After months of living with a baby with slow weight gain and a lot of vomiting we finally reached a diagnosis of non-IgE mediated cow’s milk protein allergy and reflux. This is how I found out my baby girl had a food allergy and how we are learning to manage it.
What is CMPA?
I had heard of a dairy allergy, but not CMPA. It 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.
The first time we discussed a milk allergy was at an appointment with my health visitor at about 10 weeks old. We had been going to see the health visitor every two weeks because my daughter was gaining weight very slowly due to severe reflux. I was struggling to make enough breast milk for her as she was constantly vomiting with the reflux, so we decided to try adding top up formula feeds to her diet. Although I felt disappointed about having to do this I knew it was the best thing for her. The health visitor advised using a comfort formula to be gentler on her tummy. I didn’t use a formula for reflux as we were already giving her Gaviscon to thicken her feeds. I was warned that her symptoms may get worse if she did have CMPA.
What are the Symptoms of a Milk Allergy?
- Back arching
- Not feeding well
- Swelling or redness around mouth or eyes
- An extreme reaction can be anaphylaxis
As soon as we started on formula feeds we noticed a difference. Halfway through her second feed she started projectile vomiting. I spoke to the GP straight away because I was worried about her getting dehydrated. I was told to keep on with the trial for a week to see if it was just her tummy adjusting to the new formula.
Over the next week we had more vomiting and explosive diarrhoea with mucus in it. Her skin which had always been dry went a really mottled colour and she started to be really snuffly and wheezy. At my next health visitor appointment she was still struggling to gain weight, even though she was feeding all the time. This time the health visitor decided that it was a milk allergy. She was fantastic and spoke to the doctor for me and arranged a trial of an extensively hydrolysed formula called Nutramigen. This formula has small amounts of cow’s milk proteinin that have been heavily broken down and are easier to digest. I also had to go completely dairy free if I wanted to continue to breastfeed (which I did).
How Quickly will Baby Improve?
There wasn’t an immediate change as she still had cow’s milk in her system and in mine. Over the first week on the new formula we saw a slow improvement. She was still being sick with the reflux, but we could see a difference. I was feeling more positive and baby girl seemed so much happier.
After two weeks we had a set back and she started to be constantly sick after her formula feeds. The GP decided that she couldn’t tolerate any cow’s milk and moved her onto an amino acid formula called Neocate. These formulas contain no cow’s milk at all and are great for stopping the reactions, but don’t allow baby to build up any tolerance to cow’s milk. The worst part of these formulas are the smell (and taste!). I was lucky that she just drank it straight away, but if they aren’t keen you can mix half your normal formula and half neocate and then slowly reduce the amount of normal formula until 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 vomited, but it was less often and no longer projectile vomiting. She started to thrive and gain weight. Now we just had to wait for a paediatrician’s appointment to see if they agreed with the diagnosis.