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.

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.