Suspected CMPA – has anyone done a milk challenge and gone back to normal formula?

[Rachalice]

My little boy is 8 weeks old and was put on Aptamil Pepti 1 at around 4 weeks old because of suspected CMPA, mainly due to a persistent nappy rash and frequent poos. It was never formally confirmed that he had CMPA.
His symptoms did seem to improve on Pepti, particularly the rash and diarrhoea, but we’ve since had a lot of issues with reflux, spit-up, wind and constipation, especially since introducing Gaviscon. I’m finding it difficult to know whether these symptoms are related to CMPA, reflux, the formula itself or just normal baby behaviour.
I’m wondering whether he ever actually had CMPA in the first place, and I’d really like to establish this rather than keep him on specialised formula unnecessarily.
Has anyone else had a baby with suspected (rather than confirmed) CMPA and done a milk challenge by reintroducing standard formula to see whether symptoms returned?
I’d particularly love to hear from people who:

• Were prescribed Pepti or another extensively hydrolysed formula based on symptoms alone.
• Did a reintroduction challenge to confirm or rule out CMPA.
• Found out their baby didn’t actually have CMPA and successfully returned to normal formula.
• Or tried a challenge and found their baby’s symptoms did return.

What symptoms originally made you suspect CMPA, how did you go about confirming or ruling it out, and what was your experience when you reintroduced normal formula? I’m not looking for medical advice on how to do the challenge, as I’ll discuss that with our GP/dietitian. I would just really appreciate hearing other people’s experiences, particularly with babies who were diagnosed based on suspected symptoms rather than a confirmed allergy. ❤️

Bumping this for you, OP.

We did but my DS was breastfed so the dairy he was getting was from my intake iykwim. The doctor suggested I shouldn’t cut out all dairy as we were lucky his main symptom was eczema rather than stomach issues. His allergy was confirmed by allergy testing at the hospital and we saw a nutritionist who advised us. He was dairy free during weaning though and then went onto the cmpa formula then when he was 1 we started the milk ladder. No sign of allergies since then.

My son has CMPA, he was incredibly unsettled day and night from about 2 days old, screaming in pain, drawing his legs up. Developed rashes, projectile vomiting, foul smelling poo (and pooing very frequently), mucus in his poo and eventually blood in his poo. I was advised to try the reintroduction challenge to confirm the allergy but I couldn’t face it after seeing him so distressed for so long. The specialised dairy free formula resolved all the symptoms so it was clear to me that the dairy was the cause. If you’re in doubt though I would try the reintroduction to check whether it is actually an allergy. Because if your baby doesn’t actually have CMPA you can wean as normal and don’t have to do the milk ladder later on.

Ask if your GP or health visitor can refer to the dieticians as they’ve been a great source of info/support to me. Good luck xx

My DD was diagnosed CMPA over the phone, based on symptoms, family history of the same allergy and other allergies.

After 2 weeks of no dairy and also cutting out anything with soy in it, she was a different baby, her facial rash cleared up in a week and her nappies were so much better. We didn't get on with the first formula prescribed, made her sick, so they swifchis to neocate, I was breastfeeding but combi fed as DH was taking over for his pat leave at 6 months. Neocate worked well and we used gaviscon for reflux as this just wouldn't budge, gaviscon helped a lot.

She's 4 now and we have done the milk ladder, been a bit back and forth, only thing she struggles with now is actual milk

Pepti is a very mildly hydrolysed formula. There is a scale, my baby had Nutramigen from 8 weeks to 16 weeks but we were still struggling with some symptoms just not as bad. Reflux was horrendous though.
At 17 weeks she was prescribed Pepti 1 despite me telling the GP to give her an amino acid formula, and that Pepti was less hydrolysed than the Nutramigen.
48 hours later my baby was admitted to hospital due to how badly she reacted (non iGE so no swelling etc) and that was her allergy confirmed, no tests or anything.
A week in hospital, and we finally got prescribed an amino acid formula.

Your baby is still reacting, so I'd push for a better formula rather than reintroducing one that already caused reactions. If a complete dairy free formula stops reactions (you need to give it two weeks but should see improvements before then too) then you have your answer, but I wouldn't reintroduce the dairy formula to test it out, cut it out completely instead.

What I would add is that wind, constipation and reflux can all be linked. My eldest always struggled. I would try and treat the constipation to see if it helps with the reflux. Other poster makes a good point about other non dairy formulas being available.

My youngest had the most non-dairy formula in the end. On dairy she was pooing 12-14 times a day and her bum was red raw.

Thanks everyone. Dietician actually called yesterday and said to keep him on pepti until he’s 5 months old, then start the reintroduction before weaning.

he wasn’t refluxy at all before he started the pepti - it’s just so thin!!! The gaviscon works wonders but is causing the constipation. Feels like I’m just swapping one problem for another :(

Did they struggle with constipation at all? The gavsicon works so well but it constipates him :(

A little, but I think i did half of what they said you could do in a day to combat that and from six months introduced a prune puree

I’m doing 2/3 bottles a day with a sachet in so hopefully it will help! 🤞