I just don't know what to think anymore! UPDATED Jan10

[*Kara*]

So, DD has been on a milk based formula since birth... Nestle GoodStart.  Only thing different about it as a formula is that it is made with partially hydrolyzed whey proteins only.  No casein (like Enfamil/Similac etc).  It's not considered a HAF or other specialty formula.. Nestle just uses whey and likes to label it as having "comfort proteins"    Never had issues with eczema/reflux/spitting up etc.

I introduced cheese and yogurt as part of her weaning around 7/8 months of age... no issues at all with either.  She eats loads of both of these things still with no issues.

I tried to wean to cow's milk at 14 months... we got as far as half formula/half milk and we had screaming/short naps/NWing/and bad gas with pulling knees up to chest.. now that I look back, she started a mild reaction at about 75% formula/25% milk...

Have reattempted to transition to milk a few times since then with same results at same 50/50 mix level, though without a reaction before that level of 50/50.

Have tried coconut milk/almond milk/and now rice milk and she isn't really fussy on them.. .likes the rice the best for sure though.

I tried a combination coconut/almond milk and got a reaction just like cow's milk after a week or so of using it for smoothies etc.... checked the label for cross contamination and it did list soy.  I didn't even think to check that as I have never given her soy because of the whole phytoestrogen debate.  Unsure if it was the soy that caused the issue.

This kid has zero sensitivity to any hidden dairy/soy - I have never restricted it and never had a problem.

She is also fine with milk in cooking...

Could this be a lactose issue?  Her formula is not a low-lactose version so I am almost certain that isn't the case... or could this be a MPI/MSPI that she will outgrow at some point??  Or, could it just be a basic reaction to a new protein that she will adjust to if we push through for a couple of weeks?

So confused and don't know what to think anymore


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UPDATE Jan 10th.

So we have had naps that are 2 hrs each with no wakeups/faffing or anything of the sort.. just nice quiet and lovely sleep!  Nights have been the same with the exception of tonight - took ages to settle and was quite faffy for the first 30 mins after she did settle to sleep... there is some 2 yr molar movement though so it could be a bit of that... and a bit of OT (those same teeth are causing bubs to eat half of what she typically eats in a day so we wake up STARVING at 530/6am)...  makes for long days and OT to start a bit...

I just need some BW vibes that it isn't the milk, it's the teeth.

[Sam-n-Max's Mommy]

Hi Kara,

Not totally sure what is going on here, but my DS was very similar to your DD.  He did have reflux and we went through a few formulas before finding something that worked, but for us, Enfamil Gentlease was ok.  Introduced yogurt and cheese with zero problems.  Fine with milk in cooking.  Went to transition to cow's milk at 13 months and DS had the exact reaction your DD had.  Tried again at 15 months, same thing.  Doctor had us try Lactaid.  He didn't really have a reaction to that.  At age 2, for reasons other than digestive upset, DS's Developmental Pediatrician tested him for food intolerances (thinking is that food intolerances have something to do with certain delays etc, not relevant here).  Turns out DS has an intolerance to casein (as well as gluten and egg) and we had no idea.  In retrospect, maybe I didn't attribute some fussiness to the foods, but I guess I'll never know.  Anyway, we use almond milk here and DS does well on it (he went off of milk totally when we tried to transition from Lactaid to almond milk, but now really likes it).  I tried a soy drink with him (Silk Fruit and Protein) and we had issues, so I also suspect a soy intolerance. 

Your DD may adjust to the protein in time or may outgrow the intolerance if she has one.  I *think* the only way to know for sure is a blood test , but I don't know.  We were never looking for an intolerance in the first place, we just thought it was lactose that was a problem!!  I don't think my post is helpful, but I think my point is that sometimes there can be an intolerance even when they don't always have issues (like with yogurt, cheese, etc). 

(((Hugs))), it is very tough!

[ENMS]

From what I've read online, I don't think lactose would be the issue here. Although Good Start has sugars that are 70% lactose and 30% maltodextrin, it's not exactly low-lactose...

I think Nicole has a good point re: casein intolerance. Is there any way you could do a RAST test for her? Our GI seems to say that it is relatively reliable to detect MPI.

If you do decide to try milk again, would you be open to trying enzymes with it? It may help. I know enzymes are currently not very known / discussed but I've gotten to know them a lot more due to my DS and his intolerances, and I believe they can really help. Just a thought

http://www.livestrong.com/article/440795-digestive-enzymes-milk-protein-intolerance/

[*Kara*]

I think Nicole has a good point re: casein intolerance

I think this might be the issue too... I have found some things online that suggest many intolerant to casein can be fine with things like cheese/yogurt etc as the process of making these foods breaks the proteins down somewhat... same idea as the whole cooked milk deal I suppose!

I had to Google RAST   From what I can figure, that only detects an IgE +ve allergy??  So intolerance wouldn't show up??

DD has her 2 yr checkup tomorrow so I will have a chat with our moron doctor

[ENMS]

Ah you're right re: RAST, I got confused.

Good luck today

[Sam-n-Max's Mommy]

Kara, I will look back at my files and see what the test was that DS got.  He didn't get tested for allergies, just intolerances.  His Developmental Ped believes in intolerances, his Ped GI does not! He said he only believes in allergies, not intolerances.  I happen to disagree with him as I really don't beleive DS would test + for a casein allergy, but I know for a fact once we took it all out of his diet (along with the gluten and egg) that we saw a huge difference in his bowel movements (even though they were never seriously abnormal) and his eating habits (he became less picky!), not to mention the benefits we saw developmentally (focus and attention), but that is totally another story for another day

Good luck at the doctor.  I've been known to refer to mine as a moron as well, but not to his face

[Lolly]

Kara - have you compared the lactose with the regular formula. Our UK comfort formulas which are totally hydrolyzed whey protein based like yours are a LOT lower in lactose than the ordinary formula - I remember comparing when we switched and that's part of what makes them "easy digest". I've tried to find the details but so far have only got the lactose per 100g for one and the lactose for 100ml made up for the other so it's not comparable .

The Nestle Good Start info on their web site does say about it being lower lactose.

Laura

ETA - just found the info on a supermarket site! Aptamil first formula is 7g of lactose per 100ml and the Comfort/ Easy digest is 2.7g per 100 ml. The ingredients look the same as the Nestle at a quick glance so I would think the lactose is comparable.

[*Kara*]

Laura - you are my hero!!!  I was going to start looking for that info at nap time today!  I have found another site that has amazing info about lactose content in dairy and what can typically be tolerated even by those with lactose intolerance.. everything that she has had thus far in terms of dairy and quantity should be fine for someone with LI, so it might even be that!

Hmm, maybe I will rule it out and swap out some of her formula in her bottles for Lactose free milk (it's almost the same price as cow's milk is here).. we can't get full fat, but we do have 2% and she is over 2 years now so it should be fine...

Will go to the store later today and start swapping tonight...

[*Kara*]

Laura - where did you find info for the Nestle re: lactose content?  I can't find anything

[*Kara*]

I just found this bit of info on the Dr Sears website too...

I am really thinking this might be it...  If it was a protein issue, we would likely see a skin reaction (eczema/rash) or some form of respiratory reaction - none of that happens, it just gas and a red bum as described here...   huh.

http://www.askdrsears.com/topics/feeding-infants-toddlers/milk/lactose-intolerance

[ENMS]

Kara - lactose intolerance is exactly the same as what my DS has... except that for him, it's sucrose and isomaltose that's the issue instead of lactose. But really it all comes down to the same, it's sugars that can't be broken down so it should be similar symptoms to what I'm experiencing with M.   Gas, watery diarrhea, diaper rash.

I also tried to search for lactose content and couldn't find it. But, Good start regular formula has 57gr of carbs per 100g of powder, and 7.5g of carbs per 100ml. I read that 70% of the sugar is lactose and 30% is maltodextrin. So I'd therefore assume that there is 40gr of lactose per 100g of powder and 5,25 gr per 100 ml. Does that make sense?

For the lactose content of other dairy, this site has limited info, but it's definitely reliable. I'm sure there are better and more complete websites with information.

http://www.csidinfo.com/dairy.htm

[*Kara*]

I also tried to search for lactose content and couldn't find it. But, Good start regular formula has 57gr of carbs per 100g of powder, and 7.5g of carbs per 100ml. I read that 70% of the sugar is lactose and 30% is maltodextrin. So I'd therefore assume that there is 40gr of lactose per 100g of powder and 5,25 gr per 100 ml. Does that make sense?

That does make sense  

We don't have diarrhea at all - though never have.  We often have things go the other way in that department (think back to ER visits at 8 months and a Rx for MiraLax - good times!).  All of that brought on a lovely leaky gut that reacted horrendously to wheat/gluten... thankfully a 6 week elimination was enough to heal from that and all was good again with grains...


I bought 1L of a lactose free milk (Natrel) so we will see how she does... I mixed it tonight (cause I like to punish myself!)... 5 ozs formula and 2.5 ozs of the new milk in her bedtime bottle.... it's only been just over an hour... but no sign of trouble yet.

[Lolly]

I couldn't find the lactose content of the nestle - only the UK's comfort formulas so I compared our non comfort and comfort to see the lactose difference. The ingredients of the nestle good start and the UK comfort looked the same and the description of what it's good for is very similar (hydrolised whey proteins, no casein etc) so I am *assuming* the lactose levels are similar.

Good luck with the new milk!

Laura

[ENMS]

Hope it went well!

[*Kara*]

I couldn't find the lactose content of the nestle - only the UK's comfort formulas so I compared our non comfort and comfort to see the lactose difference. The ingredients of the nestle good start and the UK comfort looked the same and the description of what it's good for is very similar (hydrolised whey proteins, no casein etc) so I am *assuming* the lactose levels are similar.

Elise figured it out!  It's 70% lactose... so given the grams of carbs, we got it to be just over 5g of lactose per 100 mls... not at low as UK comfort milks but it's 30% less than standard formula here!

I got an EW this morning at 530am after an 8pm BT but someone didn't eat dinner last night   I kept the monitor on all night and she never made a peep!  So, I have upped her to 4 ozs LF milk and 4 ozs formula for her nap bottle (she isn't really eating much with 2 yr molars bugging her...).  It's been half an hour so we will see if she transitions okay during her nap today... that was always when she woke screaming with cow's milk.

If this doesn't work, I might try Enfamil Gentlease... 1/5 of the lactose of regular formula (so that won't bother her if 70% lactose isn't) but it does have casein protein in it... that would prove it is casein that causes the issues...

First though, we explore this lactose idea!