weaning a suspected CMPA baby - advice please!

[JRmumma]

Ds is 5 months and has reflux and suspected CMPA and is on Aptamil pepti milk. The paediatrician told me in October that he would refer DS to a dietician in "the next clinic'. I though he meant the next dietician clinic, but after chasing it up ive just found out he meant he will refer me at next appt with him which isn't till March! DS will be 7mo by then so not v useful for weaning advice as by the time i see dietician i guess he will be 8-9mo.

So can anyone who has weaned a suspected CMPA baby give me any tips?

After first tastes of fruit and veg puree etc, should i try him on yoghurt/cheese etc? I know i cam use his normal milk for cooking but what about other dairy foods? Just avoid?

Thanks for any help

Based on our experience with the dietician, I'd say don't hold out much hope for tons of useful, detailed advice from them! Also the dietician won't make a decision about whether you should introduce dairy - it should be the paediatrician who would make that call. The dietician is just there to inform you about what to give to ensure a healthy diet with the right nutrients.
I would give the paediatrician a call and speak to him in detail about what he advises you to do - the fact that we don't get appointments for months at a time doesn't stop me from calling whenever I need to get more clarification about something and ours has always been good about calling back. Ours has said that we should avoid all allergens tested positive for, until we have another set of skin-prick tests at 12 months. Then, we will be told to introduce dairy in small amounts and gauge any reaction.
My guess is that you will be told to avoid dairy until your next appointment.
Re the actual weaning process, the only differences I can think of for us have been:
Each food gets introduced for 3 days to give you a chance to see if there is any reaction. It does mean it takes a while to get a really good variation in the diet but the baby doesn't care - it's all new and exciting!
We keep a food diary - on the left is all the food he's had, on the right is brief info re mood/eczema/poo etc, so we can see any patterns emerging.
It can be more time consuming - only about half of our meals will be the same as our son's so I tend to batch cook and freeze stuff for him so I'm not having to cook from scratch every day.

Oh, actuallly, if it's only dairy that's an issue you should be able to do a lot more than half of meals for all of you so hopefully that won't be too bad.
Once he's more established and moving onto 'meals' just try to make sure that he's getting plenty of protein - I don't like to give meat more than once a day, so one meal is always full of beans/pulses/lentils or protein-rich grains like amaranth and quinoa (quinoa especially is excellent as it's a complete protein and contains all the amino acids that animal-based proteins contain).

Take a look at the introduction advice in this book. The advises caution in introducing potential allergens. Expert opinions differs on this subject and in my opinion (not a qualified one!!) delaying is a good idea. Lucy Burney's book gives good advice on alternative sources of nutrients.

Reading with interest. Just started weaning my 6mo son who we think is lactose intolerant, he's been happily guzzling nutramigen 1 since five weeks. I've avoided all dairy so far as we're seeing the dietician next week. No idea what to expect from them.

Is there a Lactose/cows milk intolerant support thread around here anywhere? You sound like you know your stuff.

And MistyB; can't get the link to work, what book is it?

Thank you

Thanks, yes i called the paediatrician today and have a phone appt for Friday to discuss.

I hadn't realised that it was the paediatrician that would advise me on the dairy issue, i thought that's what the dietician was for. But anyway, my paediatrician is a bit of a dick and he wouldn't prescribe me the milk as he thought DS should suffer for a bit longer on just reflux meds 'just to make sure' so had to get it from the doctor instead. So i have a feeling he is going to be awkward about this, which should be interesting.

I was also going to speak to the hv about it today but missed the clinic as i got my days/timings confused. Ive also made a doc's appt for Monday which ill cancel if the paediatrician is any help, otherwise ill take it back to the GP for advice.

Sorry about the link. Nutrition for babies and Toddlers by Lucy Burney, it is out of print but available second hand.

Lots of advice and experience on the allergies board.

I know what you mean about the reflux meds - our son was put on ranitidine and domperidone at 8 weeks when first diagnosed, and we were constantly being told to just keep going with them even though they said that he probably didn't actually have reflux, it's just that CMPA can present the same symptoms as reflux.

We made the decision to gradually reduce his doses until he wasn't on any meds before he started on solids, partly because I didn't think it was right to have a small baby on meds for months "just in case" and also because there is some research about ranitidine that I wasn't happy with - can't remember it off the top of my head but something to do with the way that it works can actually increase the risk of allergies once the baby is having solids.

I didn't know that about ranitidine greta. We are still on meds but im also reducing them as i don't think he has reflux anymore. We stopped Gaviscon after a month because any amount of it made him constipated.

Were any of your babies actually tested for CMPA ss i was told it wasn't possible till on solids.

My DS is CMPA. My DD was tested for CMPA before we weaned her do we knew what we were dealing with, so they are talking rubbish.

Agree about the dietician, the one we saw was rubbish. I had to tell her about rice milk no longer being suitable for under 4s because of the arsenic content.

trixy did the paediatrician test your LO?

We attend an allergy clinic at our local hospital with DS. I asked for advice on weaning my DD at one of DS's appointments and they made an appointment to test her. We see an immunologist rather than a paediatrician.

Yes, our son was tested at exactly 6 months, so we started weaning a couple of days later. It's difficult though, because although egg, peanut and soya came up positive on the skin prick tests, dairy didn't react - their conclusion was that he has a delayed onset allergy rather than an immediate contact one, so he probably wouldn't have a reaction straight away, but would get sickness, upset stomach, eczema starting anything up to 3 days afterwards. They've based their diagnosis on all our anecdotal evidence, so really until we introduce a bit of dairy after the next appointment we won't actually know for sure whether he even has the dairy allergy or whether it might just have been reflux after all that was just grown out of.

It's all a big guessing game really!

Thanks, well ill ask for an allergy test then. Bit yeah, o reckon the only way is probably trial and error.

DS definitely had reflux as a while ago symptoms came back and went away again when his doses were increased, but initially the meds stopped the screaming directly after bottles but he clearly still had a tummy ache, excessive wind and explosive poos etc so my feeling was that he also had CMPA as i understand they often go hand in hand.

HOWEVER i don't want to unnecessarily restrict his diet when weaning if he doesn't have CMPA but as you say, testing wont be conclusive anyway if its delayed onset allergy.

Why didn't i get one of these mythical easy babies i hear so much about?!

Reading this with interest. Our twins have been on nutramigen1 since 10wks as they were experiencing CMA symptoms (reflux, constipation, excema, mucus) the HV convinced our GP to prescribe it but have never seen a paediatrician.

Should we get them tested before weaning?

Cornwall have you been referred to a paediatrician/allergy clinic by the GP? It doesn't seem good that the GP would prescribe the formula but not refer you to a consultant as the formula is expensive so you'd think he'd want to avoid prescribing it if it turns out it's not actually CMPA.

I'd ask for a referral because otherwise you have no idea which direction you need to go in once they are on solids.

No, our HV specialises in allergies and spotted the symptoms. As soon as they started taking Nutramegen the screaming and discomfort stopped but the heavy posseting has continued. The GP prescribed it on advice of the HV. We are seeing a paed about something else so I will ask about it.

We went private in the end and got a paediatric cmpa specialist (we are in Belgium). She was great and we had skin tests done straight away (at 7mo) and she wants to see us again at 9mo. I found this site useful for some blw cmpa baby recipes sarahnsprogs.wordpress.com/