Cow's milk causing constipation - best alternatives?

[trimbler]

Hi there,

DD has a history of watery green stools from birth, getting her reflux and tongue tie under control, together with block feeding due to oversupply, seemed to pretty much sort this out, but she was slow to get going with solids due to discomfort on first introduction. She seemed to react to yoghurt and grains with constipation initially, so we pulled back on grains and dairy (except for rice, which she seemed ok with, strangely!) for a while and reintroduced them gradually. She seems fine with cheese, yoghurt, milk based processed/cooked foods eg custard and cheese sauces, and grains now, except that we're still cautious about giving her lots of wheat or milk products in one day as this still seems to make her a bit uncomfortable. My gut feeling is that she had some gut irritation early on (I also had abx in labour and wondered if that didn't help things??) and it's just taking a little longer for her gut to mature? I've never felt the need to go on an elimination diet myself as the above measures seemed to sort her out.

So right now, she's eating solids really well, has a breastfeed on waking in the morning and at BT, also after her morning nap on the four days a week when I'm home. I had been pumping to give the CM breastmilk for mid-morning until last week, when I was struggling to keep up with demand and decided that it was time to replace that feed with a different milk, since I could no longer pump enough for those feeds, together with any BT feeds I have to miss (1-2 per week). So the CM gave her cow's milk last Wed+Thu, she screamed a lot during Wednesday night and starting producing small, hard pellet stools

So I'm thinking about substitutes... I know there are so many on the market so not quite sure where to start or how long to give each one - or whether it's more likely to be the lactose or the protein that she's reacting to?? I bought some lacto-free cow's milk as we've had a friend of DS's for breakfast a couple of times who's lactose free, he decided he wanted toast instead so we still have it and I'm thinking I'll send that with her to the CM tomorrow. I also bought some a2 milk as I was intrigued and it seems to last a little longer so I could try that next maybe if she's still bad with the lacto-free milk. She's still producing hard stools today though, so not sure how long to leave it before trying something new so that I know what to attribute to the new milk, and what to attribute to the effects of the cow's milk she had last week? She's still been having some boiled cow's milk on her breakfast cereal, although she doesn't eat very much, preferring her toast and marmite. Should I perhaps stop giving that? Unfortunately I can't produce enough breast milk for the CM especially as I'll have to miss BT three times this week and want to prioritise that

TIA

[MasynSpencerElliotte]

I would skip the lactose free milk - if it is MPI (which is way more likely than lactose intolerance at this age) then that milk will be just the same as regular milk. With the hard stools I would be tempted to cut back or eliminate dairy for a bit until it settles out. I have no idea what A2 milk is? When DD2 was small (she had MPI and got horribly constipated, was dairy free until she was 5) we were told by our health nurse to use formula until age 2 instead of any milk alternative - but in saying that we used soy milk and made sure to make up the lack of fats she would have gotten from whole milk in other ways.

[Hedgehog17]

There are many milk alternatives out there, so it's worth trying all of them (except for rice - it's not suitable for young children!).

In terms of treating constipation, is she taking a good probiotic daily? That can help  Also any sort of pure fruit juice is good (DS likes peach) so a cup of that per day will ease things  Is she drinking water during the day? I have to encourage DS to do this otherwise he gets constipated very quickly 

It's worth a trial of the lactofree and the A2 to see if it is either the lactose or the A1 protein causing problems, so I'd do that first, then try soya, oat, almond etc if she's still not right 

[trimbler]

Ooh thanks you two we did put her on 30 days probiotics a while ago, no idea if it helped but maybe it did... She's been fine with the dairy she's had really until last week with the straight cow's milk and I know that for some things the cooking or processing used for yoghurt/cheese can change it enough that they don't react to it but I can't remember whether that's the lactose or the protein or both! With my lack of knowledge of chemistry I'd suspect it would be the protein as the milk products would still contain lactose?? Or is that denatured in some way too? Perhaps we'll try the a2 milk first (Heidi - I think it's fairly new here, apparently the a1 protein in cow's milk is that one that tends to cause problems, so a2 milk just has that taken out and only contains the a2 protein) and go from there... She does like to drink a lot of water during the day (unlike DS!) and I mostly give her p fruits rather than apples/bananas but will continue to work on diet. Can't decide if I want to start on fruit juice just yet, given DS's addiction to it and refusal to drink anything else

[ENMS]

Hi there, she sounds a lot like my friend's kids. They do ok with dairy in general but get constipated from milk. They drink goat milk and do absolutely fine with it so just another idea for you!

[trimbler]

Ooh thanks Elise, that does sound like it's the cow's milk protein, doesn't it! Well, we've had some softer stools again today, don't think she's quite had the big clear out she needs, perhaps she's saving that for the CM tomorrow A2 milk for next week then, will let you know how it goes, thanks for holding my hand

[MasynSpencerElliotte]

Interesting about A2 milk! Kind of wish we had that here...DD3 had formula until she was 2 as soy didn't sit well with her either. She still doesn't really like milk but gets her dairy through cheese and yogurt.

[Healthyme15]

I will recommend to your baby to try this Digestic from Mimonis. This is very effective for constipation problems. It is safe for babies also as it is purely organic. 

[trimbler]

Ok so I *think* that a2 milk has made an amazing difference no screaming, straining or pellet stools, just soft ones, can't say completely normal looking but I think that has more to do with her teething than the milk Just not sure how easy it'll be to find when we're away visiting relatives over Christmas, but I can always bf then. DH did the shopping last night though and came back with loads of semi skimmed a2 milk so now have to decide whether to make an extra trip tomorrow to get some whole a2 milk or just send her to the CM with semi skimmed...not sure she'll like it so much! Oh btw I was wrong about the a2 milk having a1 protein removed - it's just taken from cows which only produce a2 in their milk so it's naturally free from a1

Anyway, thanks all

[Hedgehog17]

Really glad the A2 has made a difference 

You can get whole A2 in Tesco and Waitrose (larger stores) - we usually stock up there!

[trimbler]

And Morrisons and presumably Sainsburys (where DH went), glad it has a long shelf life, or perhaps that should be fridge life, you know what I mean Apparently there was a pellet stool tonight but she hasn't had milk other than mine this weekend so perhaps unrelated?? Anyway if I go quiet now, all is resolved but if not I'll probably be back