Wednesday, August 19, 2020

CMPA, reflux and allergies.

 

Allergies and milk update.

I will first explain what cmpa and reflux is, the symptoms, diagnosis and treatments before going onto Ariyah-mai update on her milk, feeding and allegies ect...

Cmpa- cow milk protein allergy
This is an very common allergy to the protein within cows milk this is different from lactose intolence. Cmpa occur before the age of 1 due to the body's own immune defence system, whereby the immune system responds differently to the proteins in cow milk. Causing many symptoms. (listed below.) not all baby's with cmpa get all of the symptoms and can differ on how it effects each baby.
  • Rash like hives
  • Vomiting
  • Ecxma 
  • Wind and stomach promblems
  • Direah
  • Conspiatation
  • Heavy breathing (respiratory issues) 
  • Coughing
  • Runny noses
  • Reflux
  • Bloating
Lactose intolence has similar symptoms however is extremely rare under 5 years old. It does not involve the immune system its more of a digestive issue involving the sugars in milk not the protein. where an upset stomach is the result of having too much lactose. 

Cmpa symptoms are very similar to reflux and colic, which are also very common therefore could be miss diagnosed as eirther of these when baby is still young especially if your baby is have only a few mild symptoms or delayed symptoms. Therefore it is important to keep track especially when weaning a baby to see if they react to anything they have eaten or from their formula. It can also happen the other way round were a milk allergy is suspected but it may be due to reflux which normally settles around 6 months when weaning or once baby is able to sit upright more. 

Many baby with Cmpa can also have reflux as a result but can be separate by have one and not the other. Early treatment is the same for both cmpa, and reflux. By eirther cutting out dairy from the parents diet if baby is breastfeed, or changing to a hypoallergenic baby formula that can be precripted if formula feed. Symptoms should resolve almost straight away if baby has CMPA however it could take a few days or weeks to get cows milk out of their systems especially if they have started on soilds and it was in food that was eaten. Some baby's can even react just by touching milk produces or if cross conatimation happens, when preparing food. So being very vidulent by ensure sides are wiped and u tensile are washed thurally. 

On the plus side almost all baby's grow out of CMPA, with 40-45% by the time they are 3 years old then 60-85% by the time the child is 5. Unfortunately for a few it can continue into early teenage years. But rare for adults to have cows milk allegy.

Reflux-
This is when baby brings milk back up aka vomiting during or soon after a feed. It happens because babies windpipe is still developing. It means that milk or food can be pushed back up the oesophagus, due to the muscle not being able to shut of the little volve that keeps food or fluids down. It is very common and happens to 4 out of 10 babies. Normally it is mild and does not cause any really issues, it will revolves itself, normally when the babies 6-12 months as there digestive system developed as well as when they start to sit or stand upright. Most babies grow out of it by 1. No medication is needed just some changes to feeding for example sitting baby upright during feeds and for a while after. Feeding little and often instead off large amounts of milk in one go. 


Common symptoms of reflux. 

  • Vomiting, spitting up milk or projectile
  • Arching their backs and turning head away
  • Coughing 
  • Crying aand irriablle during and after feeds
  • Waking frequently and problems sleeping. 
  • Choking or like they have something struck there. 
  • seeming to have a sore throat,or ear infections
  • Constant hiccups
  • Poor weigh gain
  • Loss of weight
  • Refusing or fighting during feeds 
  • Seems in pain or discomfort, especially when laid flat 
However reflux can be very bad when it is caused by a cow milk protein allergy or other allergy which is when it includes other symptoms not just vomiting. On top of those above, these can be cold like symptoms (runny nose, sneezing, snuffly, wheezing, coughing.) along with bloating, trouble winding or constipation. Rashs, blood in stools. So be sure to talk to a gp or health care provide if you feel the reflux needs medical intervention and can not be managed by yourself. 

Ways to manage reflux 
  • Giving baby smaller amount of milk in one go, but feed often. 
  • Generally burb baby inbetween or several times throughout a bottle. 
  • Sit them up more when feeding
  • Keeping them upright after they have had  milk. 
  • Using gripe water or infocol to help their wind 
  • Using salin drops and nose sucker to help relief the cold symptoms 
  • Humidifier help too
  • Do not do tummy time straight after a feed leave it a few hours. 
  • Using anti reflux milk or precription milk if you talk to your gp. 
They say never lift the head of the cot or moses basket but our health visitor told us to and we got a wedge that was a perfect fit to just tilt the mattress in Ariyah-mai's moses basket while she slept and in the pram. This help wonders so it's down to digression but do not use things like books or normal pillows make sure you invest in something design to fit and is safe. Also NEVER put anything like baby Ceral or rice in their bottles to thicken their milk. It can cause chocking, unless it is proper thickener precripted by health professional.

Ariyah-mai's update

Many of you who have followed our whole jounery will know we had difficulty with Ariyah's reflux and milk. If you have not please go back and read my previous posts about it. (https://transdadstoarainbow.blogspot.com/2019/11/reflux-and-colic.html?m=1&zx=303ac60956fcf729

A brief summary of her history is that from a tiny baby at only 2 weeks old she started projectile vomiting, suffered with constipation, bloaty, was hard to wind. She would scream in pain because of her tummy. We used gripe water, infocol, Feed her little and often and burbed her throughout her bottle, this didn't help. She did get rashes a few times as well as having a cold, runny nose or being bunged up and a cough. Without a temperature or actually being ill within herself. We kept getting told it was just a viral infection and respiratory. But they were confused as she never had a temperature or seemed unwell. She weren't sleepy actually the opposite being very alert.

At 8 weeks after hospital stay for vomiting dyhration and rash we were kept in over night. Ariyah had to be tube feed because she lost so much weight and was just vomiting. They finally listen to us and diagnosed her with reflux, possible milk allergy but told to see how she goes. She was put on medication plus given hypoallergenic precription milk. It settles slightly but still had lots of the symptoms above. The cold and cough did get better when we moved our of a damp flat, but she was still being sick alot and had all the tummy issues. Ariyah was put back on her meds. It just wasn't doing anything. Then had a reaction to the liquid form which was a higher dose, so we stopped that. Ariyah got given gavison instead which actually made her worse.

Currently she is on no medication for her reflux it's been about 3 weeks but she started to cough and gag/choke a lot again. However she is not being sick.

This is due to yet a another change in milk. Our Gp after 3 months of moving to kent told us that they can not precription the milk airyah is on which is similac, apprently they don't do it down in kent, it is a London thing she said. However for last 3 months the same gp has been precripting it andd the chemist had no problem ordering it. She has been on simulac alimentum since sshe was 8 weeks old. But now they gave ass nutramigen which is still a hypoallergenic milk. Whilst it's the same thing just a different brand it was alot thinner and had a different taste/smell. Ariyah was not taking well to it at all. She. Was only drinking a few oz, was very unsettled and stopped sleeping through the night.

At 7 months old we finally got an appointment over the phone with a dietitian. When we ran through everything our poor little one had suffered with, straight away she said it was a milk allergy, to cows protein. Therefore she gave us another formula where the protein is so broken down and there was no soya as often that can trigger the allergy too. This has made all the difference.

At first it was hard, because Ariyah-mai h wouldn't drink it. We wean her onto it slowly but adding one scoop first to her old milk so doing 6:1. Each day we drop the old one and added an extra new one so 5:2, 4:3, 3:4, ect.. Until the bottle was the whole 7oz of the new milk. We found that the new formula was so thin that it was not filling her up. She would not drink it all maybe 4 oz at most, due to taste or the thinness. Then she was wanting it more often, furthermore she was waking in the night again. It was not easy she was crying and struggling when drinking. So we were precripted thickener to add to her milk to well make it thicker. This really helped and she is now back to her usual 4/5 7oz bottle with 8 at bed. Although she now will only drink it cold (think this is more due to the weather where it has been so hot)

Her new milk which is neocate with Carobel thickener seems to have settled her so much. She is not vomit at all really now, odd little bits every few days maybe. Her tummy has settled abit. She still get constipated but doesn't seem to be in much discomfort and has not had bad diarrhea like before. We have complety cut out dairy and soya from her diet as advised. When she has had soya we do notice she will get a it little bit of a rash or her ecxma will fleer up.

However as I said we have noticed that she is now choking on nothing, her saliva or coughing more again. She having trouble with finger food or lumper blended dinners that she was fine with before. So another call to the dietitian and health visitor is needed. Nonetheless we noticed a huge improvement in her moods, tummy and just general discomfort. She not being sick, she more comfortable and less bloated. Back to our happy little baby.

Other allergies we think ariyah may havee but just got to keep an eye and check as she gets older is soya and nuts. Soya can be similar reactions to Cmpa because of the way the proteins are broken down. Therefore it's very common that if a baby has CPMA they are also aleergic to soya or wheat. Equally to CPMA most babies out grow these allergies very young, it can also just be a slight intolerance.

Ramdonly her nut allergy is something we are not sure the extent of it or if it was a one off. We had tried all the  other allergic foods

  • Fish
  • Eggs
  • Wheat
  • Tomato 

Insep nuts. So the dietitian told us to give ariyah smooth peanut butter. She has the tiniest bit on toast only had half so two finger bits. She seemed fine no imidate reaction, hour later had a nap. And Wass fine. Then arounnd 3/4 hour after we were out for a walk when her handss started to go puffy, her cheeks and bottom lips started swelling. We rang go and they precripted periton saying to just see how she goes. They said it was only. A real concern if she was struggling to breath, going blue and if her top lip or tounge started to swell. By thee time we go to thee chemist to get the medss the puffiness had gone. She seemed fine. So pharmacist said to just watch her and if needed it give her meds but at the moment shee didn't need them. Therefore unsure if it was thhe peanuts and as she only had the tiniest bit it was not a severe reaction but could be worse if she had more. Therefore told to. Advoid it til a controlled allergy test can be done.

So if you suspect your baby has reflux or allergies or whatever it maybe, just push push push. Do not stop til you get answers and solutions. Your baby is important and you as a parent no better then anyone. We are here for advise. feel free to comment what you found has helped or if your suggerling with a reflux baby, we are here to help with mmay tips. We learnt the hard way, with trial and error so we are happy to pass on our wisdom.

On a amazing note Ariyah-mai said dad!! She can say lots of other words too. But finally said dad to us both on different occasions on the same day. Now she none stop dad dad.



(Written in July 2020)

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