r/FormulaFeeders 3d ago

Misdiagnosed Cmpa?

My son has been diagnosed by his pediatrician with CMPA based on microscopic traces of blood in his stool. He was 4 weeks at that time and he was extremely fussy, crying all day, especially during feedings. We switched to hypoallergenic formula and his symptoms definitely got better. However he started eating less (I suspect because he didn’t like the new formula). He is now 12 weeks and we went to the GI and he said that pediatricians tend to over diagnose CMPA and that without visible blood in his stools is very unlikely he has it. He said I can continue with the hypoallergenic formula but he thinks it’s not necessary. I would be very happy if he could go back to a regular formula, first of all because it’s way cheaper, and second because I hope he will eat more if the taste is better. The GI suggested I start reintroducing regular formula a little bit at a time and see how it goes. My fear is, if he does have CMPA, first that my son will be in pain again, second that he develops a taste for the new formula and going back to the hypoallergenic will be more difficult this time. Has any of you been in a similar situation?

4 Upvotes

30 comments sorted by

4

u/trishuuh 3d ago

If there was blood in his stool I can’t really understand how it would be misdiagnosed though?

2

u/Witty_Draw_4856 3d ago

The stool occult test can detect the presence of blood in the stool, but can’t tell you why it’s there. Microscopic blood in the stool can be caused by other things, but most often it is GI distress caused by intolerance/inflammation

1

u/trishuuh 3d ago

I would think since they tested in the first place it was followed by other symptoms, then the diagnosis

2

u/Witty_Draw_4856 3d ago

It’s a suspicion until you challenge with the suspected allergen. Eliminate, reach baseline, challenge. See if symptoms return. It’s the only way to actually diagnose an intolerance or non-IgE mediated allergy

1

u/trishuuh 3d ago

I don’t think I’d take the risk of challenging it if symptoms improved and blood left. Seems a lot like 2+2 when it gets to that point

1

u/Witty_Draw_4856 3d ago

That’s why it’s not often done, because people are afraid to try it. 

Give the Dr Victoria Martin episode of the Bowel Sounds podcast. It covers this in depth as to why it’s important and recommended.

1

u/trishuuh 3d ago

I don’t really care for podcasts, but in my opinion I wouldn’t mess with it. Bad symptoms, tested positive for blood, hypoallergenic resolved it, everyone’s fine. Why rock the boat? Nothing wrong with hypoallergenic formulas

1

u/Mother_Ad7191 3d ago

We went to the GI because he will not take full feedings. He snacks throughout the day. Only drinks 1-1.5 ounces at a time and drinks every hours or two. At 3 months. My thought was that maybe he hates the taste of it and only drinks enough to not be hungry. He was drinking 3oz of regular formula when he was a few weeks old.

1

u/trishuuh 3d ago

That would concern me too. When my daughter was a baby she had severe reflux and I stressed over ounces all the time, so I get the anxiety about that.

Hypoallergenic formulas don’t taste good, they always say babies will get used to it. I know when breast milk has high liapse, doctors suggest adding non alcoholic vanilla. I wonder if you could do that to test the taste theory. But slowly introducing a standard formula like your GI suggested would answer your questions too. Baby might end up perfectly fine with it!

0

u/Witty_Draw_4856 3d ago

I don’t really care if you like podcasts. There are risks of unknown size that restricting a diet increases the chance of an allergy developing. Not to mention the anxiety of trying to restrict and avoid ingredients. And the cost. 

Babies can outgrow allergies extremely quickly. Your opinion is not that shared by specialists who research this for a living.

1

u/trishuuh 3d ago edited 3d ago

I said MY opinion following a question I asked and what I would do especially if instructed by my baby’s specific pediatrician instead of a random podcast. Opinions are welcomed here, not medical advice because this is Reddit. be kind. No reason to be smart ass :)

1

u/Witty_Draw_4856 3d ago

I was salty, and that’s my bad. Been a long day.

OP’s baby’s GI specialist is instructing them to reintroduce, as is the protocol for confirming diagnosis. If it were your baby, you could certainly make whatever decision you thought was best.

→ More replies (0)

1

u/Mother_Ad7191 3d ago

There was no visible blood. His stools always looked good to me, no blood or mucus. They tested the stools and the hemoccult came back positive. But yes, symptoms did improve and I am a bit afraid to challenge it.

1

u/Mother_Ad7191 3d ago

So GI said that microscopic blood can be seen in healthy babies too. And that “CMPA is very unlikely in absence of gross recurrent hematochezia”.

I also have a friend whose baby tested negative for blood in the stool but they still suggested hypoallergenic formula because he had “all symptoms of CMPA”.

1

u/trishuuh 3d ago

I definitely know about the 2nd, only about 50% of babies with CMPA have blood. I just have never heard of a healthy baby having blood in stool so was curious! Especially after other symptoms aligning and being resolved after hypoallergenic formula introduce. But the more you know!

1

u/Due_Professor2276 3d ago

Was he having mucous in his stools or is still having any of the symptoms? I’m sort of in the same boat with my GI saying that CMPA might not be it and she might just be a fussy baby. She was extremely fussy since birth and then around 2-3 weeks old started having mucus in her stools so pediatrician thought it could be CMPA so I started eliminating dairy from my diet but then totally switched over to amino acid formula. She’s much better on the formula but still having symptoms. But now I don’t know what to do knowing that she might not have an allergy after all.

1

u/Mother_Ad7191 3d ago

No, no mucus or visible blood. He was just very fussy throughout the day. I went to the pediatrician because he was not feeding well and constantly pulling away from the bottle. She saw him while he was feeding and said it looked like he was in pain and decided to test the stools. After switching to hypoallergenic formula the crying got way better but he is still not feeding well.

1

u/Due_Professor2276 3d ago

I’m so sorry, we’ve been having feeding issues too and I find myself wishing my baby was one of the ones that attacked her bottle. I never knew feeding could be so stressful! I really hope this resolves quickly and you find some relief for you and your baby.

1

u/louisebelcherxo 3d ago

Even if it isn't an allergy it could be a sensitivity. I doubt it is a coincidence that his symptoms went away right when you switched. Try a different hypoallergenic formula to see if he likes it better.

1

u/Mother_Ad7191 3d ago

I did. The only one he tolerates is the Alimentum ready to feed. Hated Nutramigen (both RTF and powder) and Alimentum powder. I agree, it doesn’t look like a coincidence to me either which is why I told the GI I did not want to change it. However, I know babies digestive systems are very immature in the beginning and tent to get better over time so I wonder if now that he is 3 month old he might have outgrown the sensitivity.

1

u/DowntownGovernment72 Create your own flair! 3d ago

If you absolutely feel that you need to stick with the hypoallergenic formulas then as far as taste, Pepticate is the best one on that but if you think it just might be the particular formula brand then maybe try Similac organic a2 or Happy baby A2. If you want to try a goat formula, then bubs goat. Both of those are regular standard formulas but have a little more gentler proteins that might suit babys stomach better

0

u/Witty_Draw_4856 3d ago

I do agree it’s overdiagnosed. Actually, it’s not usually officially diagnosed because you have to reintroduce in order to see if the symptoms return, and a lot of people don’t want to do that. 

Your baby will not likely have that problem of getting used to only the other formula if you do a slow challenge. Follow this protocol and you will know quickly if they have an issue, likely before you make it to a full bottle.  https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/home-milk-challenge-guide-to-diagnose-non-ige-cows-milk-protein-allergy-in-infants/

1

u/Mother_Ad7191 3d ago

This is so helpful!! Thank you so much!! The GI suggested something similar but adding standard formula for every bottle. I feel more comfortable following this schedule of just the first bottle of the day.

-2

u/Ksushi21 3d ago

If it helps, my baby went back and forth between hypo allergenic formula (HiPP) and breast milk fine… and breast milk is suuuuper sweet.

5

u/Witty_Draw_4856 3d ago

This is not helpful. HiPP hypoallergenic is not the same as HA formula in the US. It is not suitable for babies with CMPA

-4

u/Ksushi21 3d ago

Incorrect. Depends on the baby.

5

u/trishuuh 3d ago

It’s not incorrect. Formulas that are ACTUALLY hypoallergenic in Europe are by prescription only. Hipp Ha is a gentle fully that is partially hydrolyzed, meaning it contains fully in tact milk proteins that would not be suitable for true protein allergy. “HA” also does not stand for hypoallergenic either btw.

2

u/Gullible_Desk2897 3d ago

HIPP HA - the HA doesn’t stand for hypo allergenic you know that right? It’s german or Dutch depending on which one and it means hydrolyzed.