How to get my 16 week old to transition to Nutramigen or Alimentum

[evygayle]

Hello....please help. Has anyone ever have any advice to give me as to how to get my 4 mo old to transition to Nutramigen. He has been breastfed for the past 4 months but my milk supply is very low and he has actually lost weight since his 3 mo check. He will take milk based or soy formulas easily but is not taking to either Nutramigen or Alimentum well. I am worried about his weight so any advice would be well taken. I just tried to mix it with the regular formula but he just played with the nipple making faces.

Thank you!

[Jimbob]

How much regular formula did you mix it with? When we were weaning my son to neocate at 11 months we had to take it slowly. We started by mixing 1 oz of neocate with 7 oz of regular formula. We slowly increased the neocate until we were on just neocate.

Kelly

[jennyh]

hi .the only way i could get my 2 lo`s to take this kind of formula was to feed them when they were asleep tbh.i dont know about the 2 formulas you are using but i know the pepti junior we use is the most horrid smelling and tasting thing i have come across.it will take time for your lo to get used to the taste so i would persevere though.good luck.

[donna_issabella]

With Henry, he was 3.5 months when we went cold turkey from breast milk to Nutramigen. By this time though he had been on bottles with expressed BM for 10 weeks, so we did not have to contend with bottle problems.

I would go half and half - if you are able to express enough!! And just wean that way. It is tough, because I found the weeks I stressed, my supply dipped ALOT as well. Also, do try to continue excluding milk from your diet until he is 100% on the formula.

HUGS and GOOD LUCK!!
DI

[evygayle]

Thank you everyone!

Luckily my LO will take from a bottle. I will go slowly. I didn't have BM expressed today and the NP told me that I could use the Prosobee and go 1/2 and 1/2 or start even slower (with 1oz Nutramigen to 5 or so ounces of Prosobee)....I tried the 1/2 and 1/2 and no go. So I will go even slower and work on pumping tonite.

:)Wish me luck and thanks again.

[Mydreamcametrue]

Why is he having to go on Nutramigen/Alimentum in the first place?  Do they think he has an allergy or intolerance to milk/soy? 

If anyway at possible you could pump, then I would and do a slow transition.  Like the PP said though, If you do pump I would not do any dairy or soy products.  There is a lot of info here about MSPI diets and the ingredients to avoid.

Also what bottles are you using and stage nipple?  This could be playing a factor. 

You could also try the Ready to Feed Alimentum or Nutramigen, which ever you are using.  They don't smell nearly as bad.  The Alimentum seems thicker also, good for reflux babies.

I hope this helps and good luck.
Wendy

[evygayle]

Thank you Wendy....I will try the RTF kind....I had to switch him to either Nutramigen/Alimentum mainly because of the stomach pains he was having, really bad gas pains, crying a lot during the day and much of the night. Now I think he has been hungry since his weight check was lower than the last one....it was so distressing, I just cried in the office. She is not so sure he has a milk/soy intolerance but wanted to see if the Nutramigen would help the gas he's having. It's all so confusing to really know!!!!

What signs are the main signs if your baby has a MSI?? He has no diarrhea, occasional vomiting (they think he has silent reflux), no rash or ezcema...so I'm not sure.

[Mydreamcametrue]

Hi there.  Well lets see my first son now 2 1/2 screamed and cried all day and night pretty much from day one.  At 6 weeks they told us to try Nutramigen and he was like a new kid.  He still did have silent reflux though.
When he became 1 years old we tried milk and well that is another story.  He ended up on Rice milk for a while.

Even if your little is not MSPI, the milk or soy protein could be causing his reflux. 

My new baby, now 6 months was the same as yours.  He cried and grunted and strained was just so uncomfortable.  He had so much gas.  we ended having to go on an Amino Acid based formula.  Now we are on RTF Alimentum.  We did try a regular milk based formula and according to his "poop" he seemed fine, but he was still really fussy and seemed like his reflux was worst. 

The signs of MSPI are constipation, diaherra, mucus in poop, etc.  But reflux can also be a sign.  The reflux can be caused by the milk/soy protein intolerance.

You are deft. headed in the right direction. 

Which RTF are you going to try?  They are more expensive, but so worth it. 

The main difference in the Ready to Feed Nutramigen and Alimentum are:

Nutramigen: The carbohydrate is corn syrup solilds and the oils are different.

Alimentum:  The carbohydrate is sucrose (which is table sugar) and different oils are used.  Also the Alimentum has  medium chain triglycerides.
MCTs passively diffuse from the GI tract to the portal system (longer fatty acids are absorbed into the lymphatic system) without requirement for modification like long chain fatty acids or very long chain fatty acids do. In addition MCTs do not require bile salts for digestion. Patients who have malnutrition or malabsorption syndromes are treated with MCTs because they do not require energy for absorption, utilization, or storage. Rich sources of MCTs include coconut oil and palm kernel oils and are also found in camphor tree drupes. The fatty acids found in MCTs are called medium chain fatty a

Also Alimentum is the only corn free formula.

Now if you do try the RTF Alimentum and for some reason he starts to have diaherra or more gas, then I go to Nutramigen RTF:
The only reason I say that about the Alimentum is because of the sucrose in the RTF.  My son had more gas with the Alimentum when he was just a few weeks old, but now at 6 months handles this formula great!

Sucrose intolerance, also called Congenital Sucrase-Isomaltase Deficiency (CSID) or Sucrase-isomaltase deficiency , is the condition in which sucrase, an enzyme needed for proper metabolization of sucrose, is not produced in the small intestine. The result of consuming sucrose is excess gas production and often diarrhea and malabsorption.

I did not mean to confuse you in anyway, I just wanted you to have all the information I am familiar with. 

Good Luck and please let us know how he takes to the RTF.

Wendy

[evygayle]

Hi Wendy,

I totally do appreciate all the knowledge I can get. My head is spinning today with one large headache...I did not try the RTF yet but I will tonite. My doctor's office gave me the RTF Nutramigen sample so I'll try that. Today he went on a big strike, I'm thinking b/c I tried the Nutramigen and Alimentum yesterday (or was it the day before - it's getting blurry) I even pumped 5 oz and added just 1 oz of Nutramigen to it. He finally took that yesterday but has been striking today. Cries and cries when I nurse or give a bottle. It's so upsetting. I was to the point that even if he took anything at all, I'd be happy (until the gas monster at 2am).....it's funny but the gas mainly starts at 2am each morning for an hour or two. Why is that I wonder?? I tried nursing today, the old Prosobee formula mixed with the small amt of Nutramigen, the Prosobee by itself.....I even thought of trying the Good Start formula since I heard it is sweeter although I know nothing about it and it's milk based. But thanks to you I will try the RTF. Should I try it with just an ounce or so mixed with maybe BM?? I'm so tired, sorry if I repeat myself.

Thanks again!!! You've certainly had your hands full! Ryan's weight check is in 2 days. They will be sending him to the GI if it stays low or dips lower.

:)Evin

[Mydreamcametrue]

Is he on meds for reflux? 

The gas at 2:00a:m, the same thing happened to us.  He was gassy all day, but at night it was the worse.  He would not sleep at all and grunted and grunted to get the gas out.  Gosh, it was really bad. 

I do know gas and reflux all can go hand and hand.  If you do have to go to a GI doctor, make sure YOUR doctor calls and gets you in sooner.  If not, more than likely you will be on a waiting list for months.

Good Start formula works for a lot of little ones.  Here is what I know about it:  The protein is 100% whey protein.  Other milk based formulas are whey and casein.  Whey protein is supposed to be much easier digested.  Also Good Start breaks down the proteins into smaller pieces to digest easier.
Personally I did not have luck with either of my child.

Have you tried Enfamil Gentlease??  It comes only in a powder.  It is milk based, but the proteins are partially broken down and only has 1/4% of lactose.  It is designed for gassy/fussy babies.

Personally if it was me and he is still refusing the RTF Nutramigen, then I would try Enfamil Gentlease.  Tyler was on an Amino Acid formula and then we were able to go right to  Enfamil Gentlease.  I have switched him Alimentum RTF though, just because his reflux was getting worse and he was fussy.  I will have to say he was less gassier with the Gentlease though, but seems less fussier now.

I know it is hard and confusing.  I never knew any of this before my first child was born.  I just thought you had a baby, breastfeed or formula feed regular formula, they eat, sleep, poop and that was it.  NOPE....

[taygensmom]

Can I jump in and ask which of those formulas can be used for a baby with both milk and soy allergies?? My friend is looking for a formula that will work...

[evygayle]

Thanks Wendy,

I feel addicted to checking this website for help and it is a relief to have support from someone who understands..... I just set up my GI appt.  Hopefully I can figure out something on my own before then. Ryan is on Prilosec....he's been on it for over a month. Not sure if it is actually reflux. I was reading another post and read about dysphagia. We'll see. Maybe he's just a gassy baby and doesn't like to eat very much. I'm hoping for a good weight tomorrow. He did take the Good Start 4 oz this morning without trouble and nursed during the night with no problem. If he's not ready though (at times when I'm imagining he would be starving), he sputters, cries, turns his head. I really want to try the RTF Nutramigen but I'm afraid he'll go on strike again for a day if he doesn't like it and then won't take anything....I also wonder if he nurses a lot during the night, he may hold out during the day (although he won't nurse great during the day either).

Weird thing....remember I mentioned that my LO is gassy really badly every am?? Well, at 2am, he woke up (he'd been waking hourly but didn't always want to eat)...I laid him in bed with me (I could barely close my eyes though) and he slept peacefully til I woke him at 7:30am when I got up. Not a stir, not a gas pain, nothing.....it's not the first time either.

Weight check tomorrow! Thanks again.

[evygayle]

Hi Taygensmom, I'll let Wendy or someone else answer you but I believe both are ok if I am right. They are both for hypoallergenic. Wendy and the other moderators have a lot more answers though.

Wendy, one more thing, I did try Gentlease but didn't give it much of a go. I had given 3 bottles of it one day and he was really gassy but it could have been a fluke. So I then had switched to soy. If GS isn't working, I'll try it again before really pushing the switch to Nutramigen/Alimentum.

[Jimbob]

It depends how sensitive her lo is. Some children do fine with hydrolysed formulas like nutramigen and alimentum wherethe milk protein is extensively broken down. Some children still react to these and need an amino acid based formula like neocate or elecare. My son can't tolerate the hydrolysed formulas but does great with neocate.

Kelly

[Jimbob]

I forgot to mention that all these formulas smell and taste terrible so you tend to have to wean them onto these formulas.

Kelly

[taygensmom]

So the first formulas are still milk based right, just broken down? Is the neocate milk based?

[Jimbob]

No neocate is not milk based.

Kelly

[Mydreamcametrue]

Just to add, most kids with a milk and soy allergy can handle Nutramigen or Alimentum just fine.  Personally I would do Nutramigen.  It does smell really bad and as you can see some babies have a hard time taking it.

Like Kelly said, some still cannot tolerate that little bit of milk, even though it is so broken down to not cause an allergic reaction.  If that is the case, Neocate and Elecare is the last option.  You cannot buy these formula's in the store.  You can go to the Website or Ebay and order them or you can get your local phramacy to place an order, but it is $50.00 for 1 small can that way.  To be honest, I found Neocate and Elecare not to smell nearly as bad as the Nutramigen. 

evygayle:  When is your GI appt?  Just to warn you, not sure if your GI doctor will be like mine, but when we took my 6 month old (he was 2 months at the time).  They bascially said "Look, you have switched formula's way to much and often, you need to stick to one formula for a full 2 weeks and see what happens".

Yeah easy for them to say when your baby is screaming and crying all day and night.  As parents we just want a solution.  But, I would really try to decide which formula you want to try and stick with it. 

If it was me I would 1 of 3 things:
1.) Breastfeed only (unless your supply is really low) and cut our ALL milk and soy ingredients (even hidden).  There are some great info. on here about which ingredients to avoid).

2.) Is it possible to pump your milk (not give it to him) and freeze, so you have it for the future and you can keep up your supply with pumping

and then

3.) Keep trying the hypo-allergnic formula or stick with the Good Start and see.  I have read tons of babies that just had gassy and fussiness and reflux did respond well to the Good Start.

My first son refused Nutramigen the first time we gave it to him and I gave up, but then did not have a choice but to keep trying and finally after a few attempts he did take to it.

Good Luck....  Keep us posted. Wendy

[evygayle]

Thanks Wendy...I hadn't logged on for a couple days and you answered my question already!!! I have been really trying to just nurse Ryan and supplement if I need to. His gas has been at an all high- it's so sad- he sounds like a little hollow chamber with bubbles inside and then screams when the gas finally comes out too....funny you mentioned the switching formulas b/c I was worried a lot about that too. I told the doc (regular peds) that I was on the GS and she said 'great' but then offered me Gentlease to try. Huh?? So I thought of trying it and I did for two small bottles and he screamed all night. So now I'm sticking with the GS for at least 2 more weeks (mostly BF).....He hasn't gained weight so I'm afraid to try the Nutramigen right yet until I know the GS is not working and leaving him extra gassy. If so, I'm going to stop the supplements of GS and cut out my milk/soy and try to pump, weaning Nutramigen in. Does that sound allright to you? I don't mind pumping but sometimes it is hard with the other two children when I'm always with the baby and pumping when I'm not holding or with him. It's a balancing act. I never knew eating could be such an issue (of course, until the toddler years!)

:)Evin

[Mydreamcametrue]

Gosh poor thing.  I really feel for you.  Tyler (my 6 month old) was just like that the first 3 months.  It was awful.  We actually spent 1 night in the hospital because of it.  He was in so much pain.

We ended up on Elecare, the amino acid based formula and within a month he was doing so much better.

Now, I don't know if it was just something he grew out of or 1 thing that the GI doctors realized with him was that he had a tight anus. 

It is called anal stenosis.  He was having a hard time getting even soft liquid poop out and all his gas was backing up and causing pain.

So, I had to do anal stretches 2 times a day to stretch his butt.   

Yeah, trust me no fun, but it does not cause them any pain, just relief.  You would not believe the gas he would let out.

All I did was get a rubber glove, put KY Jelly on my pinky finger, insert it just to the knuckel and move it side to side. 

Before that I would use a Q-tip and just insert it a tiny bit and he would blow out so much gas.

Not telling you to do this, but that was our problem.

Does he seem constipated any?

If the GS does not seem to help, I would cut out all dairy in my diet and really try hard to get him to take Alimentum or Nutramigen.

Sorry you have to go through this.  I know it is hard with other kids.