Identifying and Managing Dairy/Soy Allergies

What Is MSPI/CMPA?

MSPI: Milk Soy Protein Intolerance

CMPA: Cow's Milk Protein Allergy

They're essentially the same thing. Baby's immune system reacts to proteins in cow's milk and often soy. It's not lactose intolerance (that's rare in babies). It's a protein issue.

About 2-3% of babies have it. Most outgrow it by age 1-3.

Symptoms We Saw

Not every baby has every symptom. Here's what tipped us off:

Digestive Symptoms

• Bloody or mucousy stools (this is the big one)
• Chronic diarrhea or very watery poops
• Severe constipation
• Excessive gas and obvious discomfort
• Reflux that didn't respond to typical treatments

Behavioral Symptoms

• Excessive crying, especially after feeds
• Arching back during or after feeding
• Refusing to eat or frequent feeds (snacking because full feeds hurt)
• Generally miserable baby who doesn't respond to normal soothing

Skin Symptoms

• Eczema that won't clear up
• Persistent diaper rash
• Hives (less common, more serious - call doctor)

Getting a Diagnosis

There's no perfect test for MSPI in babies. Diagnosis is usually:

• Symptom assessment: Blood in stool is pretty definitive
• Elimination trial: Remove dairy/soy and see if symptoms improve
• Challenge test: Reintroduce later and see if symptoms return

Some doctors do allergy testing but it's not always accurate in babies under 1 year.

If You're Breastfeeding

Dairy and soy proteins pass through breast milk. If baby has MSPI, you have to eliminate them from YOUR diet.

What I Had to Give Up

• All dairy: milk, cheese, butter, yogurt, ice cream, cream cheese
• Hidden dairy: whey, casein, lactose in processed foods
• All soy: tofu, soy milk, edamame, soy sauce
• Hidden soy: soybean oil, soy lecithin (in EVERYTHING)

It took 2-3 weeks to fully clear from my system and hers. The first two weeks I saw no improvement and almost gave up. Week 3, her symptoms started resolving.

What I Could Eat

Less than I thought, more than I feared:

• Meat, chicken, fish (plain, not breaded)
• Most fruits and vegetables
• Rice, potatoes, oats
• Olive oil, coconut oil
• Some specialty dairy-free products (Enjoy Life brand saved me)

Supplements I Took

• Calcium: 1200-1500mg daily (since I couldn't have dairy)
• Vitamin D: 2000 IU daily
• Continued prenatal: For other nutrients

If You're Formula Feeding

You need a hypoallergenic formula. These are extensively hydrolyzed - the proteins are broken down so baby's immune system doesn't recognize them.

Options

• Similac Alimentum: What we used. Smells terrible, tastes worse (apparently), baby didn't care.
• Enfamil Nutramigen: Similar to Alimentum. Some babies prefer one over the other.
• Gerber Extensive HA: Generic option, less expensive.
• EleCare or Neocate: Amino acid-based formulas. For severe cases where even hydrolyzed formulas cause reactions. Extremely expensive.

Do NOT use:

• Soy formula - most dairy-allergic babies react to soy too
• "Gentle" or "sensitive" formulas - proteins aren't broken down enough
• Goat milk formula - protein structure too similar to cow's milk

The Cost

Hypoallergenic formulas cost 2-3x regular formula. We spent about $400/month on Alimentum.

Ways to manage:

• Ask pediatrician for samples and prescription (sometimes insurance covers with prescription)
• WIC often covers hypoallergenic formula with doctor's note
• Buy in bulk when on sale
• Some manufacturers have assistance programs

Timeline of Improvement

What to expect after elimination:

If you see no improvement by week 4, it might not be MSPI. Could be other food proteins (egg, wheat) or something else entirely.

When to Reintroduce

Most pediatricians recommend waiting until 9-12 months to try reintroducing dairy.

How we did it:

• At 11 months, I ate a small amount of cheese
• Watched for symptoms for 3-4 days
• No reaction, so I gradually added dairy back to my diet
• At 12 months, offered her yogurt directly - no reaction
• By 14 months, she was eating all dairy products with no issues

About 75% of babies outgrow MSPI by age 1. Another 15% by age 2. Some take longer.

Starting Solids with MSPI

Avoid dairy and soy in first foods. Otherwise, introduce foods normally.

Safe first foods:

• Avocado, sweet potato, banana
• Oats (plain, check for soy lecithin)
• Meat purees
• Most fruits and vegetables

Watch out for:

• Butter in prepared foods
• Cheese in finger foods
• Yogurt (wait until after successful dairy reintroduction)
• Many baby crackers and puffs contain milk or soy

See Starting Solids Guide for more.

Dining Out and Social Situations

This was harder than the diet itself sometimes.

• Restaurants: I became that person asking detailed ingredient questions. No shame. My baby's health matters more than being "easy."
• Family gatherings: Brought my own food. Explained clearly why I couldn't "just have a little."
• Well-meaning relatives: "A little won't hurt" - yes, it will. Blood in stool is not negotiable.

Hidden Sources of Dairy and Soy

Things that caught me off guard:

• Canned tuna (often packed in soybean oil)
• Most bread (milk or soy lecithin)
• Chocolate (contains milk solids)
• Many medications and vitamins
• Non-dairy creamer (often contains casein - a milk protein)
• Deli meat (sometimes contains milk proteins)
• "Natural flavors" (can be dairy-derived)

Resources That Helped

• App: Fig: Scans barcodes, identifies allergens
• Website: Go Dairy Free: Product lists and recipes
• Support groups: Facebook groups for MSPI moms saved my sanity
• Enjoy Life brand: Top 8 allergen-free snacks

When to See an Allergist

See a pediatric allergist if:

• Symptoms don't improve after 4-6 weeks of elimination
• Baby has severe reactions (vomiting, hives, swelling)
• You need to eliminate multiple food groups
• Baby isn't gaining weight appropriately
• You need help managing the allergy long-term