It is the worst thing to know there is something not right with your baby. As their parent, you instinctively know when something doesn’t feel right and you just want to find out what it is and fix it. My baby was doing really well until around 6 weeks old. Then she stopped gaining weight and started being poorly all the time. This was the start of or journey with severe reflux and CMPA.
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What is CMPA?
CMPA (cow’s milk protein allergy) is an allergic reaction to the protein in cow’s milk. This can be immunoglobulin E (IgE) when the reaction is immediate or non-IgE mediated when the reaction is delayed.
How is a Cow’s Milk Allergy Diagnosed?
If you are worried that your baby is showing the symptoms of a cow’s milk allergy talk to your health visitor or GP. They will monitor your baby’s symptoms and weight gain and will refer you to a paediatrician if they think your baby is showing signs of an allergy.
The first time a milk allergy was suggested to us was at an appointment with the health visitor at 10 weeks old. We had been visiting the health visitor every two weeks because my daughter was gaining weight very slowly. I was also struggling to make enough breast milk for her as she was constantly vomiting with severe reflux. So we tried adding top-up formula feeds using a comfort formula which is gentler on the tummy. I couldn’t use a formula for reflux as she was already having Gaviscon to thicken her feeds.
As soon as she started taking the formula her symptoms got progressively worse. So the GP decided to refer her to a paediatrician and start treating her for CMPA.
What are the Symptoms of a Cow’s Milk Allergy?
- Diarrhea which can have mucus in it
- Skin rashes
- Back arching
- Not feeding well
- Slow weight gain
- Swelling or redness around mouth or eyes
- An extreme reaction can be anaphylaxis
Your baby may not show all of these symptoms. My daughter has a non-IgE allergy so her reactions are delayed. She will show some symptoms quite quickly – usually vomiting not long after having cow’s milk. But other symptoms are delayed – she will have diarrhea a few hours later, her skin goes mottled and then she will get fussy and snuffly. She really struggled to gain weight as she also had reflux which was made even worse because of her allergy.
What is the Treatment for CMPA?
While we were waiting for a paediatrician’s appointment we stared on treatment for CMPA. We began with a trial of an extensively hydrolysed formula called Nutramigen. This formula has small amounts of cow’s milk protein in that have been heavily broken down and are easier to digest. She did show an improvement when drinking Nutamigen for around 10 days and then she started to get worse again. The GP then moved her on to Neocate which is an amino acid formula with no cow’s milk proteins. Although this formula smells awful she drank it and started to improve. I also found using Dr. Brown’s bottles really helped with her tummy pains and reflux.
I also stared a completely dairy-free diet as I wanted to continue to breastfeed.
How Quickly will my Baby Improve?
There isn’t an immediate improvement when they start on the special formula as they still have cow’s milk in their system. Over the first week on the new formula, we saw a slow improvement. My baby was still being sick with the reflux, but the other symptoms were improving and she was being less fussy.
If your baby starts to improve and then gets worse again you can talk to your GP about trialing them on a formula which contains no traces of cow’s milk. It is better to stay on a formula which contains traces of cow’s milk if your baby can stomach it as it helps to build up a tolerance to cow’s milk. The worst part of these formulas is the smell (and taste!). I was lucky that my baby just drank it straight away, but if they aren’t keen you can mix half of their normal formula with half of the new formula. Then slowly you reduce the amount of normal formula until your baby adjusts to the new taste.
After using this new formula we saw a big improvement within a few days. Unfortunately, the reflux still meant she regularly vomited, but it was less often and no longer projectile vomiting. She started to thrive and gain weight.
What happens Next?
When a paediatrician has confirmed the diagnosis of CMPA your baby will be prescribed the new formula until they are around 12 months. At 6 months you can begin weaning and use milk alternatives such as oat milk. They will then need to be reintroduced to cow’s milk by starting on the milk ladder. We have just started this next step and I will share our progress.
Update Dec 2020 We have tried the milk and soy ladder several times over the last two years. So far she can now tolerate soya lecithin but nothing else. She still reacts to very small amounts of cow’s milk and so we haven’t been able to reach step 1 yet but we will keep trying.
Check out this practical guide for dealing with sleep, weaning, leaving the house and helping your baby to improve their symptoms.