Cmpa help please

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I’ve got a nearly 14 month old who is eating well but still has 2/3 bottles of formula. Just managed to train him out of having more overnight, was waking up once/twice a night.

When do they stop prescription formula? I’m slightly terrified that the doctors will realise that he is now over a year and just stop it. What can I do to to reduce the bottles?

Typical day is
5am ish 7-8ozbottle
9am ish breakfast - 1 weetabix oat milk and 1/2 a banana plus 3oz of oat milk in beaker
11am snack of fruit and some water
12.30 lunch - 1 slice of bread with filling (cashew butter, avocado, jam, marmite, mackerel) lump of cucumber, 6ish organix carrot sticks and a soya yogurt or pot of fruit purée. Water
4pm snack something like chicken pieces or bread sticks or fruit
6pm dinner - depends on what we’re having might be stew, spag bol, fish fingers mash and veg
8pm 7-8oz bottle
Sometimes wakes between 10-11 and has another 4oz bottle

Any help and advice would be very welcome please.

I'm in no way experienced as my first LO is only 9.5 months but for what it's worth...

We were doing
7.30am 5oz bottle And porridge made with 3oz
11am 7oz
12.30pm EK pouch equivalent
3.30pm 7oz
5:15pm EK pouch equivalent
6.30pm 9oz

However few days ago I decided to drop the 11am bottle. He has started having a much better appetite for lunch - maybe EK pouch equivalent plus a yogurt plus couple of finger food items. He has refused or had only 3-4oz of the 3.30pm bottle and dinner amount has been similar to lunch.

What I'm trying to say is I'm glad I made the step to drop the 11am bottle as he has increased his solids straight away. I think that's the only way to do it really

once they are over a year you can just switch to normal dairy free milk from the supermarket no need for formulas. They recommend the alpro junior soy (assuming child is fine with soy) but it's so sugary we use oat milk. It's still expensive about 1.40 a litre but nowhere near the cost of formula. Just don't use rice milk as it's not for uder 5s due to aresnic content

If they weren't cmpa you would be offering cows milk by now....

Do you mean put oat milk in a bottle or swap early/late bottle to cup?

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It's recommend they have a full fat equivalent milk, the alternative milk are semi skimmed so i would stay with prescription formula a bit longer.

That said that's a fair bit of milk he's having. I would give a more substantial lunch - omelette, pasta and see if that helps.

I’m guessing he’s waking at 5 am for his milk? Have you read the No Cry Sleep Solution? It has some good tips on early waking.

Could you try something like this:

Bottle on waking
7am breakfast
10 am snack and beaker of milk
12 noon lunch
3pm ish snack and beaker of milk
5pm dinner
7pm bottle

As others have said, I’d keep him on the formula for as long as they’ll give it. If they do stop, you just need to ensure he has enough good fats in his diet so plenty of things like oily fish and olive oil.

Yes waking at 5 for milk and this is a great improvement as before Xmas he was waking for milk 3 times a night. We sleep trained over the holiday.

I did wonder if I should make him more substantial lunch, not had any luck with him eating egg or pasta but I’ll try again.

What is enough good fats though, portion wise? And how often?

Ideally you should be offering oily fish 3 times a week. If his formula does stop and you switch to something like Oatly I’d also add olive oil to things like (pasta) if he’ll eat it and mashed potato.

You could try tuna, mayo jacket potato for lunch? The Helmand full day is dairy free. The guidelines are up to 4 portions of oily fish for boys per week and two for girls.

You don't need to worry about adding fat unless his weight is an issue but once he's off the formula olive oil in veg, oatly cream is a good one, avocado/hummus on toast all good stuff.

I found the little pasta shapes were better or spaghetti seemed to go down well with the oatly.

I hadn’t realised the guidelines for oily fish were that DoIt. Have you got a link please?

Lidl’s full fat mayo is DF too OP.

Thanks for the mayo tips hadn’t thought about giving him it. Tried pasta mayo tuna and cherry tomatoes for lunch. He picked out the tuna and threw the rest on the floor. Any suggestions how to up the flavour he doesn’t seem to like plain food.

Could you mix the mayo with tomato ketchup to add more flavour? Have you tried him with any of the cheese stubstitutes too? If he does like flavour, have you tried him with curry? You can always stir in a loop of Oatly cream if you want to make it more mild. My DD also loved a vegetable burger at this age, think it was the chilli she liked.

Lots of people don't know about the oily dish recommendations I think, here's the link, it a couple of pages in.

https://www.food.gov.uk/sites/default/files/multimedia/pdfs/publication/growingchild0310.pdf

BBQ sauce with mayo?

Mine really like Dahl with oatly or the co-yo stirred in.

Thanks for that @DoItAgainBob. I haven’t seen that document before and didn’t know that the recommendations are different for girls and boys

Sorry about my typo. Meant to say you can add a dollop of Oatly cream if the food is too hot or spicy

Thanks will try tomato or bbq sauce and see how we go.

Like the sound of vegi burger myself so will have a google and try to make.

Must also eat more fish as a family especially as I can see the sea from my house. Husband will have to suffer in silence.

If you want to try more fish, mine like salmon nibbles. Cut up a salmon fillet into chicken nugget size pieces. Dip I’m beaten egg and then dip in breadcrumbs. Bake in the oven for about 15 mins. If you have older children you can get a bit of a production line going

So I made veggie burgers, they went down ok so definitely going to be repeated.

Salmon nibbles is the next new thing to try thanks.

I’d try him with a chicken Korma too

Are there any milk substitutes that you aren't supposed to use?

Just rice milk for under 5's due to potential inorganic arsenic. Most are not suitable for a main drink before two years.

Thank you, I'm really struggling with ideas to give my 9 month old.

Which bits are you struggling with?

I personally found it tough to know what to give my DS. He is CMPI but also can’t tolerate much soya or coconut milk. The dietitian told me at 12 months to try and move him into soya milk in very small quantities, starting with soya in things, then soya yoghurt, then soya milk. If he couldn’t tolerate that (he couldn’t), then move straight onto the milk ladder 3 months later. You start with malted milk biscuit - bits at first - then build up to a whole biscuit before moving on. You move through things like flavoured crisps, mash potato etc before you try full fat milk.

The biggest challenge for babies with CMPA is their calcium intake. Nutramigen gives them what they need to long as they have a decent amount - at 12 months this was circa 13oz a day. Other good sources are fortified cereals like Cheerios, that can be given as a snack, dried apricots, and leafy green veg. You can also buy orange juice with calcium and consider giving a vitamin supplement like abidec.

Our routine looks like this:
7am 8oz bottle
7:30am bread & jam,
9am banana
10am cracker / biscuit / homemade cake
11am nap
1pm lunch - meat sandwich with pom bear crisps or pasta with stir in sauce or beans on toast or bacon with egg and beans or sausage and waffles always followed with fruit
3pm snack - Ella’s fruit pouch, crackers, biscuit
5:30pm - dinner - cottage pie (soya milk mash), chicken curry with rice, risotto with greens in, sausages with waffles and peas, lentil stew, beans on waffles, sausages with soya milk mash and peas, always finish with fruit.
7pm - 8oz bottle

Hope that helps

Thank you that's great. He's still breast fed and a total bottle refuser. I'm struggling with different and interesting things to feed him. So for breakfast he has a lot of peanut butter on toast, rusks, fruit but I can't think of what else to give him because I can't give him yoghurt or cereal. I've been referred to a dietitian but I'm still waiting to see one.