5 month old- Reflux/suspected cmpa, don’t know what to next 5 months

[SophieRules]

My poor baby is uncomfortable and unsettled most of the time. He brings up every feed, sometimes a couple of tablespoons, sometimes more. I suspect cmpa as when he had a lot of formula he had blood in his stool and has some of the other symptoms. Keeping him upright makes no difference. We are now trying gaviscon, it seems to be making no difference. I cut out dairy as he’s mostly breast fed for a month and couldn’t see a strong difference so I reintroduced and suspected he became more unsettled but I’m not sure, it wasn’t a night and day situation. I’m trying to wean him off breast milk so he can have hydrolysed formula but this will take at least a month or more probably because I have a lot of milk. He is coming up to 5 months and my mental health is suffering from seeing him upset day after day. He is gaining weight well, looks healthy etc but he’s not happy a lot of the time. What should I do next? Should I be waiting things out or trying other methods? I don’t know what to do

If you suspect CMPA, you need to be very strict about cutting dairy AND soy (as the proteins are similar). No ghee in curries, no shop bought cakes, biscuits, no takeaways, no eating out (all restaurants use either soy or butter in cooking), no tofu, no soy based alternatives, no pesto, basically all homecooked. I did this for my son (EBF) and even the smallest amount of dairy in my food made him puke about 6-8 hours later! If he does have CMPA, dairy causes inflammation and that damages the gut, which in turn will make it less likely he'll recover sooner (according to the specialist we saw).

Regarding formula, you need to be careful as there are different types. Some still have dairy but broken down. But if your son reacts to the small amount of dairy in breastmilk, it's likely he cannot tolerate those. He needs fully dairy free formula, which tastes awful and you need to add vanilla or nesquik at first. It also causes reflux as it's so thin so comes with its own side effects.

Careful when weaning. We gave my son a couple of teaspoons of yogurt and ended up in hospital as he couldn't stop vomiting.

He's 15 months now and we have succesfully introduced baked dairy and baked cheese, so there is hope.

Please don’t stop breastfeeding, it’s very possible to cut dairy & soya out of your diet and continue to breastfeed. If you were still giving him some standard formula whilst being dairy free it will have stopped you seeing any improvement. You need to cut all dairy & soy out of his diet, that means none for you, and no formula for him, for at least a month. Allergy formula is awful, aside from having none of the antibodies etc of breastmilk allergy formula tastes vile too.

Both mine had CMPA I just cut dairy and soya out of my diet. There was an improvement within a couple of days and a couple of weeks later a massive difference.
You have to be careful to avoid all dairy and soya but cheese is really the only tricky one these days. It seems like it will be difficult to continue bf but it’s really not easy to get them to take the formalu as it is foul.
You’re also really close to starting weaning which will make it easier
If they’ve got an inflammation in the gut this needs to go down before you see an improvement.

What symptoms of child did your child have? How obvious was it with they were a baby?

This is what makes me unsure also as a lot see an improvement within a few days

No need for both of you to suffer. He needs hydrolysed formula & a prescription for Omeprazole from GP.

Also when did you wean? Did you get support from a dietician?

Silent reflux, lots of spit up and generally uncomfortable, squirming during feeds. Generally unhappy. I was quite strict with my diet and saw a massive improvement within 2 weeks.