Written by Dr Neil Shah for Doctify
The symptoms for both cow’s milk allergy and reflux are quite hard to spot in newborns as they affect the gut. The symptoms can easily be confused with colic, lactose intolerance, poor feeding or general fussiness. Furthermore, the symptoms commonly occur at night so an examination in the clinic room can be misleading.
Families often experience a delay in diagnosis of up to three months or more with numerous visits to health care professionals (on average, families visit specialists around 17-18 times before the diagnosis is considered). The delay in diagnosis is not only frustrating but can also have a negative impact on a family at a time when the new arrival should be celebrated and cherished. Instead, new parents will feel a combination of exhaustion, fatigue and anxiety.
Cow’s Milk Allergy
Cow’s milk allergy is the most common food allergy amongst children and affects around 4% to 6% of all newborns. It is a reaction by the body’s immune system.
The most common symptoms include:
- Nasal congestion
- Painful passage of flatus
- “Soft” stool constipation with excessive straining
- Skin rashes (usually eczema)
- “Silent Reflux”
- Stomach cramps, noisy bowel sounds
- Red anal margins
- Mucus and occasionally mucus in the stools
There is much confusion with lactose intolerance. This is rare in under ones and is usually secondary to a gastroenteritis. Lactose is a natural sugar found in milk. Lactose intolerance can also present with symptoms such as diarrhoea, vomiting, bloated stomach and stomach pains.
If your baby is fed with infant formula, your GP can prescribe extensively or fully hydrolysed formula. This means that the milk proteins are broken down into smaller parts, making them easier to digest.
It is important that you do not cut out milk and dairy products from your child’s diet without medical advice as they provide important sources of nutrients such as calcium. Cutting out these types of food could result in your child not getting the nutrients he or she needs. Talk to your health visitor or GP who may refer you to a registered dietitian.
A lot of babies and young children experience a degree of reflux, posseting or bring food back up. However, if the food brought up doesn’t actually come out of the mouth but flows back into the gullet it can lead to something called silent reflux. The child may swallow the food back down or the stomach contents/stomach acids may not be brought far enough up the gullet to be swallowed. Since there are no outward symptoms for silent reflux to explain why a baby is distressed or uncomfortable, it makes it even harder to be diagnosed. Some babies might get so uncomfortable that they stop feeding (causing potential growth issues) whilst others feed as a means of soothing their pain (causing potentially large weight gains).
One of the symptoms of reflux is a prolonged or even a chronic cough. This may be more common after food or drink has been ingested or at night when your baby is lying flat (i.e., when it is easier for the stomach contents to be regurgitated). The symptoms will result in your child feeling unsettled due to the acid which will be accumulating in the gullet or coming back up the throat.
If you believe your baby has reflux, seek advice from your GP. Sometimes, the condition can be cured with home care changes that are also recommended for reflux or posseting. Such changes include:
- Letting your baby burp regularly during feeds
- After feeding, holding your baby upright for some time
- Feeding your baby less but more frequently rather than overfeeding
- When bottle feeding, ensuring that the hole in the teat is not too big (i.e. reducing the flow of milk)
- Slightly raising your baby’s head while he or she sleeps. Safe ways to do this include putting books under the head end of a cot or crib or putting a pillow under the mattress. Never put pillows in the cot itself.
In more severe cases, medication or even an operation may be recommended by your GP.