Tuesday, March 14, 2017

Cow’s Milk Protein Allergy: After one year

Our little babette has already turned one year old and a lot of things have changed. Here’s a little update on what has happened and the milk transitions we had after she turned one.   

After being diagnosed with Cow’s Milk Protein Allergy, we stuck with NAN HW for her milk since she responded well to this milk. We started with NAN HW1 when she was still between zero to six (0-6) months old and then shifted to NAN HW2 when she reached six to twelve (6-12) months. We continued with NAN HW3 when she turned one. Take note that our little babette’s stool while taking NAN HW is more on the liquid side (but not like the one you get when your baby has diarrhea) and is greenish black or grayish black in color (image).

Enfagrow Toddler Transitions
However, we were faced with another challenge when we had to travel to the US to attend a wedding. We asked our little babette’s doctor as to what milk substitute we could give, in case we couldn’t find NAN HW3 in the US. The doctor told us that NAN HW3 was available in the US. We didn’t want to go unprepared so we searched online for milk substitutes. Unfortunately, we weren’t able to find NAN HW3. So we resorted to Enfagrow Toddler Transitions instead. Although we brought along a box of NAN HW3 for the travel, once we ran out, we became worried as to the effect the new milk would have on our little babette. This is because Toddler Transitions has a different composition from NAN HW and is not anymore hydrolyzed whey protein. This milk was just like any typical milk. There is completely nothing wrong with it. But for a parent whose child has a history of cow’s milk protein allergy, this is something we were worried about. But our little babette responded well to the new milk and we were relieved and happy. And because we kept monitoring her stool, (please be warned that this contains an image of an actual stool) here’s what it looks like after taking Toddler Transitions. Although the stool looks hard, the consistency is a bit soft. And this really made us happy since we could immediately flush it on the toilet. 

--- We apologize if this blog contains images of stools. As a parent, we find this helpful because when we were trying to figure out cow’s milk protein allergy, we wanted to understand it and really get the whole picture. We wanted to know what changes we have to expect as well as what we should look out for. We weren’t able to find a lot of comprehensive information that is why we include relevant details, such as stool, in this blog. ---

When we arrived back home, we then switched to Enfagrow A+. It is a bit expensive since a 1.8 kg box costs about Php1,800.00 (as of the time of writing). So we decided later on to switch to Bear Brand Jr. (for 1-3 years old).  It’s more affordable and our little babette still gets the nutrients she needs. A 1.6 kg box costs about Php600.00 (as of the time of writing). You can compare their nutritional facts if you like and you’ll find that Enfagrow A+ has a bit more than the other.

It will be up to you if you’ll go for the more affordable milk or for the premium ones. What this post is all about is letting other parents know that after our little babette turned one, we tried giving her typical milk that is based on cow’s milk. And up to this day, we’re happy to say that she has responded well. We haven’t seen (and hope to no longer see) any bloody stool since we switched to a different milk.

As always, this is based on our experience, which may be different from yours.  You may consult your child’s doctor if you wish to switch to a different formula. Although we cannot truly conclude that our little babette no longer has cow’s milk protein allergy, what we are thinking is that perhaps she has already outgrown it.

How did your child outgrow cow’s milk protein allergy? We’d love to hear it.

Friday, November 18, 2016

Traveling with Kids

Traveling is one of the many enjoyable activities that you can do with your family. It is definitely a great way to spend quality time with your kids and your husband/wife. However, it can be stressful and challenging, especially if you are travelling with children who are two (2) years old and below.

There are a lot of resources online that will help you prepare for baby’s first long distance flight. It is important that you read these so as to anticipate what could happen and how you should handle it. During the time of our travel, our little babette was already 13 months old, could already walk, and already eats solid food.

What to bring. As always, bring along your baby bag that contains everything that your baby will need during the flight and during layovers. This includes diapers, wipes, medicines, baby formula, picture storybook, and food. Bring the necessary medicines your baby would need for the trip but keep these within the allowable limits for hand carry baggage. In our case, we had to bring several ointments and medicine for our little babette’s allergies.

What to wear. Have your baby wear comfortable clothing. Leggings are ideal for little girls and pants for little boys. Since it can be a bit cold inside the plane, have a jacket ready in your baby bag. Long distance flights typically provide a pillow and a blanket per passenger. You can use the provided blanket to keep your baby warm as well.

Have them wear shoes that are comfortable and easy to put on or remove. We opted for strapped rubber shoes for our little babette and had her wear socks as well. This way, when she wanted to remove her shoes, the socks still kept her little feet clean and warm.

Food. If you are still breastfeeding then you don’t have to worry about bringing baby formula with you. You simply have to bring your nursing cover. For those who need to bring along baby formula, place the formula in a spill-proof and airtight formula dispenser that is ideal for traveling. Bring only enough for the flight and store the rest of the baby formula in your check-in luggage. You can ask for hot water from the flight attendant when you already need to prepare your baby’s milk. We suggest that you ask for hot water an hour before feeding to give it time to cool down. This is because they will really give you very hot water.  Just mix in the formula later when it is time for your baby to feed.

Although most airport personnel will be able to understand that the formula is for the baby, there might be some who would suspect its contents since it is in powder form. So make sure to bring only enough in your hand-carry luggage and place it in a formula dispenser.

If your baby is already eating solid food, you can bring along finger foods such as cereals, biscuits, bread, and basically anything that is not messy. This is also convenient during long layovers where you can’t find any available store where you could buy some food.

While on the plane, you can even ask for baby food from the flight attendant. But if they don’t have any baby food available, they will give you the same food that was served to all passengers. Our little babette likes the bread that comes with the meal. So, we save the bread for her.

In-flight entertainment. Long distance flights have in-flight entertainment in the form of music or movies. Each passenger has his/her own screen and earphones. There are many channels that you could choose from in an international flight. But, depending on your child, he/she may not appreciate it unless he/she is already familiar with the characters in animated movies or shows. Earphones can also be distracting for your little one, especially if they are not used to wearing them. So don’t expect the in-flight entertainment to entertain your child.

In our case, we brought along some toys for our little babette as well as entertained her with the view from the plane’s window. Take note, however, that the view will mostly be clouds and the ocean.

Toys. Bring along toys that are familiar to your baby such as their favorite stuff toy or a picture book. You can also opt for toys that engage your child such as those that have lots of colors and have different textures. Choose a toy that would not be so noisy or loud since this could disturb others.

Check with your doctor/health provider. It would be best to pay a visit to your baby’s doctor especially if your baby still has some immunization to catch up. This will also let you know if the place you are going to visit is safe and does not have any medical outbreaks or if there are medical conditions that you need to be careful of. Our little babette was vaccinated with MMR and Varicella as per the doctor’s advice since we will be travelling abroad. This is also a good time for you to ask your health provider/doctor regarding substitute baby formula in case you can’t find the same baby formula abroad.

Challenges. Let’s face it; little children are not fond of staying put for long hours. Expect that, for long distance flights, your little one will be bored, will cry, be fussy, and make a lot of noise. If your little one is already starting to walk, he/she will want to get down on the floor and walk. There is also a tendency that your child may not feel like eating.

Changing a diaper while inside the plane will also be a challenge, given the small space of the plane’s lavatory. But you will be glad to know that there is a diaper-changing table even in that small space.

When it comes to sleeping, be prepared for discomfort. However, you will be able to get some sleep. It’s just that it won’t be as comfortable as that of lying down on a bed. You will be lucky if your little one sleeps soundly all throughout the flight. Some airlines have bassinets that you can use so make sure to ask about this or consider this before booking your flight. You can even find airlines that have a “Flying Nanny.” Their main job is to provide you with an extra set of helping hands while on the air, especially when it comes to putting your child to sleep or entertaining them. 

Traveling is a wonderful experience and who best to share it with than those who are close to your heart. Just hope that you have seatmates on the plane who are considerate, understanding, and have extra patience for very small children. We are definitely looking forward to our next destination as a family!

Happy trip! 😀

Tuesday, December 23, 2014

What milk to give to an infant with Cow's Milk Protein Allergy

As they say, “Breast milk is best for babies.” But in cases where breastfeeding proves to be difficult because of a total elimination diet, especially for infants diagnosed with cow’s milk protein allergy, the only option may be to formula feed your baby. The question is what milk do you give to an infant with Cow’s Milk Protein Allergy? 

One of the first suggestions that you would probably hear from your health provider is to try soy milk. In our case, we tried Isomil and S26 Soy Gold. But because soy milk was causing our little babette to have hard stools, we switched to a hydrolyzed whey formula. We were able to try both Nutramigen and NAN HW. But we decided to settle on NAN HW because Nutramigen is so expensive. In addition, Nutramigen is also only available in selected Mercury Drug stores and in only one size, a 400g can. NAN HW is available in a 400g can, 800g can, and 1.4kg box. Its price will also not come as a shock to you, unlike that of Nutramigen. 

Before we were actually able to settle on which formula milk to give to our little babette, we researched about possible substitutes for breast milk. Amino acid based milks came up in one of our searches but I am not sure whether this type of milk is available in the Philippines. We haven’t asked our doctor about amino acid based milks either so if you are interested, you might want to get more information from your health provider.  Some considerations also while we were in the process of switching from Nutramigen to NAN HW are the difference in terms of the nutritional content. NAN HW has lower nutrient values compared to Nutramigen per 100ml of the formula.

Nutritional Facts for NAN HW (left) and Nutramigen (right).

When our little babette was first diagnosed with the allergy, the question we asked our health provider was whether she will outgrow the allergy and be able to drink cow’s milk formula later on. We were told that some babies outgrow it but for now, we just have to wait and observe. It is still too early to tell.

There are milk substitutes that you could choose from. But, as always, it would be best to consult your doctor or your health provider before switching to formula milk.

Wednesday, November 26, 2014

Cow’s Milk Protein Allergy: Our Version

Photo credits to: Jomphong of freedigitalphotos.net

Pooping is a normal activity for all human beings, even for babies. Although their small tummies can only accommodate a limited amount of milk, you can still be left wondering how they can poop that much. Our little babet was pooping normally since she was a breastfed baby. But the moment her diaper showed a bloody poop (the entire poop in the diaper was bloody red in color and not just poop with streaks of blood), we had to go to the doctor’s clinic right away to find out what was wrong. Blood in infant stool is definitely not normal and needs immediate attention.

We brought the soiled diaper with us, only to find out later that it won’t have the same appearance as when we first saw it. It appeared to be dark brown (or the color of blood that has dried up) instead of bloody red when we showed it to the doctor since the contents have already been absorbed in the diaper. The baby showed no signs of discomfort or pain. It was as if she was pooping normally. She was active, drinking lots of breast milk, and was generally happy. And because the doctor wanted to be sure, he ordered a fecalysis as well as for the laboratory to conduct an occult (hidden) blood test on the stool. Catching stool from an infant is definitely challenging. We used a urine collector to make it a bit easier. The stool that we collected was submitted to the laboratory. Late that night, we decided to have our little babet admitted to the hospital.

To cut to the chase, our baby was diagnosed with cow’s milk protein allergy. This left us baffled because she wasn’t on cow’s milk. She was being breastfed. She was only formula-fed on two occasions and those were several weeks ago already. It turns out that for breastfed babies, cow’s milk was coming from what the mother was eating. Eventually, I was put on a total elimination diet for dairy products. This meant that I should not eat any cheese, drink or consume products with milk, butter, and other products that contain cow’s milk. This also meant that I had to read the ingredients of all food products that I intend to eat. It was undeniably hard and it was very frustrating. We were told that it would take about 2-3 weeks for the blood to disappear, provided that the total elimination diet was observed. In our case, there was still blood after almost a month. We decided to switch to formula milk instead and tried soy milk.

There was an immediate change in our baby’s stool just after one day. We were able to try both Isomil Advance and S26 Soy Gold. Blood was no longer present. However, she was having difficulty with pooping. She would cry in pain and turn red. Her poop became hard and often came out as small balls or was very long (for an infant). It was heartbreaking having to witness her pooping because she was definitely in pain. We tried giving her water in between feeds as well as adding more water to her milk. But it didn’t improve the situation. Later on there were little streaks of blood in her stool, probably because her anus became irritated with the painful pooping. After visiting the doctor once again, he recommended that we switch to NAN HW. But he also told us that the best milk would be Nutramigen. We decided to switch to Nutramigen.

It took a few days before our baby was able to pass stool. But when she did, we were relieved because it had the right consistency. The color of the stool was more on the greener side than on the tan or light brown side. The milk also tasted like rust/iron. No wonder our baby’s face turned sour when we first gave it to her. But she seemed okay with the taste later on. She was pooping fine and there was no pain. The only painful thing was the cost of Nutramigen – Php907.00 (as of the time of writing) for only a 400g can. Oh my!

A 400g can of Nutramigen only lasted for three days. It was really very expensive and difficult to find since you can only purchase it in selected Mercury Drug stores. Aside from Cow’s Milk Protein Allergy, our baby also has several skin allergies. Among the comments that we found online have varied statements as to when the allergies or rashes went away after they switched to Nutramigen. Some said immediately, others in 2 months. Because we weren’t seeing any improvements on the skin yet and because it was really expensive, we decided once again to switch to NAN HW. It is still too early for us to state whether Nutramigen did not help clear up her skin allergies/rashes since we have only tried it for a few days. 

Good thing NAN HW costs less than Nutramigen. As of the time of writing, a 400g can costs Php521.20, an 800g can costs Php1,031.00, and a 1.4kg box costs Php1,650.00. She responded well to the milk, as shown in her poop. It has the same consistency with Nutramigen and is also more of a darker green in color. There were, however, a few instances where her poop was greenish black in color. Her skin allergies/rashes have somehow cleared after a few days of using NAN HW. But we cannot solely say or conclude that this was because of the milk since we also applied another product on her skin (lotion) on the same day that we switched to NAN HW. The important thing is that she seems to be getting better.

So far things are looking bright after 10 days of using NAN HW and after applying the skin lotion only when rashes start to appear. For those who are looking for any feedback on switching from Nutramigen to NAN HW, we hope this post can help you. I’ll update this post when there are new developments. But again, it may be too early for us to tell. We are hoping and praying that everything will be okay and that our little babet will finally have smooth baby skin.

Friday, November 14, 2014

Poopy Time

Part of being a parent is the ability to correctly identify what their children are saying. Well, it would be easy if infants can actually say what they want or need. But when all they can do is cry, then it becomes more challenging. Good to know that there are crying patterns that you can attribute to hunger, discomfort, feeling sleepy, the need to be burped, and having gas in the tummy.

Now, how about determining what their poopoo means? Well, it is good to know that baby poop has been decoded and you can find a helpful guide here. It is a comprehensive guide to baby stools that has a sample image as well as an explanation. Here is additional information that you might find helpful, especially for those looking for resources pertaining to blood found in infant stool. Please be warned that this contains images of actual stools.

Image 1 – The color of the stool is bloody red and blood is clearly present. This is a product of a breastfed baby who was later diagnosed with cow’s milk protein allergy.

Image 2 – The color of the stool is light brown or greenish brown. However the stool is hard. It can appear as small balls or as one long stool. This is a product of a formula-fed baby, in particular, soy milk. And because the stool is hard, the baby can have difficulty in pushing the stool out which could result to small streaks of blood in the stool and could mean that there are small tears around the baby’s anus.

In any case, blood found in an infant’s stool is a cause for alarm. It is best to seek medical advice from your health provider right away to avoid any further complications and to know what should be done. Make sure to bring the soiled diaper/s with you so you can show it to your health provider. However, the stool as well as the blood may dry up and be absorbed by the diaper. It would help to take a picture of your baby’s stool and show it as supporting evidence. Depending on your health provider, he or she might order a fecalysis and for the laboratory to check the stool for any occult (or hidden) blood.

Turning to the World Wide Web to get an idea about what a bloody stool means is helpful and will give you an idea about what questions to ask but it can also send you over your head. Remember that each case is different. So don’t be afraid to ask questions to your health provider and don’t leave unless you are satisfied.

Tuesday, November 11, 2014

Bundle of Joy

Photo courtesy of Raphael Gregor Banta

Hello World! : ]

Welcome to my little bundle of joy on the Internet - Little Babet. Just as a new mom is excited to hold her newborn child, I am also excited to let you in on this wonderful journey called Parenthood. 

Yes, nobody ever said that parenthood was going to be easy or that it won’t be challenging. It is, every single day. But when you become a parent, you get to have a lot of realizations. It’s a different kind of experience, one that will make you laugh, smile, cry, and feel a wave of emotions. There are days where you find yourself unconsciously humming nursery rhymes or unconsciously swaying (as if putting your baby to sleep). Yes, there are good days and there are also bad days. You may have placed yourself as the least priority for several times already and have become the second instead of the first. But at the end of the day, a simple smile from your little bundle of joy is all it takes to remind you of the enjoyment that parenthood brings.  

So savor every moment. Carry them in your arms while you still can and while they still want to be cuddled. And love them with all your heart.