Posted By Posting
May 17, 2011
chicagotom
How Can I Differentiate Between Reflux and Food Allergies
Good morning. Unfortunately I have some experience in dealing with acid reflux and food allergies as my now 2.5 year old son had it from the day he was born until about a year ago. My wife and I welcomed his little sister into the world last month. While at first she did not show the signs of reflux or food allergies, she is showing them now.....particularly the reflux. She seems to have a pretty severe case of it. Anyways, my question is this.....while I know she has reflux, I often times think I am not catching the signs of a food allergy as well. What are the differences in symptoms between the reflux and the food allergy? Any info you can pass along would be greatly appreciated. Thanks Tom
May 17, 2011
shelefisher
Michelle
Noah 6 years
Paige almost 4 (GERD graduate!)
Soren 11 weeks - (GERD, Soy and Dairy sensitive) 15mg prevacid + 2mg zantac
I'm assuming your wife is breastfeeding? A lot of reflux babies are dairy and soy sensitive which is different than a food allergy. My daughter was and now my son is so I am on a dairy free - soy free diet which made a big difference once it was out of my system (about two weeks). It's difficult at first but definitely gets easier and I'm a vegetarian who basically lived on dairy so being able to say it gets easier is huge :) With true food allergies you will see things like blood in the stool, rashes, and other symptoms in addition to the reflux. I had my daughter tested around 18 months for food allergies just in case but I felt pretty confident it was just a strong sensitivity. At 4 now she has grown out if it. For us - without the dairy free/soy free diet the medicine helped a bit but sleep was still a huge nightmare both day and night. About 2 weeks after I eliminated all dairy (it's hidden in a lot of things) and we were on prevacid for a while things got a lot better.
May 17, 2011
chicagotom
Thanks Shelefisher. I appreciate it. My wife is nursing my little girl and while she has changed her diet, she has not made all of the changes that are needed to have "safe" milk. My son was "allergic" to the protein in milk and soy. It was not until my wife changed her diet and we switched formulas to Nutramigen AA that things got better. For babies that are sensitive to the dairy and soy, is there any other less expensive formula than the Nutramigen AA? Is there anything you can buy in a store that can do the trick? While my wife is nursing right now, we are also supplementing with Nutramigen Lipil formula. I am not sure it is doing the trick, but then again, my daughter is only 4 weeks old. I know this is a process that takes some time, but I want to do anything I can to help my daughter out. It is tough watching her cry and watching how it effects all of us.
May 17, 2011
dcd
Sorry to hear about your baby girl. I'll second what Michelle said - many reflux babies are also sensitive to dairy/soy. My daughter is not "allergic" to dairy, but her intolerance is so severe she has to be on Neocate (Neocate and Elecare are elemental formulas like Nutramigen AA). At 15 months, she still hasn't outgrown her intolerance (just failed another milk trial a couple weeks ago), so we check all labels and are careful to keep it out of her diet.

The symptoms of reflux and milk protein intolerance mimick each other. It took us almost a year to sort out what was going on with my daughter. On the Neocate and a high enough dose of Prevacid, she finally got to a good place - eating well, sleeping well, no more tummy aches.

Nutramigen, which you are supplementing with now, and Alimentum can be bought over the counter. The milk protein in these formulas is partially broken down and is tolerated by most babies with a mild/moderate milk intolerance. If your baby is particularly sensitive, she may need Neocate/Elecare/Nutramigen AA. These are elemental formulas in which the protein chains are completely broken down into amino acids - essentially eliminating the possibility of a reaction.

But right now, you can't tell if the Nutramigen is working because your wife is still ingesting dairy and breastfeeding. She will probably need to cut out all dairy, including trace amounts of dairy, for a period of time for you to determine whether your daughter has a milk intolerance. Either that, or you can do exclusively Nutramigen for a week or so and see if things improve.

Are you treating the reflux? If you're adequately treating the reflux, your wife does an elimination diet, and you continue to supplement with Nutramigen and things do not improve - it may be time to look into elemental formula.

Here are some links that helped me along the way: www.marci-kids.com www.neocate.com (read everything under the "parents" tab)

May 17, 2011
dcd
ps. If you are treating the reflux, what medicine are you using? Zantac probably will not do the trick. And the Prevacid solutabs have milk in them. If you go with Prevacid, you may want to use the granules, so the milk in the solutabs doesn't confuse your trials.
May 17, 2011
chicagotom
Thanks for the responses everyone. I appreciate it. Our pediatrician prescribed Zantac for the reflux. Ari has been on it for a week and I honestly can't see much of a difference. If memory serves me correctly, the Zantac did not help much with my son either. We contacted her about this and she advised us to call our GI specialist and set up an appointment. (We set up the appt before calling our pediatrician but our appt is not until June 2nd) Regarding my wife and the diet she needs to be on, is there a link to a webpage that gives specifics? I feel bad saying this, but we had all of this written down, but it was lost when we moved earlier this year and while we remember some, we do not remember everything so if anyone has a link it would be appreciated. One other question........am I wrong for pushing my wife to simply use the formula? I think often times the complications of having to completely revamp a diet in addition to not knowing if you can eat things can be very tough to accomplish......in particular since my wife is at home with our 2.5 year old son who surprisingly has been great with his new sister. I really worry about this. My wife is holding Ari all of the time because of the reflux and her back is killing her. If you were in my shoes and you were looking for the quickest results, would you just switch the AA, Elecare or Neocate? Lastly, can you get these formulas with a prescription? I paid for the AA out of my own pocket and at present time, I do not think I can afford it straight out of pocket. Any ideas on financial help in getting this expensive formula? Thanks again everyone. It is nice to know there are others out there who are in my same boat. I come from a big family and none of my brothers and sisters and their kids have had any issues at all with this. They think my wife and I are just complaining when in reality, we are not. Until one is with a family that has a child suffering from acid reflux/food intolerances, they should not comment about things. It's a tough deal as all of you know.
May 18, 2011
dcd
Zantac is an H2 blocker. The body can build up a tolerance to H2 blockers and they will stop working. Prevacid, Prilosec, Zegerid, etc. are PPIs (proton pump inhibitors) and are considered the "gold standard" in treating reflux - because they stop the acid before before it starts, vs. neutralize the acid once it's already occurred. I really encourage you to visit www.marci.kids.com and learn all you can about medication options and how they work.

Remember, a PPI needs to be given on an empty stomach, one hour before a meal. This can be tricky with a baby. So you may want to look into compounding the medicine, which allows you to administer it any time - you can use a compounding pharmacy or mix it yourself with Buffer Babies or Caracream from Marci Kids/Reflux Solutions (at the University of Missouri, I believe.) Also remember that many pediatric GIs agree that babies metabolize PPIs much faster than adults, so they will prescribe a higher dosage of PPI than the "recommended". My daughter's reflux finally got under control at 27 mg/day split dose.

I think your wife can do the elimination diet. It's hard, but if she wants to continue breastfeeding, I would support her in doing so. The issue is that it can take 2 to 4 weeks for all the dairy to clear from her system once she eliminates it. If it were me, I would try giving the baby exclusively Nutramigen while I continued to pump in place of nursing. That way I could keep up my milk supply why we were trialing the Nutramigen. By the time the dairy cleared from my system, I would know whether the Nutramigen helped. If it did, at that time, I could resume nursing or pumping/bottle feeding.

If it did not help, I would look into a trial of elemental formula. If that did not help, I would focus on reflux as the sole cause of the baby's discomfort - or reflux along with some other GI condition.

I think the priority right now is to get the acid under control with a PPI, and trial removing dairy from the baby's diet - however you decide to do that.

As for paying for elemental, I wish I could help you. We are still paying for it out of pocket ourselves. Insurance denied our claim several times. The irony is, we live in Texas - a state which mandates insurance cover elemental formula in cases of MSPI, food allergies, etc. BUT our insurance is Blue Cross Blue Shield of KANSAS CITY. They claim they are not obligated to Texas law, even when covering patients in Texas.

I would again encourage you to explore the Neocate site, especially the link for Reimbursement Support. They list all the states which have mandated coverage, info for appealing to your insurance, and as a last resort, help from Neocate when you can't afford it.

Many people also buy their Neocate from Ebay. And definitely ask your GI for samples.

May 18, 2011
dcd
Also wanted to remind you to check out the Parents tab on Neocate.com. And to clarify that after 2-4 weeks of your wife being on an elimination diet and pumping to keep up her milk supply while the baby trials Nutramigen - if the Nutramigen helps, your wife can resume nursing or pumping/bottle feeding while continuing the elimination diet.
May 18, 2011
mangogal
Mom to two refluxers. DS 4.5 years, on prevacid since 5 weeks. Trial wean this summer...fail. Intolerant of dairy and soy DD born Nov 2010. Currently on zegerid. Had stomach malrotation & surgery at 9 months. Avoiding dairy/soy with her while BFing.
I have BF two babies on an elimination diet. They both have had moderate to severe reflux. For my oldest, figuring out he was also intolerant to dairy and soy made a world of difference. I have a six month old and I have never eaten dairy with her and soy here and there has flared her reflux. I think there are many benefits of breastfeeding and doing an elimination diet is an easier change in my opinion versus changing and trialing expensive formulas. But BFing isn't always an option for everyone and you have to do what is best for the baby and mama. Both my kids have been on prevacid from around 1 month old also.
May 20, 2011
shelefisher
Michelle
Noah 6 years
Paige almost 4 (GERD graduate!)
Soren 11 weeks - (GERD, Soy and Dairy sensitive) 15mg prevacid + 2mg zantac
as far as diet goes I just read labels and look for dairy products and caisen (sp!) and whey and lactose To make my life easier I also found dairy/soy free safe substitutes so I wouldn't go crazy. For example - Earth's Balance makes a really good dairy and soy free margarine that I use to butter toast etc... but it's also good in cooking. My grocery store carries Smart Balance margarine (I think with Flax) that is good as well and I've used that for baking and used it for toast before I found the Earth's balance. I found it easier to give up drinking milk than to find a safe one b/c none of them taste like milk to me so I drink a lot of water. Daiya makes a soy and dairy free cheese that is decent. If you've had cheese recently it will not taste good but I'm going on 6 months dairy free and it works for me. I buy the mozzarella kind and the cheddar version and make quesadillas, pizza, etc... for myself. To make the pizza taste more like pizza I ordered a large pizza with just sauce (and confirmed they were dairy free) from our pizza place then I add my safe cheese and freeze several slices so when my husband and the kids order pizza I can have some too. Oreos are totally dairy free :) as a treat Some things that have dairy that you have to watch out for: some breads (not all) most chocolate (good dark chocolate doesn't and neither do oreos) I can also say that at first it feels so hard to do this but your body adjusts and you stop craving the foods you've given up. So the first month or so is definitely the hardest. I've had some troubles with milk supply but am not ready to experiment with formulas so I've been pumping more to help build up supply and drinking mother's milk tea.
Oct 16, 2011
shamroc1
I am new to this site and was very drawn to your post. I am curious to know what your results have been to date. I also have a 8 week old daughter who has been diagnosed with reflux and is currently taking 15ml dose of Prevacid solutab (1/2 the tab twice daily) for a month now. I have been BF and just yesterday thought we would try Infamil Gentlease through the encouragement of my doctor. My main reason for post is my daughter seems to fair well with the BF but she projectile vomits - spits up at least 3-4 times every feeding and even spits up several times within each feeding. The main concern now is that with her spit up after feeding, it will awaken her from her sleep with major discomfort and crying. Once she is awake it is very difficult to go back to sleep. She tends to do well at night, this is more of an issue during the day. Nightime she will go down at 9-10 nurse again at 3-4 then again at 6-730. Her daytime feeds almost ALWAYS are interrupted with reflux and discomfort 30-45 minutes later. She tends to be very fussy as well. Did you notice success with the formula changes, did your wife change her diet,etc...We spent a day in the hospital a few weeks back as we were battling choking episodes where she would turn blue in the face so they ran tests on her and did an upper GI thus determining it was only reflux and not any other medical conditions related. Those episodes do not seem to be happening now as I am very aware of every feeding and watch her every move to ensure she does not start choking. Thanks for the feedback, Laura
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