MSPI Help!

[twang817]

Hi.  Dad here.

My 3.5mo old son has been struggling with what we believe to be MSPI for about a month now (since just after his 2mo check up).  It started with a frothy green stool with a little bit of blood in it and a rash/pimples on his cheeks.  After visiting with the pediatrician, who referred us to a GI specialist, we were put on Alimentum while my wife worked on the elimination diet.  The GI told us to eliminate milk, soy, eggs, beef, and pork.  He was gaining weight well at his 2 month check up, though I'm not certain he has continued to gain weight well.  On Alimentum, he is generally a very happy baby -- very little spit up, occasional fussing, sleeps through the night.

Our plan was to switch back to breastfeeding and one-by-one introduce foods to her diet to narrow down what he may be allergic to.  We tried switching back to breastfeeding at about 3mo, and on his third day, his stool was back to green and full of mucous (though no visible blood).  He was very fussy that night, which is almost never is.  By the forth day, his stool was nearly all water (diarrhea) and we immediately went back to Alimentum.  My wife and I took a closer look at her diet and decided that we were probably not doing a good enough job eliminating milk and soy.  Two more weeks later, we tried again.  It is now the third night.  His diaper today was full of mucous and about an hour ago he started being extremely irritable.

We wife and I both work and we simply don't have time to cook (I don't get home from work until nearly 8PM).  We end up eating out a lot.  We have found it extremely difficult to find anything at all to eat.  My wife now weighs less than when we first met.  My questions are:

1. If I continue to feed my son with Alimentum, all the way to 12-18mo, will it increase his changes of becoming permanently allergic to whatever he's allergic to?
2. If I continue to feed my son breastmilk and do a poor job with the elimination diet (meaning, he will still be exposed to some degree to whatever he's allergic to), will it increase his chances of becoming permanently allergic to whatever he's allergic to?

Thanks,
Tommy

[becj86]

Hi Tommy, Sounds like you've had a rough few months and have tried lots of things to help your little boy.

In relation to your questions, unfortunately, the research isn't definitive as to the development of allergies, so nobody really knows the answer, nice as it would be to know.

This may seem an odd question - does your wife have a lot of milk? Barring the rash, my son had the very same symptoms from oversupply and overactive letdown - I had too much milk and he wasn't getting enough fats and he gulped a lot to cope with the flow of milk. It does sound like there's an allergy of some kind there but it might be worth expressing and bottle feeding if/when you reintroduce breast milk just to eliminate that possibility. Did you try any other formula before the Alimentum?

If you're eating out, you will probably have a lot of trouble with an elimination diet - are there any other parents you know of who are doing a similar elimination diet who you could pay to cook extra for you? Just a thought :/

It sounds like Alimentum is helping him - if he's happy and healthy, sleeping well and growing and developing well it may be worth considering keeping him on that.

Just to clarify, did he just suddenly get upset and have a green frothy stool one day out of the blue after being totally fine? Had he been spitting up and generally fussy as well through the first 2 months of life?

[twang817]

This may seem an odd question - does your wife have a lot of milk? Barring the rash, my son had the very same symptoms from oversupply and overactive letdown - I had too much milk and he wasn't getting enough fats and he gulped a lot to cope with the flow of milk. It does sound like there's an allergy of some kind there but it might be worth expressing and bottle feeding if/when you reintroduce breast milk just to eliminate that possibility.

Yes, she does have quite a bit of milk and a forceful letdown.  We had considered that it may be lactose overload, so we have been bottle feeding expressed breastmilk exclusively.  I would always make sure to shake up a bottle prior to transferring EBF from our storage containers to his bottle.  Unfortunately, I think that eliminates the possibility of a foremilk/hindmilk imbalance -- that would've been an easy one to solve

Did you try any other formula before the Alimentum?

No, Alimentum is the only thing we've tried.  He tolerates it well and he really does quite well on it.  I am more concerned about never giving his immune system a chance to deal with the CMP turning into a lasting allergy.

If you're eating out, you will probably have a lot of trouble with an elimination diet - are there any other parents you know of who are doing a similar elimination diet who you could pay to cook extra for you? Just a thought :/

As far as people we already know - no.  I had hoped to find a meal service that I can pay to have food prepared; but, have had limited luck.  We are scheduling an appointment with a pediatric nutritionist in hopes that he/she may be able to direct us to some dietary solutions for busy parents.

Just to clarify, did he just suddenly get upset and have a green frothy stool one day out of the blue after being totally fine? Had he been spitting up and generally fussy as well through the first 2 months of life?

He was generally a very happy baby.  He ate well, thrived well, rarely cried, slept through the night within the first few weeks.  He had relatively mild spit up and perhaps a mild gas problem.  Then, there was a very marked and noticeable transition within a period of a day or two.  Since, each time we've tried to re-introduce to breastmilk, we would notice again a marked behavior change around the 3rd or 4th day.

[MasynSpencerElliotte]

I think a key thing to remember is that an allergy and an intolerance are two very different things. My three girls all had MPI as babies, two outgrew it by a year old and one by the time she was 4 or 5. They all had symptoms like constipation, ezcema and gas/bloating.  A true allergy generally would cause more immediate reactions like hives, vomitting, and potentially anaphylaxis. I know the new recommendations for food allergies is to expose babies (when ready for solids) to all manner of foods thereby reducing risk of developing allergies, is that what you are referring too? 

None of my kids developed an allergy to milk even though I was on an ED while BF and at the time the wisdom was to not feed more allergenic foods (especially with a family history of allergies which we have in droves!).

[twang817]

I think a key thing to remember is that an allergy and an intolerance are two very different things. My three girls all had MPI as babies, two outgrew it by a year old and one by the time she was 4 or 5. They all had symptoms like constipation, ezcema and gas/bloating.  A true allergy generally would cause more immediate reactions like hives, vomitting, and potentially anaphylaxis.

Good point.  I think my son is clearly on the intolerance side.  He does not vomit, and even when he is fussy, it is usually only at night when he's tired anyway.  I believe he is gaining weight well, but my digital scale varies so much that I have very little faith in it.  I'll know at his 4 month check up -- but my guess is that he's somewhere between 15-16 lbs which puts him right around average.

I know the new recommendations for food allergies is to expose babies (when ready for solids) to all manner of foods thereby reducing risk of developing allergies, is that what you are referring too?

Precisely.  I am seeking to avoid developing a lasting allergy.  I don't know if conventional wisdom is to avoid the allergen and allow his immune/GI/whatever system to mature; or to expose him to it so that his body can figure out how to deal with it.

None of my kids developed an allergy to milk even though I was on an ED while BF and at the time the wisdom was to not feed more allergenic foods (especially with a family history of allergies which we have in droves!).

Unfortunately, little is known about his biological mother (IVF baby).  My side of the family does not have a significant history of allergies.

At this point, my wife still really wants to breastfeed our son -- but the ED is starting to wear on her health.  She is now nearly 10 lbs under her pre-pregnancy weight and is often lethargic.  I'm looking at giving up on breastfeeding and going to strictly Alimentum.  I just wanted to know if that may end up doing more harm than good.

[MasynSpencerElliotte]

But in the case of introducing more allergenic foods I think it presupposes that there are no known allergies or intolerances to any foods. The idea is that early, repeated, exposure helps to prevent an allergy from forming in the first place. If the infant already has an allergy or intolerance I personally cannot see what can be gained by feeding them the offending food until their system can handle it. We waited until after one year old on our doctor's advice.

(((Hugs))) for your wife. ED's are so tough to do I know. I hope that the upcoming appointment will give you guys some ideas for options to broaden her diet. 

[Buntybear]

Hi Tommy,

My son was born with (or so i believe anyway) milk, egg and wheat allergies. My husband and I have no known allergies so I am not sure why Olly had multi allergies from birth. I breast feed olly for 14 months on a strict diet so can totally understand how hard it is for you and your wife. Olly would never take a bottle so I didn't have the temptation of formula feeding it must be even harder knowing that he does better on the milk 

The medical advice on allergies changes all the time as there is so much research going on. Even at our last allergy appt Olly was tested for peanut for the first time ever as there is now (in the last 12 months) a proven link between egg and peanut allergies. On this forum we are just not qualified enough to give you advice on what milk to feed your son to avoid long term allergies, as pp has said.

What I would say is that you have to do what is best for you and your family. If that is giving your son formula milk because he thrives on it, so be it. Elimination diets are hard at the best of times, even harder when you do not have time to prepare your meals from scratch.

I am not sure what makes someone's body become allergic to something but Olly outgrew his milk allergy by about 3 and we are going in after christmas for an egg challenge because it looks like he has outgrown his egg allergy too! Now we are just left with wheat (which seems to be decreasing). So there is hope and from my experience it has nothing to do with what I fed him as a baby - it is just one of those things.

hope this helps xx

[becj86]

Did your wife start eating/doing anything different around that time?

It seems odd to be an intolerance that came on that quickly. If it hadn't happened each time you reintroduced breast milk, I'd think it was a virus of some kind - that can give him green frothy stools and can obviously make a baby irritable.

[potlaura]

Hugs to you and your wife

My DS3 was MSPI and we utilised formula when the elimination diet became really difficult . He was a really happy chap after that and we introduced diary etc utilising a series of techniques given from a dietician once he was old enough and he tolerates all remarkably well with the exceptions of egg.

Euan has severe anaphylaxis but his other issues where very much intolerance if you know what I mean.

If you have access to a good paediatric dietician they are the best people to guide you on your path with your little man because every case that I see has differences and anomalies and what suits one baby does not fit the next etc.. We just trust our allergy doc/dietician and hope that their guidance gives us the most positive outcome for Euan. For what it's worth none of my other children have allergies and neither parents either it was just one of those things.

Good luck as you navigate this path xx much love

[twang817]

I found this thread in my search for more MSPI information and realized it was my own thread.  I apologize for resurrecting an old thread -- but I often find it helpful when people post updates.  If nothing else, it helps others with what to expect.

My son is now just a few weeks over 1 year old.  Since my post, he went through some pretty bad rashes/acne until the milk cleared out of his system and has then been on Similac Alimentum for the past 10 or so months.  He has done well on Alimentum -- no rashes, no blood in his stool, and he has been gaining weight well.   At 8-10 months, we've introduced most vegetables and several fruits (bananas, watermelon, apples, pears) without any problems.  He's been eating chicken (both broth and shredded) for a month or so now without any issues.

A few days ago, after consulting with his pediatrician and GI doctor, we gave him an ounce of milk.  We didn't see any reaction for several days, so we then started giving him regular cows milk.  Today, his stools had a reddish hue (though, there is quite of bit of that that's just obviously undigested carrots) and what may be the beginnings of a rash on his face.  Otherwise, no changes in his temperament -- he's still a happily mischievous little boy.  We made an appointment with the GI doctor and will find out tomorrow whether he's outgrown his MSPI.  My expectation is that he has not fully outgrown it, but it may have gotten quite a bit better.  I will update again.