Ask Dr. JJ: Allergies 2

Liz T.:

I have a 2-month-old baby boy. I didn’t breastfeed him due to a medication that I have to take, so I had no choice. He was always very gassy and fussy at feedings; after changing his formula 3 times, he’s now on soy formula. His bowel movements have been normal, but he still has a lot of painful gas and in the past few weeks, he cries while feeding and gets very fussy. So, I stop feeding and then he cries more because he’s hungry and he wants to eat. I’m at a loss about what’s wrong with him and his cries break my heart so much; it’s taking a toll on me physically, as well. I just want to know what’s wrong with him so we can fix it. What can we do? Could he have ulcers (I read that somewhere)? He was prescribed Zantac, but it stopped working. Any help would be truly appreciated! Thank you so much!

Dr. JJ:

Ask your doctor about allergic proctocolitis – many babies in the early months develop an intolerance (NOT A LIFETIME ALLERGY) to the large proteins present in cow milk based formulas and a good percentage also have intolerance to soy. The behavior exhibited by these babies is precisely what you are describing: they take one look at a bottle, and wince, grimace and groan because feeding makes them hurt. A good portion of these babies also have reflux, as their whole gut feels the aftershock of what’s going on in their colons. How do we know if babies have allergic colitis and/or reflux? Their poos may be green, mucous, or even blood-flecked. They behave like your baby. Their reflux may respond temporarily to mild agents like Zantac, but then they regress.

Ask your doctor if he/she would test your babies BM to see if traces of blood – if that’s the case, your doc may either refer your baby to a pediatric GI to assess whether it’s reflux or colitis, both, or another condition. Your doctor may then move your baby to the first line hypoallergenic formulas (like Alimentum or Nutramigen), or if those have been tried before, then to Elecare or Neocate. Your doc or the GI may suggest stepping up therapy for reflux by prescribing a proton pump inhibitor. Hope this information gives you some confidence to circle back to your doctor with good questions. If your doc is at a loss, insist on seeing a pediatric GI. There is help out there for your little guy! The good news with both these conditions is that the vast majority of babies outgrow them by their first birthday and the key is to get your little guy comfortable!

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About Dr. JJ Levenstein

Dr. JJ Levenstein is a board-certified pediatrician and fellow of the American Academy of Pediatrics and in 2012 retired from her thriving private pediatric practice in Encino, California. She served on the staff of CHLA and Encino Tarzana Hospitals for 20 years and was consistently voted one of the Best Doctors in America® from 2003 through 2012. Drawing from her experience as a pediatrician and mom, Dr. Levenstein serves as president and co-founder of MD Moms, makers of Baby Silk, the first personal care line for babies developed by pediatrician moms. She serves on the board of United Cerebral Palsy LA, is an active writer and sits on the advisory boards of several child-centered websites. She is an accomplished chef and completed culinary school in 2013! She has had a lifelong interest in child nutrition and all things related to preventive health.

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