When we Koa was roomed in, the same time I was wheeled to my hospital room from delivery room, Husband & I have been taking photos of almost everything – including his poop. Husband insisted we take photos and also take note of each diaper change and feeding details. But little did we know that would help diagnose our baby’s allergy to cow’s milk protein.
One morning, I panicked when I saw traces of blood in his stool while changing his diaper. He was 3 weeks old. We quickly sent a message to his pedia, sent all the poop photos we had and we were told he has Cow’s Milk Protein Allergy or CMPA. In my head, I was “just from poop photos, CMPA agad?“ but still followed his lead. It turns out, along with blood and mucus on his stool, Koa was already showing signs of cow’s milk protein allergy. He was very colicky and gassy – inconsolably crying. And we thought he was normally a gassy baby like other babies.
The CMPA baby
Typically the presence of cow’s milk allergy appears within the first few months of life and usually before six months. Symptoms can present a few days or weeks after the ingestion of cow’s milk protein. The symptoms can vary from diarrhea and emesis to life-threatening anaphylaxis.https://www.ncbi.nlm.nih.gov/
Some common Cow’s Milk Protein Allergy signs and symptoms may include:
- Coughing or wheezing
- Loose stools or diarrhea
- Blood and/or mucus in stool
- Colic and gas in babies
- Inconsolable crying for 3 hours or more
Breastfeeding mom & a CMPA baby
Breast milk is the best milk to provide optimal nutrition for an infant. There is a small chance that proteins pass through the breastmilk but when it does the lactating mother should avoid eating the foods their child is allergic to. Continue to breastfeed but just make sure to remove the foods that trigger their child’s symptoms from your own diet.
The difficult part of breastfeeding a CMPA baby is that cow’s milk protein actually crosses into the breastmilk. We did not consider this since during his earlier months, we did not see there was any problem. We only realized the severity of Koa’s CMPA when Koa had dark colored stool for a week and the only possible culprit was – the breastmilk. It was the only milk he was taking that might have possible cow’s milk protein in it. And that week, I had cake slices and ice cream. True enough, when we took him off the boob, his stool cleared and went back to his normal yellow coloured stool. Since then, I have been mindful of eating or drinking anything that has cow’s milk in it.
I am not saying the breastmilk is bad for CMPA babies. It is still the best milk a baby should have, but breastfeeding moms should be mindful of what she eats. She should not only be eating healthy food but should stay away from food containing cow’s milk protein. Since cow’s milk protein actually crosses into the breastmilk, the baby will ingest it and can be harmful to him. This is the case for babies with high allergic reaction to cow’s milk protein who may be fully breast-fed or mixed-fed – it will instantly trigger allergic reaction on the baby.
Infant Formula and CMPA Babies
If you’re formula feeding, your doctor may advise you to switch to an extensively hydrolyzed formula or an amino acid-based formula in which the proteins are broken down into particles so that the formula is less likely to trigger an allergic reaction. You also might see “partially hydrolyzed” formulas, but these aren’t truly hypoallergenic and can lead to a significant allergic reaction depending on the severity of your baby’s allergic reactions.
Nutramigen is the only prescribed infant formula milk for our baby. Nutramigen is the only fully-hydrolized cow’s milk protein formula milk available in the Philippines. Unlike other baby formula’s, Nutramigen has fully-hydrolyzed cow’s milk protein – most baby formulas are only partially-hydrolyzed.
Extensively hydrolyzed formulas offer complete nutrition for infants who are allergic to cow’s milk protein. Casein is a cow’s milk protein that is a common cause for allergy symptoms. Extensively hydrolyzed formulas break casein into pieces. About 90% of babies with cow’s milk allergy will tolerate these formulas.
Nutramigen is pretty difficult to find. All CMPA parents know how difficult it is to get a hold of it in the Philippines. here was a time that it was not available. We were already ordering directly from the warehouse but for a good 2 weeks – there was no supply. Everywhere. So we had no choice but to give him another formula, gentle to the tummy but (like all other formulas) only partially-hydrolyzed cow’s milk. We would first give him breastmilk, Nutramigen and then Enfamil Pro Gentlease – in this order. I upped my game in breastmilk pumping to get increase my breastmilk supply even more. And we had to stretch out our Nutramigen supply so his tummy will not get the worst with the partially-hydrolyzed cow’s milk protein. We chose Enfamil Pro Gentlease, since this was gentler on the tummy. It designed to reduce fussiness, gas and crying. It has an easy-to-digest milk protein blend patterned after breast milk (whey and casein in a 60:40 ratio)* that has been partially broken down. But even so, he was still colicky and had mucus in his dark coloured stool.
When Nutramigen was finally available his stool, his stool eventually went back to his normal coloured stool.
Taking Care of a CMPA baby
If you have a cow’s milk allergy baby or suspecting that your baby might have it, please consult with his doctor. It would also be advisable to talk to him and/or nutritionist regarding your food intake if you are breastfeeding.
When your baby starts eating solids at 6 months, make sure that your baby is not given any food containing cow’s milk protein. It would be best if you prepare his food by yourself and only serve food you know the ingredients of. Most babies outgrow CMPA at 1-3 years old, it would be best to stay away for cow’s milk protein until his doctor gives you a go signal.
It can be quite a challenge to take care of a CMPA baby, but there are support groups in Facebook where moms and dads of CMPA baby share their experiences and journey. It would be good to read about how others manage their babies but always take any recommendation with a grain of salt.