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> Possible cows' milk protein intolerance in one-year-old, How do I go about getting a diagnosis?

V
runnybabbit
post 25/04/2012, 08:01 PM
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Hi everyone. First time posting here. I've read through some threads and done a lot of Google research, but was hoping to get some advice from EB as well.

The short story is that I suspect my one-year-old might have cows' milk protein intolerance, with only (relatively) mild GI symptoms.

He has been BFed from birth and never had formula or cows' milk as a drink until last week. Introduction of cows' milk coincided with what appeared to be abdominal pain (back arching, fussiness) and frequent night wakings and difficulty settling -- compared to two night wakings usually, with him settling back to sleep after a quick BF.

After three nights of that, we stopped the cows' milk completely, and he went back to two night wakings and settling really easily. Yesterday I gave him 80 ml EBM with 20 ml cows' milk, and it was another horrific night.

I've always used dairy in our family cooking, always have had lots of dairy myself, and my son has had small amounts of yoghurt and cheese in his diet since he started on solids.

So am I right in thinking that he might have a dose-dependent cows' milk protein intolerance that only becomes really manifest when he has milk as a drink? He has always been a "bad" sleeper, and was on Losec for reflux until a few months ago -- could it be that the smaller amounts of dairy has been affecting him for months and he was just deemed a difficult baby?

I think I will be bringing him to a GP next week, but from what I've gathered here, many GPs aren't too savvy and don't really know about lactose intolerance vs cows' milk protein allergy vs cows' milk protein intolerance. What do I need to know?

If it IS cows' milk protein intolerance, given that it is not IgE-mediated, what are our chances of getting a diagnosis, with regard to testing and actual positives?

If I continue feeding him dairy but just avoid cows' milk as a drink, do I risk sensitising him further to CMP and worsening whatever condition he might have?

Sorry for the barrage of questions. Thank you all in advance for sharing your experiences and advice.
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GEH 77
post 25/04/2012, 08:10 PM
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It sounds like he does, you will need to do a challenge as intolerance can't be tested like allergies via a skin prick. You basically need to take him off it completely (including all cooked goods using it) for 2 -3 weeks, keep a diary of behaviors, skin rashes etc, put him on it including drinking it for the same amount of time & do the same. You may find he can tolerate cheese & cooked goods as the protein is broken down in the processing.

Good luck!
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SplashingRainbow...
post 25/04/2012, 08:12 PM
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We a now 17 month old who we (and gp) suspect has a cows milk protein intolerance.

We discovered it when removal of dairy from his diet requested by GP for a different reason led to dramatically improved sleeping. thinking it might be a coincidence we reintroduced dairy but sleep got worse so we removed it again and had good results within a week.

Went back to GP who agreed it was likely to be an intolerance.

We haven't done any further testing. I'm not sure what that would be, or what benefit it would bring? We are still bf, I'm dairy free and quite enjoying it, and he seems to enjoy soy formula when he is in the care of others.

Would be interested to hear what others have to say about the testing process.

I allow DS to eat bread but we use Nuttlex instead of butter/marg, and there is no milk or cheese allowed. I can't think of any other products he has apart from bread that contains dairy. This seems to be working for us so we will stick with it for now.
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brindle
post 25/04/2012, 08:27 PM
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Yes. I would remove ALL dairy from his diet. If he has had reflux, etc from early on, these may have been symptoms.

You need to do this for at least 2 (preferably 3) weeks. Then 'challenge' by giving him dairy. You will see pretty quick. It is hard work, but on a positive note it is easier when they are still babies.

I personally wouldn't replace dairy with SOY. There are cross-overs in intolerances for cows milk and soy.

Challenge them all individually.

My son had problems with cows milk, but tolerated Goats milk.

BTW: there is no dairy in bread.

Good luck

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brindle
post 25/04/2012, 08:31 PM
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I should add that my son is now 5yrs and from about 3yrs he was able to tolerate more and more cows milk products. We started with natural yoghurt.

He still mainly drinks goats or rice milk - but eats cows yoghurt, cheese, etc... and is Ok with the occasional drink of cows milk.

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mumto3princesses
post 25/04/2012, 08:43 PM
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Hi, I'm not sure anyone would test him at 1yr old but there would be a long wait for an appointment so they might test by the time you see someone.

We didn't get DD2 tested officially until she was nearly 4yrs old. We did have advice though from our Dr. I was told that most babies will grow out of it by around 12mths and of the remaining children most will grow out of it by around 4yrs.

When my twins were babies I was told they both had colic and reflux (they threw up big fountains of milk) and I was pretty much told oh well, thats life they are fine. Both weren't the best sleepers but DD2 was the worst. Neither had GI symtoms except possibly a bit constipated at times. Both also had excema and weird spots/rashes. It wasn't until in desperation I took them both to my old GP that I used to go years before they were born. (I moved) They were about 3-4 months old by then. He told me he felt they both had cow milk protein intolerance.

So, we did an elimination diet removing all dairy. I was told I had to remove everything. This included all food even margarine and biscuits. We saw signs of them being much better after only 24hours. Then by a few days later we were sure. A few months later he wanted us to do a trial which we did and they both had the same reactions as before.

DD3 grew out of it at 13mths but DD2 didn't. As she grew older we realised she would get a very sore tummy and throw up plus the spots/rashes if she had anything with dairy. Eventually she was able to handle things with milk cooked in them. Not creamy pasta dishes etc though but things like biscuits and cake with small amounts cooked in them.

DD2 was almost 4yrs when we had her tested and the allergist did a patch test thing on her back (after confirming via a skin prick test that it wasn't an allergy). It had to stay on for a certain amount of time and then we had to go back after it had been off for a certain amount of time. The control one was mean't to come up in a bump/hive like spot and the other one wouldn't have done anything if she wasn't cow milk protein intolerant. The other one was huge.

It's very unlikely that DD2 will grow out of it now at 8.5yrs old. We were told to trial things over time starting with things that have less protein in them and see how we go. Apparently it builds up in their system and in some cases it's a matter of finding out through trial and error how much their limit is. DD2 for example can have anything with milk cooked in it like cake or biscuits and will have no obvious physical reaction to a margarine in her sandwiches but after a few days she will break out on spots/rashes so we went back to nuttlex. She can't have yoghurt without feeling sick and throwing up. But could have a small amount of cheese one day as long as she doesn't have anymore for at least 2 or 3 days.
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