Welcoming to the blog our panel expert Raphaella Rookes! Specialist Peadeatric Dietician and Founder of Latch to Ladle, inspired by her beautiful boy Monty. Raphaella shares with us some fabulous guidance on CMPA - Cows Milk Protein Allergy. Find her here on Facebook
"Here at Latch to Ladle, the question about cow’s milk protein allergy and lactose intolerance is a common one. That’s not surprising really, as cow’s milk protein allergy (CMPA) is one of the most common childhood food allergies which affects around 7% of babies under 1. 
The good news is that the vast majority of children grow out of it between the ages of 1 and 2, and almost all have outgrown it by the age of 5." 
Reflux is a common condition we see in 50% of infants and it can be really upsetting and frustrating to manage. Reflux is usually diagnosed in the first six months of life and often resolves spontaneously by twelve-fifteen months. Depending on the severity of reflux there are different things you can practically do at home but you may also require different feeding positions, formulas and maybe even prescription medication as well. 
Symptoms of reflux may include regurgitation of a significant volume of feed, feed refusal, distress at feeding times and only small volumes of feed being taken. You may also notice your baby becoming more irritable when they are laid flat, they may arch their back and may even experience some weight loss as well. 
A few key things to consider before opting for medication include the following: 
Positioning – before, during and for 20-30 minutes after. Ensure your baby is at a 30 degree angle throughout this period. 
Activity – avoid too much activity; bouncing around/ using jumperoo/ baby rocker for at least 20 minutes after. 
Avoid over feeding – babies who are breast fed tend to regulate what they are having more than formula-fed babies but over feeding can happen in both. Average requirements are 150mls/kg/day for babies up to six months and this should ideally be offered over 6-10 feeds per day. 
Consider tilting the cot/ Moses basket by 10-15 degrees (putting something underneath legs of cot). 
Management of reflux varies slightly depending on whether your baby is breast or bottle-fed. 
For breast fed infants it may be worth considering the following: 
- Trial a feed thickener such as Carobel, which can be purchased HERE. This can either be mixed with expressed breast milk (EBM) or water and given on a spoon immediately before breastfeeding. 
- If there is no improvement after 2 weeks of Carobel then it may be worthwhile considering Infant Gaviscon and consulting your GP who may be able to advise on anti-reflux medication such as Omeprazole 
For bottle fed infants Latch to Ladle would suggest the following: 
Trial smaller, more frequent feeds (ensuring that total daily volume remains the same) for 1-2 weeks 
If the above is not effective then consider trialling a feed thickener such as Carobel or a pre-thickened formula like SMA Pro Anti Reflux available HERE. 
If you see no improvement with the above then consider speaking with your GP who may suggest Infant Gaviscon or anti-reflux medication. 
If reflux continues despite all over the above then your GP may refer your child to the paediatric gastroenterologist at the hospital for further review. It may also be worth considering the possibility of food allergy / intolerance at this stage as well to rule that out too. 
If you are struggling with reflux and want to discuss this in more detail, then please contact the Latch to Ladle team who will be happy to help. 
If you would like to find out more about how we can support you with our reassuring and realistic approach, please join our mailing list
Tagged as: reflux, reflux in babies
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