What’s wrong with my 4 month old?

[Jamtartforme]

DS is 4 months. From about 4 weeks old he was fussy and cried a lot in the evenings, I chalked it up to colic and it passed by the time he was about 12 weeks. We had a few weeks respite, but last week he hit the 4 month regression and it’s started up again, even worse than before. He can scream for up to 4 hours every single evening, and will only stop if we play with him, no matter how tired he is.

He’s EBF and has suspected CMPA (I cut dairy out 10 days ago, currently waiting to see if it helps). He has an eczema like rash which comes and goes and very runny mucousy nappies, although he doesn’t appear to be in discomfort and is rarely sick.

I’ve taken him to a cranial osteopath who said he has some tension in his neck and back which she has worked on, but she suspects the crying is down to CMPA.

We have the doctor’s next week to check in on everything but I’m desperate to find an answer to the screaming. Is it the CMPA, will it stop when the milk proteins have fully left both our systems? Or doesn’t CMPA present this way? Is it part of the regression?

Any ideas welcome, I’m so exhausted and just want to help him.

What's his routine like, how many naps and how does he get to sleep?

Before the regression he slept from 11pm-8am with perhaps one wake up but usually none. He naps every 2-3 hours, usually for about 45 minutes with a longer nap of about 2 hours in the afternoon. That’s all gone to shit now unfortunately, he’s waking every 2 hours and naps so lightly the slightest noise wakes him up. He’s either fed to sleep or I just sit holding him and shushing, he cries for a few minutes then drifts off.

What time is bedtime in the evening? I'd start trying an earlier bedtime, he sounds over tired if screaming for 4 hours.

He just won’t stay asleep if we settle him earlier. Tonight he napped from 5-5.30pm and from 7.30-8pm but has been screaming ever since

Silent reflux?

Silent reflux with CMPI/CMPA - they go hand in hand. We switched to Neocate, thickened feeds with Carobel, gave Omeprazole (Losec Mups), kept baby upright after feeding, slept him on his tummy (helps keep the valve at the top of the stomach closed). This was 8 years ago just for reference.

You need to try to see a Paediatric Gastroenterologist. If you can afford to go privately you can self refer

Can you see a dietician lactation consultant. Or even start with an IBCLC?

Dairy is not always the culprit. Sometimes it’s soy or a range of other things. Dairy takes two weeks to leave your body completely but you really should know within four days if it’s making a difference. If you have no difference then maybe try something else That’s the best thing about breastfeeding. You can play around with your diet and work out his triggers. Don’t take too much out though as you’ll be scared to put it back!

also look at other things (I think you are on the right track with an intolerance though due to the skin, mucous poos and history) Have you started (or another caregiver) started wearing a spray/perfume/lotion that might be unsettling. Do you drink a lot of caffeine or any other stimulant. Is he growing well?

can you baby wear? Maybe he has a need developmentally at the moment to be held more?

Also. Intolerances are not allergies and allergies to start with are rare. Often you take the trigger food out. Let his gut heal and settle for however long (dieticians are great with specific times- not stranger on internet) and then slowly reintroduce. It’s rarely a forever thing

Thank you, i hadn’t thought of silent reflux but he has many of the symptoms - a permanent cough (a few times a day but not so many times that I’ve worried about chest infections or similar if you see what I mean), nasal congestion (this has only been for a couple of nights so I assumed a cold), arching back during feeds, and also pauses in breathing at night followed by a big intake of breath. I’ll mention this to the GP and see what they think.

I’m also going to keep a food diary and grade his symptoms out of 10 every day to see when they peak.

We have 6 days until the appointment so hopefully enough time to put together something meaningful. I can’t afford to go private beyond the osteopath.

thanks again

Hi OP there might be something else going on but the really stark difference in sleep prior to 4 months ish to now makes it sound like the main issue is the usual developmental changes in sleep. You’ve gone from him having long regular naps and sleeping all night to sporadic naps and waking every 2 hours during the night. That’s hard but it is also completely normal and expected as baby sleep changes.

Have you also cut out soya? It’s common that babies with cmpa are also allergic to soya because they have similar proteins.
My baby had cmpa and I started having soy milk in coffee when out and realised she was also reacting to that as well. In the end I was egg, soy and milk free for her and gluten free for me but she did out grow all the allergies by just after 12 months. I was able to reintroduce them back to my diet earlier as the dietician recommended I did.

I was going to say similar to above. Ours was a bit like this with CMPA and much better when we eventually cut out dairy and soya.

She used to be bloated too and a bath with a warm flannel on her belly before bed helped a bit.

It sounds to me like he is over tired by bedtime. Babies of that age shouldn’t be awake for longer than 1.5 hours so if is napping every 2-3 hours he is likely to be overtired when you put him down for his nap. That coupled with not having big naps he is probably shattered by the time he gets to bedtime x

Two of mine were allergic to dairy, soya and egg and I had to cut all three out to avoid symptoms. The GP will often prescribe something like omeprazole as well in cases of CMPA.

Sounds like silent reflux, we got omeprazole prescribed for baby and it was a game changer