urban pacifier – Could Your Baby’s Gas Really Be Milk Protein Intolerance?

I am a look before you leap kind of girl. I don’t make major, life-changing decisions without carefully weighing all the options and having a firm game plan in place. I’ve been known to make a pros and cons list before deciding where to eat for dinner. So when I discovered I was pregnant, I threw myself into the most comprehensive research mode of my life. I surveyed anyone I knew who had recently given birth – family, friends, acquaintances, even the occasional random stranger on the street. I made spreadsheets ranking product recommendations and completed an exhaustive baby registry. I bought at least one of everything I had deemed a necessity. Among many other things, I had a top-of-the-line co-sleeper bassinet, and an expensive breast pump, and a subscription to a cloth diaper service. I had eating, sleeping, and pooping – the holy trifecta of life with a newborn – all under control. I was prepared.

Well. I thought I was prepared at least.

Obviously nothing really went as expected, because if there’s one thing you can count on with babies, it’s that you can’t count on them to meet your expectations. But the issue I had a major problem with was feeding. Eisley was born full term, but on the small side – 5 pounds, 10 ounces – thanks to some very minor pregnancy conditions like my hyperemesis and her two-vessel umbilical cord. Because of her small size, I felt an inordinate amount of pressure to help her gain weight as quickly as possible. This pressure was amplified by seemingly everyone, from the delivery nurse who said, “She’s awfully small isn’t she? Such a peanut.” before I had even laid eyes on her, to strangers at the grocery store who constantly underestimated her age.

Though we struggled with getting her to latch for a good twelve hours after birth, I was finally able to successfully establish nursing with the help of the dedicated staff at Sarasota Memorial Hospital. Soon Eisley was nursing like a champ. But unlike other newborns I saw, like my sister’s son Wyatt, who had been born just six weeks earlier, Eisley didn’t seem to find eating soothing. She would nurse sometimes for as many as two hours, until I was sore and aching, but once she would stop, she would cry. I produced copious amounts of milk, and her belly seemed full and distended, but still ceaselessly fussed. I walked her around for hours and searched the internet on my phone for solutions. I posited silent reflux, which my pediatrician concurred made sense. We tried several medications, with only moderate success. I also speculated about a foremilk-hindmilk imbalance thanks to my bounteous supply of milk, but my pediatrician could only shrug. Finally, I decided that even though the last thing I wanted to do was venture out in public with a squalling, miserable baby on my hands, I needed to enlist the help of a professional.

I finally ventured out one Friday morning to a free breastfeeding support group I had heard about. There were moms there with children ranging from newborns to toddlers. Eisley was about six weeks old at this point and still had not reached the seven pound mark. She and I settled against the wall, and within minutes she was wailing.  I soothed her with some nursing, but every time we stopped, the screaming started up again. I got up and walked her around the room, resisting the urge to flee. Most of the other moms shot me sympathetic glances. I didn’t feel judged. But I still felt like I was lacking.

After the official meeting had disbanded, the leader approached me and asked if I had any specific troubles I needed to address. I let it all spill it out. My baby barely slept more than an hour at a stretch, she seemed miserable and in pain, I was exhausted, she was exhausted, I nursed nonstop and then pumped to rid myself of excess foremilk and I just needed a break. She nodded along sympathetically, and then asked, “How much dairy do you consume?”

I took a moment to review a typical day for me. After an entire pregnancy of being able to tolerate very few foods, I was finally able to indulge in some of my favorite treats again, like pastries and frothy decaf coffee drinks and cheese. I responded in kind, and the leader said, “Take a two-week dairy detox. I will be very surprised if you don’t have a different baby at the end of it.”

This was easier said than done. It was around the holidays, and I was surrounded by cookies and cheesy casseroles and eggnog at every turn. But I kept to a strict dairy-free diet, and soon, my little girl seemed to be on the mend. Her persistent gassiness had eased. She was sleeping for longer and longer stretches. And though she still screamed like a banshee sometimes, the frequency and length of her howling spells diminished. Best of all, she seemed like a happier baby, and I was a much happier mom as a result. But with the happiness came a sense of extreme frustration. I couldn’t believe it had taken so long to find a solution for my problem when I had been at my pediatrician’s office weekly. He’s a great doctor, but never once had he suggested that something in my diet might be causing her discomfort. He kept assuring me that “all babies are gassy and fussy” in an effort to soothe my first-time-mom nerves. I soon learned that this isn’t an uncommon response. I talked to dozens of parents who had faced similar brush-offs from their otherwise terrific doctors. If I had known that earlier I would have advocated harder for him to examine a stool sample, which can be done right in the office.

Over the next few months I also learned that whatever I ate had a definite effect on my baby. If I so much as consumed a granola bar made in a factory that also produced milk products, we would have an unhappy next 48 hours or so. Between nursing and my extremely limited diet I dropped forty pounds in a matter of weeks. Unfortunately, though my dairy-free diet was helping my baby feel less miserable, my limited caloric intake was causing another problem. Though she had gained some weight, Eisley didn’t reach the ten pound mark until she was four months old, and a month after that she had actually dropped a pound. My pediatrician gently urged me to think about starting to supplement with formula. I resisted until he showed me a weight chart for breastfed babies, and I realized my daughter wasn’t even at the third percentile. Then I realized that while I am a major proponent of breastfeeding in general, I also ascribe to the tenet that it works best when it’s what both the mother and the child need. My child needed more than I could give her on my own.

I got lucky: the first hypoallergenic formula I found worked really well. I began putting just a few ounces of Nutramigen in a bottle, and letting her pull off the breast and finish with that. A few weeks later, she began to bypass the breast entirely, just reaching for the bottle. I began to thaw the rest of my frozen breast milk stores and give her at least one a day. The day Eisley turned six months old I used my last bag, and she ceased to be a breastfed baby entirely. We soon began the introduction to solids, and boy was that a challenge. Finding dairy-free toddler food that is tasty and wholesome is a tall order in a family full of cheese-lovers. I soon turned to vegan recipes in order to cook dishes that had complex flavor, instead of just trying to use weirdly complicated dairy substitutes. The vegan cupcakes I made for her first birthday remain among the best baked goods I have ever eaten.

It’s been almost a year now since we made that final formula switch. Eisley is just shy of sixteen months old now, and she is a bustling toddler. The days where she cried nonstop are long past us – now, she fusses if she’s tired or hungry, but stops immediately when her needs are met. At her last month, she had finally hit the fiftieth percentile for weight and the ninetieth for height. And, in a major milestone, in the last month we have finally gotten her weaned off the formula and onto actual honest-to-goodness cow’s milk. We had tried to reintroduce dairy a few times before, only to be met with gassiness and shrieking. But now, it seems that just like our doctor and lactation counselor advised us, Eisley has outgrown her milk protein insensitivity.

If your baby has exhibited any of the following signs or symptoms:

–        Vomiting or frequent spitting up

–        Bloated stomach

–        Gas

–        Diarrhea

–        Blood in stools

–        Green stool

–        Mucus in the stool

–        Eczema

–        Excessive crying and irritability (particularly after feedings)

–        Difficulty gaining weight

She may be suffering from milk protein intolerance. If you’re nursing, experiment with cutting all dairy from your life for 2-3 weeks: that should be enough time to get any lingering traces out of your system. If you formula feed, look for an alternative hypoallergenic formula. Many babies with milk protein sensitivities also respond poorly to soy, so look instead for a hydrolysate formula. These formulas contain milk proteins that have already been partially broken down, so they are easier for babies with tender systems to handle. Different formulas work best for different babies, so you may need to try a few before you find what works best for you. Here are some you may consider trying:

–        Elecare for Infants

–        Enfamil Nutramigen

–        Similac Expert Care Alimentum

–        Similac Sensitive

These formulas can be expensive: you’ll get sticker shock no matter whether you’re transitioning from breastfeeding or a different type of formula. However, you may be eligible for help. If you work closely with your pediatrician to document your little one’s illness, your health insurance may be able to help you shoulder the burden of the cost. Blood in the stool is the number one sign or symptom of a dairy allergy or insensitivity, so it’s especially important to ensure your pediatrician documents that in your baby’s records.

It may feel lonely dealing with this issue, but you are not on your own. About 1 in 50 babies suffer from some form of dairy sensitivity and this is number is on the rise, though it’s unknown whether an increased number of children is suffering, or whether we are just getting better at diagnosing the issue. Regardless, it can be extremely disheartening to realize that whatever you’ve fed your baby, whether it’s a milk-based formula or breast milk containing dairy from your diet, has contributed to her illness. And while many breastfeeding moms are able to trim the dairy from the diets and ease their child’s discomfort, especially sensitive children may need to switch to a hypoallergenic formula in order to ensure their nutritional needs are met. It can be extremely disappointing for a mother to have to end a breastfeeding relationship earlier than planned but there is no shame in doing whatever’s best for your baby.

Somehow, in all my research, I missed out on learning about the common affliction that is milk protein intolerance. Maybe I stumbled upon it at some point, but dismissed it as being too simple an ailment for whatever was making my kid so miserable. Whatever the case, I’m glad I figured it out relatively early in my daughter’s life. Two months is a long time for a baby to be miserable and gassy and a mom to be exhausted and frustrated, but I’ve known parents who have dealt with the same issue for much longer. I just hope that by sharing my story, I can save other parents and babies weeks or months of unhappiness, when a simple dietary switch might make all the difference in the world.

Kate Wight is a freelance writer and work-at-home mom. You can read more of her work at the Bob Brown Art blog or in Edible Sarasota magazine.