar situation - as does our username 🤣 although not as much congestion sounds, bar some grunting usually at 5am.