Breastfeeding Mom & Baby

Infant Protein Intolerance

Crying is a part of new parenthood. However, if you suspect that there could be more to the puzzle, you may want to look into infant protein intolerance.

For the most part, my daughter, Baby Bun was a sweetheart of a baby. Especially compared to my first born who basically never slept. She slept all the time, woke to nurse and basically created her own eat/wake/sleep schedule. It was like a dream come true for me!

But those dreams never last and around 3 months of age she began fussing more after her feedings. One evening I found her completely covered in vomit in her swing. Like, an abnormally large amount of it. The pediatrician didn’t detect any other issues and basically shrugged it off. However, around this same time I started to notice that she had very green, mucus-like stools. These were definitely not the usual yellow, seedy breastmilk stools. The doctors didn’t appear concerned about this either.

But I was. I kept seeing it and began to do my own research. Pretty soon there were specks of blood in her stool too. This (finally) did catch my pediatrician’s attention and she told me to eliminate milk from my diet as I was exclusively breastfeeding her. I did this, but saw only a minor improvement. The doctor then told me to eliminate soy, corn and eggs. What was the problem? It appeared that Baby Bun had MSPI.

What is MSPI? It stands for Milk Soy Protein Intolerance. It’s a temporary intolerance to the proteins found in these foods that affects infants under one year old. Basically, these infants cannot digest the large proteins found in cow’s milk. By a year, most children will outgrow this issue unless they have an actual food allergy.

An allergy is a different bodily response than a food intolerance. Lactose intolerance is a true intolerance that both children and adults may have. They lack the enzyme needed to digest lactose (a sugar) and therefore end up feeling ill or having diarrhea after eating something with a high concentration of dairy. An allergy may present differently. Common signs of an allergic reaction can be itchy, watery eyes and running nose, hives, swelling and redness, and/or difficulty breathing and swallowing. But an allergy can also present as stomach pain, cramping or diarrhea. It can be pretty difficult to discern the true cause of your baby’s symptoms, whether allergy or intolerance and further tests may be necessary.

MSPI does not always present with obvious symptoms right away. Over time the offending food begins to cause inflammation in the intestines which then results in discomfort for the baby. Increased crying after feedings, burping and hiccuping and general fussiness may occur first. Then potential changes in stools, such as the bright green color, obvious mucus-like consistency and even visible blood. Reflux, increased spit up or vomiting, rashes and eczema are also very common issues.

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The treatment for MSPI sounds fairly straight forward but can become complicated by many other factors. First, if the mother is breastfeeding, she will need to eliminate all sources of dairy from her diet. If symptoms continue she will need to eliminate soy protein as well, as they have a similar protein structure and often go hand and hand with this condition. If your baby does indeed have MSPI, there will be a lot of label reading in your future. Fortunately there are some really awesome mom groups on Facebook full of women all going through the same difficulties. Search for MSPI support groups or groups about breastfeeding babies with allergies.

Unfortunately for us, Baby Bun had not just MSPI but something more along the lines of FPIAP. Food protein-induced allergic proctocolitis. This meant she also reacted poorly to other foods, beside just milk and soy. I went on to eliminate all eight allergens from my diet, those being milk, soy, eggs, tree nuts, peanuts, fish, shellfish and gluten. Gluten was the last thing I completely eliminated and was also the hardest for me. (Although, clearly, I really missed cheese. Real cheese. Vegan cheese is not cheese.) My poor girl’s biggest repeat offender? GLUTEN. Her stools FINALLY cleared up after the gluten had fully exited my system. I nearly cried when I saw that normal, poopy diaper.

Awkwardly breastfeeding my sweet girl in Boulder Canyon

For several weeks I survived on mostly the same couple of foods. Rice, coconut everything, fruits and veggies and limited animal proteins because my daughter also reacted poorly when I consumed beef. Yes, she was THAT sensitive. I NEVER knew that my breastfeeding journey would take me down such an extreme road. It was exhausting and there where several times I wanted to quit or cheat and eat a big huge piece of cake. But I stuck with it all for months and my Facebook groups literally saved me.

The Facebook group called TED Mamas has some REALLY awesome information about this condition and how to begin an elimination diet. They are also very big on FPIES which is a substantially scarier condition that can be very difficult to nail down a treatment plan for. FPIES stands for food protein-induced enterocolitis syndrome and is a condition where babies and toddlers can react in a very severe and potentially life-threatening way to certain foods.

There are special baby formulas on the market for MSPI. They are called elemental formulas in which the proteins, still from cows milk, are broken down completely and therefore the baby is able to tolerate them better at a molecular level. I’ve read that elemental soy formulas are often tolerated by FPIES babies. The downside to this is that they taste absolutely terrible. My daughter hated all of them. I did eventually supplement her with Alimentum starting around 10 months old because my supply was decreasing and she also had less desire to nurse. A pediatrician can help you decide which formula to try if you decide to go this route.

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Otherwise, an elimination diet is totally possible! I know it sounds sort of awful, and honestly, sometimes it is. But you can do it! If you really want to continue to breastfeed a baby with MSPI or another similar protein issue like FPIES, you’ll have to be willing to make some sacrifices.

There are many babies who don’t do well with the formula route because they dislike the taste, hate bottles or have increased GI upset and reflux from it. There are also babies who do much better on the formula then they ever did before. From my experience with protein intolerances, I can tell you this: every story is unique. You’ll likely have to try a few different things to see what works for you.

You’re going to have moments when you feel hopeless, lost and totally confused on what to do next. I had a lot of those moments. It’s ok, mama. Take a deep breath and tell yourself that you are doing the best that you can. Because YOU ARE. Momming is hard as it is but there is nothing more upsetting than seeing your baby wailing in pain and feeling powerless to fix it. But thankfully, all hard things are temporary.

I started to reintroduce the foods I had eliminated one at a time when Baby Bun was nearly a year. She also had severe reflux, which is another story, so trying to determine if her reactions were from this or gastrointestinal upset was not always clear. Still, by the time she was twelve months old she was tolerating pretty much everything. I added gluten and dairy last and now she drinks cows milk and is basically a cheese addict (like me).

So there IS light at the end of the tunnel. MSPI and other related conditions are tricky at best and downright unfair at the worst, but with proper guidance and support I promise you’ll survive. The best and only treatment is avoidance of the culprit food(s). Whether you decide to take the elimination diet or the formula route, either way most babies outgrow the issue by twelve to eighteen months of age.

If you have been through a similar experience, feel free to comment below or shoot me an email. I look forward to hearing from other like-minded mamas! 

Disclaimer: I am not a medical doctor. This post is intended as informational only and is not to be taken as actual medical advice. Any and all medical and/or feeding concerns you have with your baby should be addressed with your pediatrician.

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