CMPA | Symptoms, Diagnosis, Coping

If you don’t know me personally, it would be news to you that I had a baby. I had been meaning to write posts but life just…happened, I found I never had the time to sit and publish. Motherhood has been both amazing and exhausting, it’s the most rewarding experience but can be stressful at times. I will be speaking about one of those hard times in this post which is our experience with CMPA. This post will be covering our experience with CMPA, the symptoms my daughter suffered, how we were diagnosed and how we cope with it.

What is CMPA

Cows Milk Protein Allergy (CMPA) is the most common food allergy in infants and children, there are a wide range of symptoms which makes it hard to diagnose. It’s difference to lactose intolerance as it is an allergy to the proteins in cows milk whereas lactose intolerance is the inability to digest the carbohydrate in cows milk. It can affect both breast and formula fed infants.

Our Symptoms

Esme was born on 24th April and I remember the symptoms starting in the hospital. I had to stay in a few days as we were on infection watch (I had developed an infection and fever during labour). I had originally tried to breastfeed but struggled and received no help or support from the midwives so had to turn to using premade formula. I was upset, as I felt like I had failed but at least my baby was being fed. I think the first lot of symptoms we’re the day after she was born. My Fiance came to visit us and she was in her crib. He was trying to change her nappy and it was like diarrhea and was everywhere, during the change she was sick. I didnt think anything of it at the time as I knew newborns spit up but thinking back to it, it was a lot of vomit. One night in particular I remember was when we tried the premade formula for the first time. I had a midwife with me and we we’re trying to get Esme to take the milk but she wasnt having it, she just screamed. We couldnt get her to settle so the midwife rubbed her tummy for a while. She pulled her poop strain face and just let rip! The midwife changed her and again it was everywhere!

Feeding was always a struggle after that. We first had Esme on Cow & Gate formula once we got home but during and after every feed we would hear her tummy grumble, she would tense up, arch her back and start crying which would continue for a couple of hours after till she was too tired and would just sleep. I called our home visitor who suggested it could be colic so we should try the comfort version of her formula which had reduced lactose and was for babies with colic and constipation. After a while of Esme being on this formula we were still having the same issues and her nappies were still bad (and were much worse on the new formula, they smelled like rotten egg!). After The Cow and Gate Comfort, I did some of my own research and thought she may have silent reflux. She wasnt vomiting but had a lot of the other symptoms. These were:

  • Foul smelling nappies which would occasionally have white seedy bits in
  • dirty nappies would be dry and pasty
  • once on the comfort milk, nappies became explosive
  • dribbling non stop with a lot of bubbles at the mouth
  • grumbly tummy during feeds
  • sneezed constantly
  • got hiccups a lot
  • coughed a lot
  • was always farting, especially in the morning but seemed to struggle to during the day

I booked an appointment with our GP and they honesty could not have seemed any less interested. I was told it was normal and she would adjust. I mentioned the possibility of silent reflux and was hoping they would see her but she was prescribed Gaviscon over the phone instead. This went on for a short while longer and we decided to change her milk again. I did more research and came across Kendamil milk which is a full cream based formula. The reviews seemed pretty good as a lot of people were saying that because it was thicker, it was stopping the reflux as it couldn’t come back up. We got some and tried it instantly. Esme absolutely loved the milk, she gulped it down but we were still having the same symptoms, if anything they were worse as she had then developed a rash.

Diagnosis

A few days after the telephone GP appointment and when the rash developed, we decided enough was enough and that she needed to be seen so we took her to A & E. As we were in the thick of Covid, only I could go in. The doctors were absolutely fantastic. They did a thorough check, asked me about everything from the birth to that moment (Esme was 5 weeks old at this point) and listened to her stomach which they said was very noisy. We didn’t have the official test for CMPA but after hearing her symptoms, listening to her stomach and seeing her rash, they confirmed it was CMPA and gave us a prescription for a new formula to start using.

Coping

We collected the formula the next day and started using it. We were prescribed Nutramigen with LGG. Nutramigen is an extensively hydrolised formula for infants with mild to moderate CMPA. It was the most foul smelling formula and I cant imagine it tasted much better (her poops also smelled like it!). Esme would not take to it and honestly I couldnt blame her, it really was bad! It had to be made up with room temperature water and couldnt be warmed due to the friendly bactria in it. We stuck with the Nutramigen for about 3 weeks but feeding times were an absolute mission so we called the GP who changed the milk to Neocate LCP. Neocate LCP is a amino acid-based hypoallergenic formula . Straight from the get go, she started taking this milk a bit better. Still not perfect, but better than before she was on the Nutramigen – It didnt have a foul odour (although the taste was bad as I tried it). We were on Neocate right up until Esme was about 6 months old but She still didnt seem 100% happy on it so I called the GP again who prescribed SMA Alfamino. Like Neocate, SMA Alfamino is an amino based non-allergenic formula. Since Being on this formula Esme has been feeding so well. It has a preferred taste over other amino based formulas to help support acceptability.

During this journey we were also referred to a dietician. This happened when Esme was about 4 months old but it was something the GP should have actioned as soon as we discovered her allergy at 5 weeks. What would have been a stressful weaning process was made very easy with the advice we received. We did try her on some dairy just recently but she began getting similar symptoms so as per our dieticians advice, we are going to wait till she is over a year old and try her on the iMap Milk Ladder (we give food with minimal dairy and work our way up to milk if no symptoms occur). I hope Esme will be able to tolerate dairy but if not, it isn’t the end of the world, there are plenty of recipes out there for babies and children with CMPA and a lot of jarred baby food is actually dairy free!

Overall, it’s been a hard journey but we kept trying and going back to the GP when we weren’t satisfied. I know it is hard and some parents receive little to none support but keep trying and keep going back and they will have to do something about it. There are also groups on Facebook with other parents going through similar issues – I joined a couple of these and the advice I received helped a lot.

I’m in no way a medical professional but I hope reading this article has helped in someway regarding any CMPA issues you may have and if you have any questions please comment below 🙂

CMPA Advice Websites:

NHS – CMPA

Allergy UK

Nestle – Understanding CMPA

Alfamino

Formula mentioned:

Nutramigen 1 With LGG

Neocate LCP

SMA Alfamino

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