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CMPA/Reflux second baby - confused and frustrated!

6 replies

n13arw · 17/01/2024 16:43

Looking for some advice/stories from other mums. Sorry for the long post!

I had my DD in December she is 6 weeks old. I have a 3yo DS who I breastfed for 12 months with the odd bottle of formula and EBM so DH could help out. We had a lovely feeding journey, it was easy and convenient and he absolutely thrived.

My plan with DD was the same as DS - I wanted to breastfeed but if for whatever reason I couldn't then I wouldn't.

DD was born 3 days before my elective section was booked. Incredible experience and so different to a 'proper' emergency section! She BF in hospital, I noticed she was a little fussy (compared to DS) but nothing major.

At day 2 weigh in she lost 10.2% of birth weight (they don't like it to exceed 10%) so the midwife advised a feeding plan and to top her up with formula or EBM. We did this and she thrived, gained weight and is still gaining weight nicely.

I was concerned that introducing a bottle so early would maybe cause nipple confusion but as there was a clinical need for it I knew I had to do it. Not sure if this did contribute but BF slowly got worse, she would fuss, not latch, come on and off constantly. Multiple midwives checked her latch etc and all was well but it just wasn't really working for us. This absolutely devastated me, despite my initial mindset of 'if it doesn't work it doesn't work' - it's much harder to take in reality! I've had major guilt that my DS was BF for a year and she has barely had 6 weeks. I know I need to get out of my own head and fed is best but it really got to me. I ended up expressing and feeding her a bottle or two of BM a day (or as much as I could express) and then the rest formula.

She has always been a bit of noisy baby at night, she was quite mucousy in the early days from the delivery but this passed. She often scrunches up and looks uncomfortable, mainly when trying to do poo. Sometimes will arch her back and bring her knees up whilst making the straining noises. She never gets totally worked up but I can see it bothers her. I believe she has some reflux too as she often spits up after feeds and again seems uncomfortable, not immediately but almost when it's passing through her system and it's toilet time.

A couple of weeks ago I noticed her poos were really mucousy and some had a green tinge, no blood at this point. I took her to the GP who said it could be an allergy but allergies are wrongly diagnosed in lots of babies so to see how she gets on over the next couple of weeks before our 6 weeks routine appointment with the paed/GP. Weirdly after that appt the weird poos seemed to ease but she has always been irregular in terms of some days we go 36 hours without a dirty nappy, and sometimes she has 5 in a day. She has plenty of wet nappies, she is alert, happy and content 99% of the time and all healthcare professionals who have seen her have said the same and that she 'handles beautifully'.

We've been feeding her readymade Aptamil, but decided to switch to the powder purely for cost really but would keep readymade for nighttime and/or out and about. We made the switch over the weekend gradually and by Monday AM she was on all powder.

On Monday evening she had a really explosive poo and I noticed there were streaks and specks of blood in it. I took her to the GP yesterday for this and she suggested it could be CMPA so prescribed Nutramigen formula (yes I checked the batch no.!). It smells weird but bless her she drank all of her first bottle with no issues, but once finished she was sick such a huge amount over the course of about an hour. Way more than a normal spit up amount for her. The same happened for her bedtime feed so DH and I agreed that to avoid the risk of her being hungry and/or dehydration that we would go back to Aptamil in the night. We did this and as expected no more vomiting in excess just a small amount of spit up. The Nutramigen is really really thin in consistency so I think this may have caused the excess sick with her reflux, I have always thought she was a bit of a 'sicky baby' compared to DS. I haven't BF her since the suspected CMPA but am still expressing to keep my supply there for the future depending on what happens but tbh I do not see expressing sustainable for a long time, especially not with a toddler and a busy social life, hats off to those who do it for months!

I called the GP again this morning because of the severe vomiting and got a telephone appt, she advised to carry on with Aptamil and discuss this further with the paed at tomorrow's 6 weeks appt. At 11am she had a dirty nappy with no blood. At lunch time today she had a dirty nappy with more blood. We've stuck to Aptamil today again as advised.

She is still happy, content, napping well, I've seen some slightly discomfort but that was before the dirty nappies.

I just feel like there is something going on, likely CMPA or bad reflux. There is something digestive I'm sure of it. I know I will get some more clarity (hopefully) at tomorrow's appointment but I guess what I'm looking for is a) somewhere to write down my thoughts! And b) someone to say if they have had any similar symptoms with their babies, any experience of Nutramigen making baby very sick, and any general advice really. It's so hard not to compare DD to DS whose feeding journey was so straight forward. Maybe he was just super super chill/easy and DD is showing signs of a 'normal' baby and I was just extremely lucky last time!?

I just want her to be healthy and happy and really to feel a little less lost with all of this. I've always been a really confident mum and this has knocked me, I feel like a fish out of water 😔

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n13arw · 17/01/2024 18:00

Anyone? 😔 x

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LunaBear26 · 17/01/2024 19:42

Can you thicken the cmpa milk? We have infant gaviscon for our son's reflex and he's on aptamil pepti so it thickens up quite well. He seems to do a lot better with this. Lots of the symptoms you describe do seem like cmpa to me so maybe give either infant gaviscon or something like carobel a go?

Good luck! Our son wasn't diagnosed till about 18 weeks and it was 18 weeks of a hellish feeding journey (and he's still not great now!).

CasaMundi · 17/01/2024 19:45

My boy had poor weight gain and constant fussiness. He was impossible to settle to sleep. Endless reflux. Endless poos. He was prescribed omeprazole which did reduce his distress a little. Finally diagnosed with CMPA. I had stubbornly stuck to breastfeeding (though like you I wouldn't have done if I was clinically advised not to). I cut out dairy and soy and things improved. He remained a poor sleeper but stopped vomiting and would only poo 3-4 times a day rather than 10-15.

Reading your post it does sound like it could be CMPA. The paediatrician told us reflux often goes with CMPA so perhaps your DD has the joy of both as ours did! Although I don't have any experience with formula I have heard babies often don't get on well with Nutramigen and those that do often need a thickener.

This sort of baby does make you feel incompetent and uncertain because whatever you do they are miserable. It's not a pleasant existence. I suppose I had the 'advantage' that I'd had trouble getting my first established on breastfeeding so it wasn't such a hard bump to have difficulties again with my second.

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QuestionableMouse · 17/01/2024 19:50

Both of my nephews has cmpa but never had blood in their nappies. They had absolutely disgusting, stinky poo but never any blood.

Not sure if it's still available but you could try neocate formula - it's suitable for cmpa babies.

n13arw · 17/01/2024 19:52

LunaBear26 · 17/01/2024 19:42

Can you thicken the cmpa milk? We have infant gaviscon for our son's reflex and he's on aptamil pepti so it thickens up quite well. He seems to do a lot better with this. Lots of the symptoms you describe do seem like cmpa to me so maybe give either infant gaviscon or something like carobel a go?

Good luck! Our son wasn't diagnosed till about 18 weeks and it was 18 weeks of a hellish feeding journey (and he's still not great now!).

Thanks for replying! Yes I have read a lot about thickening the prescribed formula so I wonder if the GP will suggest this tomorrow x

OP posts:
n13arw · 17/01/2024 19:53

CasaMundi · 17/01/2024 19:45

My boy had poor weight gain and constant fussiness. He was impossible to settle to sleep. Endless reflux. Endless poos. He was prescribed omeprazole which did reduce his distress a little. Finally diagnosed with CMPA. I had stubbornly stuck to breastfeeding (though like you I wouldn't have done if I was clinically advised not to). I cut out dairy and soy and things improved. He remained a poor sleeper but stopped vomiting and would only poo 3-4 times a day rather than 10-15.

Reading your post it does sound like it could be CMPA. The paediatrician told us reflux often goes with CMPA so perhaps your DD has the joy of both as ours did! Although I don't have any experience with formula I have heard babies often don't get on well with Nutramigen and those that do often need a thickener.

This sort of baby does make you feel incompetent and uncertain because whatever you do they are miserable. It's not a pleasant existence. I suppose I had the 'advantage' that I'd had trouble getting my first established on breastfeeding so it wasn't such a hard bump to have difficulties again with my second.

Thanks for replying! DD is not fussy most of the time, it's mainly at night when she is laid down when makes me think reflux. It's interesting you say these go hand in hand as I feel maybe what I'm dealing with is a little bit of each! It really is a minefield isn't it. Motherhood is one hell of a journey 😅

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