The Two Most Common Infant Feeding Issues: Reflux and Cow's Milk Protein Allergy

Many babies suffer with CMPA and reflux, how do you tell the difference?


If you have an infant, you may have experienced one or both of the most common infant feeding issues: reflux and cow's milk protein allergy. Reflux is when food or liquid comes back up from the stomach into the oesophagus and causes discomfort. Cow's milk protein allergy is an immune reaction to proteins found in cows' milk, and symptoms can range from mild (rash or vomiting) to severe (anaphylaxis).


Common Symptoms

Both of these issues can make it difficult to feed your baby. Still, there are ways to manage them, and often, it can be difficult to distinguish between the two, as both can cause vomiting, diarrhoea, bloating, abdominal distention and gas, which all result in the baby crying more than they would if they were completely comfortable in their body.

However, the devil is in the details, and this is where getting really focused and specific pays off dividends. While your doctors and paediatricians will look at what's going on for your baby and guess, making suggestions to trial medications, escalate these, trial hydrolysed milk, and maybe eventually get you to amino acid milk with medications combined, there is no analysis or assessment of what is really going on for your baby.

With a little focus at the beginning (and I'm talking about an hour of focus), we can actually figure out what is going on for your baby, whether it is CMPA, aerophagia, tongue tie, birth trauma, something else entirely OR A combination of any of the above that is causing your baby's discomfort. The benefit of knowing what is going on is that it allows us to be super focussed on the strategies and actions we take to relieve their discomfort, and fast.


What if your baby had a tongue-tie release, you've changed milk, and they still have reflux?

First up, did you establish what symptoms the tongue tie was causing and what the CMPA was causing? Without knowing this beforehand, we are throwing darts in the dark, without knowing which wall the dartboard is on 🙈

Then, when we say that baby still has reflux, we really need to separate out the symptoms because, strictly speaking, reflux is only the regurgitation of stomach contents into the oesophagus.

So what else is happening?

Silent refluxing or vomiting or projectile? and how frequent and how severe?

When does it happen?

Or are the symptoms lower digestive system discomfort? poor sleep? general crying and discomfort?

Is the feeding comfortable or not? How much air are they taking on?

After the tongue tie release, did you get gentle oral play exercises to do multiple times a day for weeks?

If so, did you do them? Do you know why they are so important?

When we take a short time to figure it out specifically, we get really specific answers to be able to help our babies.

And when you changed milk (assuming you've changed milk), what changes did you observe?

What milk did you change to?

In true CMPA, moving to an amino acid milk should make drastic changes within days, if not hours.

There are far too many more questions to know the answer to before we can get the right answer for your baby, and believe me, I trust that there is one.


Frequently Asked Questions about CMPA


Is there a difference between CMPI and CMPA?

Technically, yes, CMPI is an intolerance, and CMPA is an allergy. However, both are transient in babies - that baby's digestive system will mature to be able to fully digest the milk and ultimately be okay.

CMPI is not actually Cow's Milk Protein Intolerance; instead, the baby is likely to have a natural inability to fully break down the sugars and/or carbohydrates in their milk and tend to have symptoms like bloating, flatulence and painful tummy.

This intolerance happens because babies don't produce the enzymes to break down complex sugars until they are older, and often, it's not even lactose or the milk they have a reaction to. Rather, they are not able to digest many of the other ingredients in milk. It might look like lactose intolerance on the outside, but really, it's simple digestive immaturity.

Nothing more.

However, our medical system has completely ignored the body of evidence compiled around this topic in the 1980's. My work focuses on making sure that baby is drinking milk and eating foods that support their body's natural development rather than forcing them through it.

CMPA is an allergic reaction, and symptoms can include skin irritations, respiratory issues and digestive complaints. However, all symptoms could also be present with reflux. The Workshop will help you figure out what's actually going on, and if you're breastfeeding, the masterclass will guide you on how you can change your diet. if the baby is on solids or starting solids soon, the weaning course, make sure you choose foods that are easier for them to break down.


How long would you expect to see changes after changing to a dairy-free formula for a baby with CMPA?

Honestly, if it is true that CMPA is causing your baby's discomfort, switching to dairy-free milk should produce noticeable changes within 24 hours. Your baby may not be 100% better, however, the change should be dramatic and noticeable very quickly. There is absolutely no need to trial milk for two weeks at all.

However, the milk you try should be an amino acid milk as these are the only dairy-free milk. Hydrolysed and extensively hydrolysed milk still contain dairy in them and may make no difference whatsoever.

If you're breastfeeding, you should leave all dairy, beef and soy out of your diet for two days and see what happens. However, caution must always be used; there are many, many more things that a baby can react to, and it is not always dairy. The Reflux Free Baby online course has everything you need to know about milk choices, your diet and your baby's diet to guide you through what is going on and what and how to change things.


Is this blog helpful? Feel free to share it with the buttons below.


Perhaps you would like to read more articles from The Baby Reflux Lady? Here are some suggestions:


Get your free Reflux & Colic Symptoms Tracker

We will never sell your information, for any reason.