You should check that your doctor approves of the measures suggested here, and not make any substantial changes to the child’s diet, or your own (if breastfeeding), without medical supervision.
Bottle-fed babies
If your baby is being fed with cow’s milk or cow’s-milk formula feed, and you suspect that this may be the cause of the symptoms, then ask the doctor to prescribe a ‘milk-free’ formula. These are of three types: soya-based formula, such as Wysoy, Formula S, Prosobee or Isomil, comminuted chicken formula such as Chix, and hydrolysed formula or hydrolysate, such as Pregestimil or Nutramigen. The hydrolysates are made up of cow’s milk, cornstarch and other foods, but treated with digestive enzymes so that the milk proteins are partially broken down. This makes them a great deal less allergenic, although they still cause problems in some children who are highly sensitive to cow’s milk.
Do not expect instant results, especially if the baby has diarrhoea or colic -it may take up to two weeks for the baby’s digestive system to return to normal. If there is no improvement, discuss the situation with the doctor, and consider trying another type of ‘milk-free’ formula – it may be that one works for your baby while another does not.
In general, there is evidence that children who have developed a sensitivity7 to cow’s milk may become sensitive to soya proteins as well, if they consume them in large quantities. For a young baby who has several more months of formula to come, the hydrolysates are probably a better choice than soya formulas, therefore.
Should the baby recover on one of these alternative formulas, then cow’s milk formula should be tested about a month later, to see what effect it has. It may be that the switch to an alternative formula happened to coincide with a spontaneous recovery. Or the sensitivity to cow’s-milk could have cleared up thanks to a month of avoidance. Either way, the baby can now return to cow’s milk formula.
For babies who seem to react badly to all the different formula feeds, the possibility of some other cause, such as an infection, should be reconsidered. If all such causes have been ruled out, and there is strong evidence for food sensitivity being at the root of the problem, then breast milk is the best solution. Enquire about the possibility of donated breast milk from a milk bank -you may be fortunate enough to live in an area where such a bank has been established. Alternatively there is relactation – returning to breast-feeding. This is not possible for everyone, and it is not something to be undertaken lightly, but it may be the only answer for some babies. Help can be obtained from breast-feeding advisory groups. Mothers who choose this course of action should not drink cow’s milk themselves, nor should they eat butter, cheese, yoghurt or soya.
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