Could this be CMPA?

[PoorBabyBaby]

Baby is a month old and suffering quite badly. I've mentioned my concerns to two different doctors but neither seem to think there's a problem and just think it's baby over eating because he's had some intense cluster feeding sessions.

His symptoms are:

• Vomiting multiple times a day. Sometimes more than an hour after a feed. Both milk and curdled/proper vomit. Sometimes multiple times in a row. Seems like a lot. He's still putting on weight though.
• Very liquid-y nappies. Very little texture in the. We thought this was normal until we googled it...
• Poo comes out forcefully/ feels like an explosion in his nappy when we're holding him
• Lots of sneezing
• Sounds congested a lot of the time
• Hiccups multiples times a day
• Dry skin
• Mild eczema on face
• Scrunches body and legs up at night groaning in pain. Cries out when he does this. Arches back.
• Coughs during feeds sometimes

Does this seem like CMPA? The doctors have me doubting myself but it seems like it is to me? Any advice/anecdotes so gratefully received.

Certainly sounds like CMPA, which can cause reflux type symptoms too.

Is baby formula or breastfed?

It’s the eczema, congestion/sneezing and tummy pain which makes me think probable CMPA. The liquid poo and explosive nappies could be quite normal. If breastfed, it’s worth checking if baby’s latch is right and if you have a forceful letdown then this can cause some of those symptoms. Also worth checking for oral ties.

I agree totally with the poster above. In my experience professionals are usually pretty disinterested if baby is gaining weight. If you're breastfeeding you don't need a doctor - cut out dairy (and preferably soy too) for at least 2 weeks, preferably 4-6 then reintroduce and you'll have your answer.

Eczema at 4 weeks old is presumed CMPA until proven otherwise.

I should have said that he's breastfed, sorry! I'm going to cut out dairy starting now, I just don't want to have this wrong and he suffers for longer than he needs to if it's not cmpa and it's something else.

@nocoolnamesleft that's so interesting because when I mentioned it to the paediatrician she just asked if I had eczema in my family, which I do, and said that's what it is...

Yeah, from about 3/12 onwards I'd buy it running in the family, but 4 weeks is young for that...

Sounds just like my 7m old BF daughter, I cut out dairy, symptoms improved.

Weight gain throws doctors off the scent; interestingly babies work off instinct and feed at the breast more frequently to 'solve' the problem of discomfort. They're trying to fix things as this is where they mostly have their needs met.

Regarding CMPA, the protein in cows milk will no longer be in your body, and cleared within 2 hours of consumption, so you can continue to BF. However, the damage to the babies gut/lining of stomach will remain irritated for up to 6 weeks Ish so you may see some of the symptoms gradually subside.

Don’t replace dairy in your diet with soya as 59% of babies with cmpa are also allergic to soya. You need to find a dairy alternative eg oat milk which is forfeited with vitamin D, calcium and iodine.

Join the cmpa for breastfeeding Facebook group. I'd avoid soya too as the proteins are often recognized by the body in the same way as dairy.

More confused than ever, here's an update:
Baby became so distressed, would scream in pain if put down, was struggling to latch. We ended up taking him into a&s after speaking to a doctor.

Paediatrician there was excellent. Suspected either severe reflux or CMPA, prescribed omeprazole, told to try that in a week if other things didn't work such as inclining bed etc, see if it worked, then revisit cmpa.

Next day baby starts projectile vomiting. Back to a&e. Same lovely doctor. Very thorough. Said to investigate for Stenosis. Admitted to hospital, told we'd have ultrasound next day. If ultrasound clear, start omeprazole straight away as baby clearly in lots of distress.

Next day, day shift doctor comes round. She discounts all of it. No ultrasound. Told it's not cmpa because his eczema would be bad and all over his body. Told to try gaviscon and not use omeprazole.

I'm so confused and now worried that something important is being missed 🙁

Should add, baby is EBF, and I've been told to pump and mix gaviscon before every feed! Baby is fed on demand a ridiculous number of times a day and I struggle to pump! How will I manage that!?

Doctors sound less than helpful. But in all honesty whatever you use meds wise just masks the symptoms of allergy. So cutting out dairy and soya will hopefully work to reduce symptoms. If it isn't keep an eye on what you are eating and replacing dairy with. My DC are allergic to dairy eggs and oats for example so oat milk was a huge issue for us.

I questioned the directions for giving gaviscon to breastfed babies with my doctor and he said you just need to get it in however you can, don't need to express if they will take from a spoon/syringe.

So I mixed 5ml of boiled water with each sachet, waited for it to cool and give directly with spoon before every other feed (I had a cluster feeder too).

That second advice is terrible. You should carry on directly feeding baby from the breast. You’ll end up exhausted and tied up in knots trying to pump and feed via bottle purely to mix gaviscon. I’d feed back to the hospital how poor that advice is and how it isn’t breastfeeding friendly at all.

Unsettled babies are really difficult so you have my sympathy. I’d try one thing at a time personally otherwise you’ll have no idea what has helped and what hasn’t. How long have you been off dairy/soya? I’d be tempted to either carry on with that or try the omeprazole if you’ve already been issued with some?

@PoorBabyBaby How are you getting on lovely?

I agree, terrible advice to express every feed, not so easily done. You could do some feeds with gaviscon, others without. Dairy elimination from diet. Yes CMPA can present itself with the widespread eczema, however if some days you are not having dairy or soy in your diet, symptoms in baby will be lessoned.

Did you manage to speak to your HV team to get personalised support to get to the reason/cause of the symptoms?

@PoorBabyBaby hi there, I hope things improved for your little one? Would be great to hear as I am in a very similar situation!

@SRyellow it's been a real journey. Baby is 10 months now and lots better. I was breastfeeding and cut dairy and soy out which helped a little initially, but then the reflux peaked again. Cut out wheat and egg too, no change. Switched to a hypoallergenic formula at 5 months because we still thought some undiagnosed allergy was causing the reflux. That was awful. It's a really disgusting formula and we struggled to feed baby.

Turning point for us was lansoprazole. It got a lot worse before it got better. Took a good 8 weeks. If you Google acid battle it'll explain why things get worse on PPIs before they improve. Anyway after 8 weeks, at around 7 months, things drastically improved. I think combination of medicine and a maturing sphincter. We're now weaning off the lansoprazole. Baby is still randomly sick but nothing like before. The pain is seemingly gone and babe can sleep through the night in peace. Also, it looks like we have no allergies either.

my little boy who’s 4 weeks old Friday, I had noticed these lumps and rash appear on his face, we’ve been to the doctors and they seem to think this is a CMPA allergy. He has symptoms of reflux, scrunching his legs up when lieing flat, sneezing after bottles and just general fussiness.

can anyone relate and tell me if they think he’s got a CMPA? my first boy had one and has the exact same symptoms.